Living wills set to reach 300,000. North-South divide
The Coscioni Association has compiled figures on advance healthcare directives filed in 6,601 local authorities: an 18% increase compared with 2023
Key points
There are over 278,000living wills recorded by the Luca Coscioni Association in 6,601 Italian municipalities, representing an 18 per cent increase compared with 2023. It was Law 219/2017 that regulated advance healthcare directives (DAT, also known as a living will), which allows individuals to decide in advance which medical therapies and treatments they wish – or do not wish – to undergo should they become unable to express their own choices due to debilitating illnesses or injuries (in some municipalities, registers had already been established previously).
On average, therefore, one advance healthcare directive was drawn up for every 166 adult residents, but this ratio varies across the country: advance healthcare directives are more common in the North and in medium-sized towns.
The regulations
Under Law 219/2017, which came into force on 31 January 2018, advance healthcare directives (DATs) may be drawn up by any person of legal age and of sound mind, ‘in anticipation of a possible future incapacity to make decisions for themselves’. This document (drawn up as a public deed, a notarised private document, or a private document submitted to the local council’s registry office or to healthcare facilities) sets out the individual’s wishes regarding medical treatment (including artificial nutrition and hydration) and consent to or refusal of diagnostic tests and treatment options. It is also possible to appoint a trustee to represent the person drawing up the DAT in dealings with doctors and healthcare facilities.
Before making a decision, the law recommends obtaining ‘adequate medical information’ on the consequences. Indeed, the law as a whole promotes the right to health, dignity and self-determination, placing the patient’s informed consent at the centre.
The data
The survey carried out by the Coscioni Association in 2026 received responses from 4,821 local authorities responded to the survey, whilst a further 1,780 had taken part in previous surveys. The mapping therefore covers 83.5% of local authorities; however, it does not include, in addition to the Advance Directives (ADs) registered in municipalities that have never responded or have not updated their data as of 2025, those ADs filed with notaries, healthcare facilities and consular offices.
