ROME, July 7, 2025
Italian lawmakers debate assisted suicide
Proposed legislation sparks controversy.
- Parliamentary majority in Italy approved a text to define provisions for assisted suicide, based on a 2019 Constitutional Court judgment.
- The Constitutional Court outlined four conditions for accessing assisted suicide, assessed by the National Health Service.
- Critics argue the proposed law narrows access, excludes the National Health Service, and makes assisted suicide more complex.
The question of assisted suicide in Italy remains hotly debated; what conditions must be met for someone to have access to assisted suicide? Access hinges on the irreversibility of the person’s pathology, their level of suffering, their ability to make free decisions, and their dependence on vital support treatments.
A complex legal landscape
After years of anticipation and increasing calls for clarity, the parliamentary majority approved a measure in the Senate committees on justice and health. The aim is to define the “Executive provisions of the judgment of the Constitutional Court of 22 November 2019, n. 242.”
Constitutional judges, while acknowledging the need to protect individual dignity and collective interests, haven’t explicitly established a “right to die” in the Italian system.
However, they stated that a blanket ban on assisted suicide, in specific situations, could “unreasonably limit the patient’s freedom of self-determination.” This includes the choice of therapies aimed at alleviating suffering, potentially “imposing a single way to take leave of life.”
The Constitutional Court identified four conditions that would allow access to assisted suicide. These assessments must be handled by the National Health Service:
- The irreversibility of the pathology.
- The presence of physical or psychological suffering that the patient considers intolerable.
- The patient’s ability to make free and aware decisions.
- The patient’s dependence on vital support treatments.
Disparities in application
The lack of legislative action has resulted in inconsistent application of the principles and conditions for assisted suicide across Italy. According to some legal interpretations, healthcare companies have a duty to provide assisted suicide, referencing the Court of Trieste’s order of July 4, 2023. However, others disagree, citing the Court of Ancona’s order of March 26, 2021.
Regions like Lazio and Umbria have interpreted the “dependence on vital support treatments” requirement narrowly, while others, like Friuli-Venezia Giulia, have taken a broader view, referencing a case involving a woman with multiple sclerosis.
Other institutional entities, outside of Parliament and the national representative circuit, have attempted to intervene. Some regions claim the authority to implement the Constitutional Court’s jurisprudence on assisted suicide.
Notably, Tuscany approved a regional law in February 2025 to regulate organizational methods for accessing medically assisted suicide procedures. This law is currently being challenged by the government before the Constitutional Court.
Citizens also proposed an abrogative referendum concerning article 579 of the penal code, related to direct active euthanasia, which was declared inadmissible. The Constitutional Court, in sentences n. 135 of 2024 and n. 66 of 2025, addressed the requirement of “dependence on vital support treatment.”
The constitutional judges clarified that they haven’t recognized a general right to end one’s life in any situation of suffering. Instead, they deemed it unreasonable to deny assisted suicide to patients who already have the right to refuse or revoke consent to life-sustaining treatments.
Defining “vital support”
The constitutional judges clarified that the notion of “vital support treatments” must be interpreted in accordance with the rationale behind previous rulings. This further limits the legislator’s discretion.
The Court emphasizes that patients already possess the fundamental right to refuse any health treatment, regardless of its complexity or invasiveness. This includes procedures typically performed by healthcare personnel, even if family members or caregivers could learn them.
The Court stated that procedures such as manual evacuation of the patient’s intestine, insertion of urinary catheters, or aspiration of mucus from bronchial passages, which are concretely necessary to ensure the performance of vital functions, to the point that their omission or interruption would predictably determine the patient’s death in a short period of time, they will certainly have to be considered as a vital support treatments, for the purposes of applying the principles that stated by sentence no. 242 of 2019 “(Court of Constitution n. 135 of 2024).
Proposed law faces criticism
A proposed law, scheduled for debate in the Senate on July 17, 2025, is facing criticism. Opponents argue it disrupts the balance between protecting human life and respecting patient autonomy.
Critics contend the proposed law narrows access to assisted suicide only to individuals dependent on machinery, specifically “dependent on replacement treatments of vital functions.” This allegedly evades the broader interpretation of sentences no. 135 of 2024 and 66 of 2025.
The proposed law also ties access to assisted suicide to mandatory palliative care, despite the Constitutional Court’s statement that patients should only be informed about palliative care as a possible alternative.
Furthermore, the law introduces a national evaluation committee appointed by the government, excluding the National Health Service from the evaluation process. It also prohibits the use of national health system staff and devices.
In essence, critics argue that only those who can afford private medical care will be able to access medically assisted suicide, violating principles of universality and equality in accessing health services.
Opponents argue that the proposed law not only violates the constraints set by the Constitutional Court but also makes requesting medically assisted suicide more complex, denying fundamental rights.
