Italians Debate End of Life Options

(ANSA) - Rome, October 1 - A long-running debate in Italy over living wills is set to flare up again, as a string of bills addressing end-of-life options begin their journey through parliament. On Wednesday, the Senate Health Committee starts examining various proposals for regulating living wills, which allow people to stipulate what medical treatment they want in case they later become unable to make a decision themselves.

The measures under consideration range from liberal proposals that would allow euthanasia through to draft laws that would limit a patient's wishes to one consideration among many when deciding a course of treatment. However, most fall somewhere between the two extremes, and the fiercest battles will be fought over whether patients should have the right to request an end to the administration of food and water under certain circumstances. The Catholic Church has made its position clear, with interventions from two top churchmen in recent days saying nutrition is not a medical treatment, and so should not be a matter for living wills. The president of the Italian Bishops Conference (CEI), Angelo Bagnasco, said allowing people to make such decisions in advance risked paving the way for euthanasia.

He said choosing medical treatments was not the same as allowing people to opt for starvation. His stance was echoed on Tuesday by the CEI's outgoing secretary-general, Giuseppe Betori, who said some kind of regulation was required for end-of-life situations. But he stressed this was not the same as giving patients the right to die.

''We are not in favour of the principle of self-determination but we want legislation that makes it clear there is no obligation to undergo aggressive treatment nor a right to demand that all treatment be abandoned,'' Betori said. Rocco Buttiglione, head of a centrist Catholic party, the UDC, applauded Betori's remarks, saying a ''good law is needed, starting with the rejection of the idea that artificial nourishment may be suspended''.

However, despite the Church's influential position, views in Italy are mixed. Two high profile end-of-life cases - one of which dealing with a father's fight to switch off the machine that has kept his daughter alive but in an irreversible coma for the last 16 years - have generated considerable public sympathy for the idea of living wills. Commenting on the bills on Tuesday, consumers association ADUC pointed to Article 32 of the Italian Constitution, saying it would consider a legal challenge if a restrictive law on living wills was approved. Article 32 states that no one should be forced to undergo medical treatment unless required to do so by law. Turning to the issue of food and drink, ADUC rhetorically asked: ''How can anyone claim that feeding a patient via a tube inserted up their nose or surgically introduced into their stomach is not medical treatment?''

The Luca Coscioni Association, an offshoot of Italy's Radical party that fights for the rights of the terminally ill, urged MPs not be swayed by the Church and warned there was a real risk of a law ''shaped by the Vatican and heedless of public opinion''.

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