Rosagemma Ciliberti1, Ilaria Gorini2, Valentina Gazzaniga3, Francesco De Stefano4, Matteo Gulino5. 1. Department of Health Sciences, Section of Forensic Medicine and Bioethics, University of Genova, 12 Via De Toni, 16132 Genoa, Italy. Electronic address: rosellaciliberti@yahoo.it. 2. Department of Biotechnology and Life Sciences, University of Insubria, 9 Via O. Rossi, 21100 Varese, Italy. Electronic address: ilaria.gorini@uninsubria.it. 3. Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, 79 Corso della Repubblica, 04100 Latina, Italy. Electronic address: valentina.gazzaniga@uniroma1.it. 4. Department of Health Sciences, Section of Forensic Medicine and Bioethics, University of Genova, 12 Via De Toni, 16132 Genoa, Italy. Electronic address: Fdestefano@unige.it. 5. Department of Medico-surgical Sciences and Biotechnologies, Sapienza University of Rome, 79 Corso della Repubblica, 04100 Latina, Italy. Electronic address: matteo.gulino@uniroma1.it.
Abstract
PURPOSE: Italy has long lacked a law regulating patients' informed consent and advance directives (ADs). All previous attempts to introduce a law on this matter failed to reach positive outcomes, and aroused heated ideological debate over the exact meaning of life and death. We report on the new law on informed consent and ADs approved by the Italian Parliament on 14th December 2017. MATERIALS AND METHODS: We analyse the new law and discuss the main ethical points connected with it, in the Italian context and in comparison with the international situation. RESULTS: The law provides for fundamental ethical principles and important guidelines: respect for patients' self-determination in all phases of life, option to refuse or interrupt life-sustaining treatments, including artificial nutrition and hydration, the legitimacy of end-of-life decisions, and the implementation of palliative care to ease suffering and pain. CONCLUSIONS: The effects of the new law must be tested in the field. Its objectives will be achieved if, in clinical practice, ADs are able to satisfactorily represent informed personal preferences through patients' relationships with their physicians, as part of personalized advance care planning. Future studies are necessary to assess the impact of the new law in Italy.
PURPOSE: Italy has long lacked a law regulating patients' informed consent and advance directives (ADs). All previous attempts to introduce a law on this matter failed to reach positive outcomes, and aroused heated ideological debate over the exact meaning of life and death. We report on the new law on informed consent and ADs approved by the Italian Parliament on 14th December 2017. MATERIALS AND METHODS: We analyse the new law and discuss the main ethical points connected with it, in the Italian context and in comparison with the international situation. RESULTS: The law provides for fundamental ethical principles and important guidelines: respect for patients' self-determination in all phases of life, option to refuse or interrupt life-sustaining treatments, including artificial nutrition and hydration, the legitimacy of end-of-life decisions, and the implementation of palliative care to ease suffering and pain. CONCLUSIONS: The effects of the new law must be tested in the field. Its objectives will be achieved if, in clinical practice, ADs are able to satisfactorily represent informed personal preferences through patients' relationships with their physicians, as part of personalized advance care planning. Future studies are necessary to assess the impact of the new law in Italy.
Authors: Spyros D Mentzelopoulos; Su Chen; Joseph L Nates; Jacqueline M Kruser; Christiane Hartog; Andrej Michalsen; Nikolaos Efstathiou; Gavin M Joynt; Suzana Lobo; Alexander Avidan; Charles L Sprung Journal: Crit Care Date: 2022-04-13 Impact factor: 9.097
Authors: Caroline Moeller Arnfeldt; Mogens Groenvold; Anna Thit Johnsen; Branka Červ; Luc Deliens; Lesley Dunleavy; Agnes van der Heide; Marijke C Kars; Urška Lunder; Guido Miccinesi; Kristian Pollock; Judith A C Rietjens; Jane Seymour Journal: PLoS One Date: 2022-07-28 Impact factor: 3.752