Medically assisted suicide: Tuscany approves new law on the end of life, regulated times and procedures

The Tuscan Regional Council has approved the new law on medically assisted suicide. After a long debate, the text establishes clear procedures and certain times for access to healthcare, in line with the rulings of the Constitutional Court.

La Tuscany has a new law on procedures and times for regional health care for medically assisted suicide. The Regional Council approved by a large majority, with 27 votes a favor (Democratic Party, Italia Viva, 5 Star Movement and mixed group), 13 votes against (Lega, Fratelli d'Italia, Forza Italia) and a vote not cast (from the Democratic Party councilor, Lucia De Robertis).

During the debate in the chamber, they were approved the amendments presented by the president of the Health Commission, Enrico Sostegni (Pd) for the majority.

Particularly Amendment no. 3 was approved, which replaces Article 2 which refers access to medically assisted suicide to people in possession of the requirements indicated by the rulings of the Constitutional Court, approved with 24 votes in favour and 5 againsti. Amendment no. 4 replaces art. 3 and regulates the composition and functioning of the corporate body (Permanent Multidisciplinary Commission), approved with 26 votes in favour and 6 against.

A sub-amendment presented by regional councilor Marco Stella which calls for the inclusion of a palliative care physician with care skills has been approved.

Then the classroom has Amendment no. 5 was approved, which replaces Article 4 which regulates the methods of access to medically assisted suicide, with 25 votes in favor and 5 against.

Amendment no. 6 was then approved with the insertion of article 4 bis which establishes in 37 days the deadline for the conclusion of the procedure, with 25 votes in favour and 5 against.

Amendments no. 7 were also approved, which inserts article 4 ter on the implementation methods;

• Amendment 8 which inserts Article 4 quater to support the implementation of the medically assisted suicide procedure, with 26 in favour and 7 against;
• amendment no. 9 which replaces article 5 which provides for free services;
• Amendment no. 10 which replaces article 6 which provides for the financial provision, with 24 in favour and 6 against.
• Furthermore, the chamber approved a sub-amendment to the preamble to guarantee health and psychological assistance to patients and amendment no. 11, replacing the preamble in its entirety, where references to an essential level of assistance (LEA) are eliminated with 25 in favor and 6 against. During the discussion in the chamber, numerous amendments and sub-amendments presented by regional councilor Marco Stella (Forza Italia) were rejected.

 Agenda

To accompany the approval of the regional law on medically assisted suicide two motions approved by the Regional Council Chamber. The first presented by the group of Italy Viva commits the Regional Council to support the concept of the end of life as a gentle death, including in regional policies the valorisation of palliative care and investment in dedicated facilities, such as hospices and community hospitals, in order to guarantee dignified care for people in the terminal phase.

It is then expected thatcommitment to reiterate in the new Integrated Regional Health and Social Plan 2024-2026, as an integral part of its missionand, the concept of 'being born well and dying well', with particular attention to palliative home care. Finally, there is a commitment to verify that each general manager of local health authorities demonstrates that they have implemented adequate palliative care and to ensure that investments in this area are at least doubled compared to current levels.

The agenda was approved with the 23 votes in favor of Democratic party, Italy Viva e Movement 5 Stars. They were present in the Chamber but they have the Democratic Party councillor decided not to cast her vote Lucia De Robertis, and nine councilors of the groups of Brothers of Italy, Alloy e Forza Italy.

The other order of the day, approved with 25 votes in favour Pd, Italy Viva e Movement 5 Stars e The 11 votes against Brothers of Italy e Alloy, was presented by the Democratic party and commits the Council to take action with the Government and Parliament to initiate a national legislative process to organically and uniformly regulate the procedures relating to medically assisted suicide, in implementation of the Constitutional Court ruling no. 242 of 2019 and no. 135 of 2024.

In this context it is the commitment to urge, in particular, the Government to take a legislative initiative on the matter aimed at introducing clear and uniform discipline is foreseen, capable of guaranteeing homogeneous criteria for the application of constitutional pronouncements, protecting the dignity of the person and operational certainty for the healthcare professionals involved.                                                     

Explanations of vote

“Secularism and the right to self-determination”, these are the guidelines to follow according to the councilor Maurizio Sguanci and opens the statements before the final vote, confirming the favorable vote from the Italia Viva group. "I thank the Coscioni association, we are going to regulate health procedures, which until today have been unequal, with people who have had to wait years, in the face of a right established by a ruling of the Constitutional Court".

