PERSPECTIVE article
Front. Public Health
Sec. Public Mental Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1657070
This article is part of the Research TopicEthical and Psychiatric Considerations in Euthanasia and Medically Assisted Suicide (E/PAS)View all 12 articles
Reconsidering Dependence on Life-Sustaining Treatment as a Criterion for Assisted Suicide: The Italian Legal Unicum in Comparative Perspective
Provisionally accepted
Marco Albore1*
Letizia Sorace1
Sossio Del Prete1
Raffaele La Russa2
Gianpietro Volonnino1
Paola Frati1
Giorgio Bolino1- 1Department of Anatomical, Histological, Medical, Legal and Locomotor Apparatus Sciences, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy
- 2Universita degli Studi dell'Aquila Dipartimento di Medicina Clinica Sanita Pubblica Scienze della Vita e dell'Ambiente, L'Aquila, Italy
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The legalization of Medical Assisted Voluntary Death, including assisted suicide is spreading worldwide, alongside the recognition of the centrality of the patient's right to self-determination even in case of therapeutic desistance. In Italy Law-no.219/2017 has granted patients the option of refusing therapy including life-sustaining treatments even without justification. The present paper offers a critical analysis of the legal-normative aspects and ethical-clinical implications of constraining assisted suicide to dependence on life-sustaining treatments. Reviewing some of the key bioethical-legal pronouncements, we discuss the current Italian system on assisted suicide in which dependence on life-sustaining treatment, even after the recent Constitutional sentences, is still one of the mandatory requirements, despite several critical profiles. Through a literature overview on medical life-sustaining treatments's notion, the dependence on them is analysed and assessed in clinical, bioethical and validity terms as a requirement for access to assisted suicide. From this it appears how dependence on life-sustaining treatment constraint shows overly ambiguous definitional boundaries, with the risk of inhomogeneous interpretations especially in the Italian framework. Interestingly, our comparative analysis reveals that Italy is a global legal unicum among the main international systems regulating Medical Assisted Voluntary Death; which, conversely, tend to target the issue on terminally or irreversibly suffering patients, independently of dependence on life-sustaining treatment.
Keywords: Assisted suicide, end-of-life, Life-sustaining treatments, Health legislation, comparative analysis
Received: 30 Jun 2025; Accepted: 25 Aug 2025.
Copyright: © 2025 Albore, Sorace, Del Prete, La Russa, Volonnino, Frati and Bolino. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Marco Albore, Department of Anatomical, Histological, Medical, Legal and Locomotor Apparatus Sciences, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Rome, Italy
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