Veneto, how the first center-right law on end of life works

Veneto, how the first center-right law on end of life works
From left to right at the top: The President of the Regional Council of Veneto Luca Zaia, the Secretary General Roberto Valente, and the President of the Regional Government of Veneto Alberto Stefani (below) during the voting operations for the approval of the regional law for assisted end-of-life, in the council chamber of Palazzo Ferro Fini, seat of the Regional Council of Veneto, Venice, ANSA

Veneto is the first region governed by the center-right to define the timing and procedures for medically assisted suicide. After two days of discussion, the Regional Council approved the popular initiative bill “Liberi subito,” already examined and rejected in January 2024 by a single vote. More than two and a half years later, the project born from a mobilization by the Luca Coscioni association with the collection of 9,000 signatures passed with 32 votes in favor, 4 abstentions, and 14 against. Decisive were the amendments presented and approved before the final vote, ten of which were signed by the President of the Region Alberto Stefani, who “softened” some passages that in the popular initiative law of the Coscioni association were judged illegitimate by the Constitutional Court.

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Thus, in the new Veneto law passed in the Council, the palliative care specialist (a figure that reassures the more conservative part of both sides) is central; a regional bioethics committee appears to provide guidance to the committees of the individual Local Health Units, medical and healthcare personnel participate voluntarily in the committees, and the drug is self-administered by the requesting patient, not by the medical staff who nevertheless supervise.

The amendments

“In the Regional Council, we approved the amendments I promoted to the “Liberi subito” bill, rewriting the text in the sense of favor vitae and respecting the framework outlined by the Constitutional Court. Our goal is clear: to protect the dignity of the person and guarantee all Venetians full access to palliative care, ensuring that every choice is preceded by serious, competent, and conscious evaluations,” wrote the Governor of Veneto Alberto Stefani on social media, adding: “For this reason, we have provided: the strengthened opinion of the palliative care specialist in the Commission called to evaluate requests for medically assisted suicide; a Regional Bioethics Committee that provides guidelines to territorial committees; the protection of the voluntariness of the assisting doctor.” The approved text also provides that the patient must be previously informed of the possibility of accessing palliative care and the possibility of requesting psychological support from the Pro Vita associations (inserted at the last minute) which are against a law on dignified end-of-life, that is, what the patient is requesting. They must not do it: they can.

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The premises

In the new Veneto law, obviously maintained, and it is the necessary premise, is the perimeter of what was established by the Constitutional Court with a 2019 ruling: the national requirements to obtain a positive response to medically assisted suicide remain firm, and therefore access is allowed to people affected by irreversible pathologies, who depend on vital health treatments, who experience physical or psychological suffering deemed intolerable, and who are fully capable of understanding and willing, thus able to make conscious and free decisions for their own body. Only the patient can request access to end-of-life.

The stages

The patient therefore continues to request access to medically assisted suicide from the Local Health Unit (Ulss) of residence. The analysis of the requirements (those of the ruling) is the responsibility of multidisciplinary medical commissions, one for each health company, to be established within thirty days of the law’s entry into force. Its members are identified by the Ulss on a voluntary basis among its employees. The Veneto law establishes that each commission includes a doctor, a neurologist, a psychologist, a psychiatrist, a forensic doctor, a nurse, a palliative care specialist, and a bioethicist. The palliative care doctor has a central role: their opinion is not binding within the multidisciplinary commission but is “strengthened.” This means that if the commission, by collegial opinion, disagrees with theirs, it must present a detailed motivation to proceed. From the Ulss commission, the decision passes to the ethics committee, which evaluates the patient’s choice and gives a final opinion. Veneto also adds a regional bioethics committee, whose appointment is the responsibility of the regional government, which will express guidelines and a non-binding opinion to be presented to the ethics committee.

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