Relieving suffering does not mean helping a person to die. The difference between palliative sedation, euthanasia and assisted suicide is profound. Some clarity on the living will from those who work on end-of-life issues every day. The editorial by the association Vidas.
The approval of the living will law came just before Christmas, on 14 December. A symbolic image immediately conveys the importance of this measure, which was greeted by the Senate chamber with a long round of applause: the tears of joy from representatives of the Luca Coscioni association, among them Emma Bonino and Mina Welby.
A years-long battle for the right to a dignified death that sees Italy trailing at the back of the pack in Europe. There has been no shortage of controversy, born of a prejudice that is hard to dispel: relieving suffering is not the same as helping a person to die.
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We at Vidas, who fight against these preconceptions every day, thought we would shed some light on the matter. First and foremost to assert, and firmly, that deep palliative sedation as provided for by the new legislation is neither euthanasia nor assisted suicide.
"The difference lies in the intentionality of the action (causing death, in the case of the latter two, ed.) and in the means that are used. The same drugs and the same dosages used in those other cases are not used here. Assisted suicide and euthanasia, which are moreover carried out in other countries according to precise legislation, a process and a procedure, take place in a matter of minutes. Palliative sedation is designed to keep a symptom under control, it does not cause death immediately and one can always decide to reverse course. In euthanasia, the procedure is irreversible," explains Barbara Rizzi, scientific director of Fondazione Vidas.
Should we therefore conclude that euthanasia and assisted suicide are synonymous? Although the aim is the same, they differ in method. In the first case, the intervention of a third party is necessary because the patient is in a state of unconsciousness or does not have sufficient autonomy to take the drugs that would lead to their death. We speak of assisted suicide, on the other hand, when it is the patient themselves who carries out every action, albeit with the support of the designated personnel.
It thus becomes clear that the invoked right to conscientious objection to the living will law is the result of a misunderstanding: deep palliative sedation is designed to alleviate suffering, it is not aimed at taking a life. To use the words of Giada Lonati, Vidas's social and healthcare director: "As a doctor, when I treat a patient I work to protect them, not to make them die. The living will law does the same: it guarantees people the possibility of being allowed to go with dignity."
