And So the Way Is Paved for Many Lawsuits

Six years ago, I launched an Italian awareness campaign to promote the living will, to bring Italy into line with the U.S., France, Germany and Great Britain — countries that are advanced civilizations, as our own country is and has always been.

For me, it was a cultural battle for the evolution of a notion in which I have always believed: secular, free, universal thought. I have written, singlehandedly or together with some of our best legal practitioners, five books on the themes of freedom and the right to accept or refuse medical care in any case on the basis of personal convictions. This is in fact the object of the living will all over the world: to place a person’s will at the center of every decision.

I also had several more ambitions. I have always thought that the living will — that is, the anticipatory expression of one’s own will regarding the treatments one wants or does not want to receive in case of loss of the faculty of self-expression — could also have an educational value, because it obliges every one of us to confront the issue of existence, to debate it with others and to question ourselves on how we would like to conclude our own biological cycle, in the case that such a grave event should occur. It is therefore a useful debate for the formation of a personality that is consciously aware of the important matter of the autonomy of decisions.

Global discussion of these arguments began in 1983, following the incident of Nancy Cruzan, who, at only 26 years of age, plunged into a permanent, irreversible vegetative state. In 1990, her family, after various petitions and appeals, obtained the U.S. Supreme Court’s authorization to suspend her artificial nutrition. Hence, the right-to-die movement was born, as well as successive civil movements to regain possession of the decision to end life: faced with medicine that was becoming ever more powerful and invasive, capable even of keeping a body reduced to a vegetable, without conscience, without visual or auditory perception, without even the perception of pain, artificially alive (if we can call it alive).

Even earlier, in 1978, the Dutchman Van den Berg wrote “Medical Power and Medical Ethics,” which introduced the “living will” (translated in Italian as the “biological will”) to various countries. In reality, the discussion on bioethics was born earlier in the 70s, when the American Van Potter coined the term with a precise meaning: Medical ethics must be inspired by the biology of the life of man and oppose the technological invasion into medicine.

I believe that many bioethicists do not know the origin and meaning of Van Potter’s concept. What is more technological and artificial than forcefully keeping a group of organs alive? And this will be the goal of the law approved yesterday (the only such case in the Western world): It will impose artificial life on us by law. And so those who, like myself, commit themselves to the progress of culture come to feel deeply betrayed, as do a large number of people who have great faith in the institutions and the people who run their country. The people are much more aware, conscious and ready for self-determination than one might think and, as all the studies show, are in favor of the living will as an instrument of the expression of individual will.

Faced with this reality, we original promoters of the living will in Italy declare that it is better to have no law than a treacherous law, and we ask that such a legislation be stopped; even if it is approved by the House and the Senate, it can only return to the courts and lead to suit after suit and appeal after appeal. The design of the current law in fact evidently infringes upon Article 31 of the Italian Constitution, as well as the will of the majority of citizens. Without this law, the decision to end life would instead be left to trials and would return to being discussed case by case, in the knowledge and awareness of doctors and the freedom of citizens, of all citizens: those who believe in the sanctity of their own life and consider it a non-disposable gift from God and those who believe instead in their own inviolable rights and freedom.