“Mario” is the pseudonym of a tetraplegic man who has been paralyzed from the shoulders down for the last 11 years as a result of a traffic accident. He made a request for assisted suicide more than a year ago, in August 2020, which the ethics committee of ASUR, the regional public health authority in the central region of Marche, has granted.
Mario is the first person to be given the green light for assisted suicide since a ruling by Italy’s Constitutional Court in 2019 said assisting suicide is lawful in some cases, including cases where a chronic and irreversible pathology causing suffering the person considers intolerable.
The committee, which granted the request following a failed petition to the regional health authority and a court appeal, said Mario was able to make his own decisions in a free and informed way.
Commenting on the case, the Vatican’s Pontifical Academy for Life released a note on Tuesday saying, “The subject of end-of-life decisions is delicate and controversial”. “The news of the green light given to the assisted suicide of Mario following the opinion of the Local Ethics Committee,” it said, “calls for some considerations.” But since detailed medical information on the patient’s clinical situation was not available, it was confining itself to “some general observations”.
Following is the statement of the Pontifical Academy for Life:
First of all, the suffering caused by a pathology as disabling as late-stage tetraplegia is certainly understandable: we cannot in any way minimize the severity of Mario’s condition. However, the question remains whether the most appropriate response to such a situation is to encourage a person to commit suicide. The legitimization of assisted suicide in principle, or even of consensual homicide, does not raise any question or create any contradiction in a civil community that considers the failure to provide assistance a serious crime, even in the most desperate cases, and that is ready to fight against death penalty, even in the case of horrible crimes? What happened to the doctors' oath to care for the suffering? Can giving death to someone else become normal?
We must ask ourselves how to be truly responsible for the lives of all. The most convincing way seems to us to take care of others according to the logic of palliative care, which also envisages the possibility of stopping all treatments that are considered disproportionate by the patient, within the relationship with the healthcare team.
This case also raises a question about the role of Local Ethics Committees. It cannot be excluded that the difficulty of the answer was also determined by the difficulty of clarifying their role. In fact, the term used is not the usual one (so far we have used the terms Committees for Clinical Trials and Committees for Clinical Ethics). Moreover, the Sentence n. 242/2019 of the Constitutional Court demands a task that does not correspond to what is provided for both types so far known: it is about a binding judgment of compliance of the specific clinical situation with the four conditions established by the Sentence of the Constitutional Court. In other words, that is a task that could be carried out more appropriately by a technical (medico-legal) committee that verifies the existence of the prescribed conditions. An ethics committee might be involved more properly in a consultation prior to the patient's decision.