Italy’s Constitutional Court hears landmark end-of-life case involving assisted suicide criteria
In Italy, the Constitutional Court is examining a highly sensitive and unprecedented case concerning end-of-life legislation (“fine vita”) and access to medically assisted suicide. At the center of the proceedings is the legal requirement known as “sostegno vitale” (life-sustaining treatment), which has been a key condition for eligibility since the Court’s landmark 2019 ruling in the Cappato–Dj Fabo case.
Italy’s Constitutional Court is hearing an end-of-life case that has drawn direct participation from patients for the first time. Eleven people with terminal or incurable illnesses have been admitted to the proceedings through their legal representatives. Their positions differ sharply: eight oppose assisted suicide, while three argue in favour of expanding access to it.
The judges are being asked to revisit one of the conditions established in earlier rulings. Current case law allows medically assisted suicide only for patients who suffer from an irreversible disease, experience intolerable suffering, are able to make an informed decision and rely on life-sustaining treatment. The court must now decide whether requiring such treatment creates an unequal distinction between patients whose medical situations may be different but whose level of suffering is comparable.
Alongside that question, the court is examining a challenge brought by the Italian government against legislation approved in Sardinia. The dispute centres on whether regional authorities can regulate procedures related to assisted suicide or whether those powers belong exclusively to the state.
In recent years, the Constitutional Court has gradually expanded its interpretation of life-sustaining treatment. Rather than applying a narrow definition, judges have tended to assess each case according to its specific medical circumstances. At the same time, the court has repeatedly stated that lasting rules on end-of-life decisions should come from Parliament rather than through judicial intervention.
The political debate continues in parallel. A bill currently under discussion in Parliament would establish nationwide criteria for access to assisted suicide, including strict medical requirements and mandatory palliative care. The proposal also envisages the creation of a national committee responsible for evaluating individual requests and would prevent the public health system from directly carrying out assisted-suicide procedures.
The absence of a national law has led some regions to act independently. Tuscany and Sardinia are among those that have adopted measures regulating access to assisted suicide within their healthcare systems. Rome has challenged those initiatives, arguing that issues involving criminal law and fundamental rights fall within national jurisdiction.
The outcome of the case could influence not only how assisted-suicide requests are assessed in the future but also the balance of authority between regional governments, Parliament and the courts in one of Italy’s most sensitive legal and social debates.