End of life, a third party cannot administer the drug

It cannot be athird person who helps those who are paralysed to die. The possibilities of means for self-administration must be tested. TheConsulta, with sentence 132, declares inadmissible the questions of constitutional legitimacy of Article 579 of the Criminal Code, proposed by the Court of Florence, which raised doubts of contrast with the Charter on the rule for the part in which it does not exclude punishability in the case of homicide of the consenting person. And therefore of a third party who puts into effect the suicidal will, which is formed autonomously and freely, of a person suffering from an irreversible pathology, a source of physical or psychological suffering that he or she considers intolerable, verified by a public structure of the national health service, on the opinion of the competent ethics committee. An external 'aid' that intervenes when the same person, due to physical impossibility and the absence of suitable equipment, is unable to proceed independently or when the available alternative modes of self-administration are not accepted by the patient on the basis of a reasoned choice that cannot be considered unreasonable.

The questions were declared inadmissible because 'the judge a quo gave neither adequate nor conclusive reasons regarding the recoverability - reads the judgment - of a drug self-administration device that can be operated by a patient who has lost the use of his limbs'.

According to the Court of Justice, the order of referral only referred to the discussion with the local health authority, since the referring court had merely 'taken note of the market research carried out by an operational structure of the Regional Health Service', whereas it should have involved 'specialised bodies operating, with the necessary degree of authority, at a central level, such as, at the very least, the Istituto Superiore di Sanità, the technical-scientific body of the National Health Service'. The judgment specifies that if such devices could be found within a time frame reasonably related to the patient's state of suffering, the patient 'would be entitled to use them'.

The Constitutional Court made it clear, however, that the person who is in the condition to access the end of life option, in the name of his or her freedom of self-determination, has the right to be accompanied by the National Health Service in the medically assisted suicide procedure. A right which, 'according to the principles governing the service, includes the procurement of suitable devices, where they exist, and assistance in their use'. A task to which the National Health Service is bound 'in the performance of a dutiful role of guarantee that is, first and foremost, protection of the most fragile persons'.

The case was brought before the Constitutional Court by a person suffering from multiple sclerosis who, being in the conditions set out in sentence no. 242 of 2019 for medically assisted suicide, as verified by the competent local health authority, is nevertheless unable to self-administer the lethal drug, as he is deprived of the use of his limbs due to the progression of the disease. Another impediment is the irreparability on the market of the equipment necessary to carry out assisted suicide autonomously: an infusion pump that can be activated by voice command or through the mouth or eyes, the only methods permitted by the current state of progression of the disease.