End of life: decisions to be taken by a national ethics committee chosen by Palazzo Chigi and the health service will be excluded

The establishment of a single national ethics committee in place of the regional ones activated for example in Tuscany after the approval of the regional law and then the exclusion of the National Health Service, the non-punishability of the helper and the mandatory provision of palliative care. These are some of the main points ready to be included in the first law on assisted suicide that the majority is working on in the select committee on the end of life meeting in Palazzo Madama. The text is now ready for presentation at the committee's next meeting on Tuesday. "The individual articles are being discussed and next week, at the first useful meeting of the joint Justice and Health committees, the text will be presented for discussion," explained the chairwoman of the Senate's Justice committee, the Lega Nord Giulia Bongiorno. According to the draft, which has already turned the noses up at the opposition because it would set up a list of obstacles to freedom of choice, the National Ethics Evaluation Committee will include seven members appointed by decree by Palazzo Chigi and who will hold office for five years.

As we read in the drafts of the law regarding the National Ethics Evaluation Committee, seven members are envisaged: a jurist chosen from among university professors of legal subjects or lawyers qualified to plead before the higher courts, a bioethicist, a physician specialising in anaesthesia and resuscitation, a physician specialising in palliative medicine, a physician specialising in psychiatry, a psychologist, and a nurse, all appointed by a Prime Ministerial Decree, which appoints the president, vice-president, and secretary from among them. This single national body will act as a filter for all requests, with no more decisions taken at the local level: today in Tuscany - the only Region to have legislated - the decision is taken by an ethical committee appointed at the level of the Asl simgola. It will be up to this new national ethical evaluation committee to examine the requests of people requesting access to medically assisted suicide (with 60 days to express an opinion, plus another 60) and if it is ascertained that the requirements envisaged by the Consulta ruling of 22 November 2019 are not met (person of age, with an irreversible pathology, source of unbearable physical and psychological suffering, included in a palliative care pathway, kept alive with substitution treatments, fully capable of understanding and wanting) the person concerned will have to wait 'the next forty-eight months' before submitting a new application, on pain of inadmissibility. Time that the persons concerned - often terminally ill - may not have.

Excluded, for the time being, is the National Health Service: end-of-life treatment will not pass through public hospitals except for people available for assisted suicide and already hospitalised. "They will not be forced to leave and the helper will enter the hospital," explains Bongiorno. The non-punishment of those who accompany the person in the last mile is also confirmed. On palliative care - one of the knots in the bill on the end of life - the draft, proposed in the restricted committee meeting today in the Senate, provides for an observatory set up by Agenas (the national agency for regional health services) to examine the regions' projects on this care. The observatory will then have to send an annual report to the Prime Minister, the Ministry of Health, and the presidents of the House and Senate, also indicating 'the regions that have not presented a project for the expansion of palliative care, including paediatric, home care, and for each pathology'. It is also provided that any residue of the sums allocated to the Regions for those cures, and left unused, will be returned to the State and cannot be used for other purposes. Finally, 2028 is indicated as the deadline by which the Regions must try to achieve the objectives set for palliative care, citing '90% of the population concerned'.