Even the group leader of the 5 Star Movement, Irene Galletti it is said "proud of this step of civilization for the Tuscany Region. The debate of these days has not been easy, it has contributed to strengthen our positions, I am even more deeply convinced of the favorable vote that we are going to express. The Parliament must face a debate like this, we wait for the Parliament to give us a hand and to arrive at a single law“. AND thanks the Coscioni association"Without you, we wouldn't be here today.".

"The debate we have faced questions consciences“, He declares Alessandro Capecchi, which announces the Brothers of Italy voted against. "I thank the offices, the legislative branch, for the work done on a bill that has been substantially rewritten. I am absolutely convinced that the path that Tuscany is taking today is not the most correct one.".

Also the leader of the League, Elena Meini, say thank you "all for the level of each intervention, for the high work and the high value expressed on this occasion. It will be a theme that I believe will distinguish each of us also in the next election campaign. I have heard Matteo Salvini many times in these days, we have been given the opportunity to express ourselves in a totally free manner and we will all vote, each following our own path, convincingly against this law".

"This popular initiative bill, as far as we are concerned, is also wrong for anthropological reasons.or – he reiterates Marco Stella (Forza Italy) -. It contributes to building in the common mentality, in the social body, the idea that fragility and pain must be eliminated, they are not worthy of being lived.you". I know that Parliament will have to legislate, but I'm afraid, I can't close my eyes, I think of Holland, Belgium, the Northern European countries and what euthanasia and assisted suicide have produced.“. Then, Stella adds, "there is also a political question, an enlarged majority that takes the votes of the 5 Star Movement. I wonder how Catholics are doing today within the Democratic Party".

Even the councilor Andrea Ulmi (mixed group - Merit and loyalty) cconfirms the intention to vote in favor of the new law"The essence of this measure is a subterfuge, in the face of the regulatory flaw at the national level. In this transitional phase it was important to give a precise direction that would determine the same behavior throughout the territory. We live in a period in which politics and its place are often taken by the judiciary. For this reason, I will vote in favor".

"It is impossible to encapsulate in a few minutes the reasons and nuances that lead the Democratic Party group, with the exception of one non-vote, to vote unanimously in favor of this law.“, declares the leader of the Democratic Party, Vincenzo Ceccarelli. “My thanks go first of all to the promoters, but to the whole Chamber and I am truly grateful to my group. We believe that this is a civilized law, we hope it represents a stimulus, a shock for the whole Parliament. It is within the competence of the Region, within the scope of the health organization of services".

In conclusion, the President of Tuscany, Eugenio Giani"Appreciation and objective sharing of the opinions expressed here, work authentically permeated by a constructive dialectic, by a deep pathos and feeling in the expression of opinions and the vote. I have rarely seen a Council so constructively active, it is a leap in quality and civilization, which Tuscany is making first compared to other Regions and Parliament. The attention that is also there at a national level derives from the fact that there was a wound, this law is placed with absolute legitimacy. It is not correct to talk about euthanasia, we give an account according to the criteria that the system dictates to us and it does nothing but give notice of procedures with respect to the drugs used and the path that must be followedand ".

Giani quotes Paolo Malacarne, “for years head of intensive care in Pisa, explains and tells us what happened after the Court's ruling after 2019. Our – continues Giani – it is a message, an expression of civility at the national level. After six years, it is not possible that Parliament does not listen to the strong and precise indication of the Constitutional Court".

With the final vote imminent, the president of the regional council, Antonio Mazzeo"First thanks to President Sostegni and the entire commission for balance with whom in all these nine months of work they have carried forward such a complex theme. The second thanks to the Chamber, you have demonstrated what good politics can be, made of listening, of comparison, of different points of view and sensibilities, starting from one's own point of view, without denigrating that of the other. Then thanks to the ten thousand seven hundred citizens who have signed this bill. I don't know if we would have had the strength and courage to be here today, you have opened up the space in us to ask ourselves profound questions that have led us to express a free, democratic vote, in the DNA of Tuscany. Then thanks to the offices, to the legislative, you have helped us, guided us, supported us in the most difficult passages. I believe it is a rule of great dignity, I am proud to preside over this legislative assembly".