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A Town Meeting on Biological Will in Italy

26. April 2009 – 15:20 by Francesco Molinari

For those who may not know it, the Biological Will is a written statement made by a person who is sound of mind, specifying the limits (s)he deems appropriate to establish for medical treatment, should (s)he be incapacitated to take further decisions due to the onset of a condition of disablement, with no reasonable hope of recovering intellectual integrity.

In Italy, articles 579 and 580 of the Penal Code forbid and sanction as crimes both active euthanasia (homicide of a consenting person) and physician assisted suicide (instigation to suicide and assistance thereto), though with less severe penalties than proper homicide. In spite of that, the Italians attitude to euthanasia has been radically changing in the past few years, probably due to the widespread debate on two controversial cases – the Welby affair in 2006 and the Englaro affair in 2009 – where medical treatment and/or artificial feeding were suspended of two patients for whom there was no chance of recovery.

According to a 2007 survey by the research centre Observa – Science in Society (see https://www.observa.it/view_page.aspx?ID=286&LAN=ENG), 3 out of 4 Italians were in favour of the Biological Will. Quite interestingly for this country, there was no big difference between Catholics (71%) and non-believers (83%).

While the national Parliament is drafting a law on this issue, already passed on first reading in the Senate last 26th March, an Electronic Town Meeting has been arranged jointly by the City of Turin and the Regional Administration of Tuscany, which was held on 25th April, the Liberation Day in Italy. About 360 people (50% Catholics) were gathered for a full day simultaneously in two rooms, one located in Turin, one in Florence, to discuss and deliberate about three specific questions:

1) “To which extent are medical professionals to abide by a patient’s biological will?”

2) “Which limits should be set to the contents of a biological will?”

3) “How should a biological will be structured?”

The ideas, proposals and recommendations emerged from the discussion have been summarised into an instant report, distributed to all participants in the Town Meeting, and that will be handed out to the President of Republic and the legislators of the Italian Parliament in the next few days.

It should be kept in mind that the aim of a Town Meeting is not to seek agreements at all costs, but to elicit different views and interpretations, allowing a comparison among a richer and broader range of opinions. This is why the discussions were not moderated, but only facilitated, by domain experts, having the task of ensuring that sufficient information was provided to participants before and during the event.

In this case, it’s also important to stress is that the Town Meeting preparation started in March last year, with a technical document issued by a high level group of experts, summarising the state of the art on Biological Will in Italy, and which was examined across 40+ meetings and focus groups held in Piedmont and Tuscany, seeing the participation of 650+ citizens overall. The document was also distributed in 130.000 copies jointly with the most read newspaper of the City of Turin, as well as in Florence last February, and made available on a specific website (https://www.biennaledemocrazia.it/testamentobiologico/documenti.shtml).

With this event organisation, the Regional Administration of Tuscany has reached the number of four consecutive Town Meetings since 2006: the previous ones dealt with the principles of a Regional law on participation (first example in Italy), the priorities of regional health policy, and young people’s recommendation to the EU agenda on climate change and energy. More info: https://www.regione.toscana.it/diritti/partecipazione/index.html. It was also the second time for the City of Turin, which hosted a Town Meeting on the Olympic Truce in 2006. More info: https://www.comune.torino.it/treguaolimpica/youngwords/.

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