End-of-life-decisions, dependence and vulnerability

Abstract

The paper critically analyzes the Italian debate on Physician-Assisted-Suicide (PAS), showing that it is characterized by a misrecognition of the medical and bioethical differences between the various treatments and procedures, with the consequent risk of adopting a reductive approach to the so-called end-of-life decisions. As will be addressed in the first part of the article, the current end-of-life lexicon proves what has just been said: the practice of PAS is increasingly indicated with expressions like "Physician-Assisted-Dying" and "Physician Aid-in-Dying", which could allude not only to assisted suicide but also to other end-of-life practices that are not aimed at the patient's death, such as deep palliative sedation. In this way, different practices in terms of procedures and objectives are mistakenly equated. The second part of the paper argues that improper undue equations can also be noticed by analyzing both the arguments of the Constitutional Court (provided in Order n. 207/2018 and Judgment n. 242/2019) and the recent attempt to extend the expression "life-sustaining treatments".