Withdrawal of artificial hydration and nutrition from a patient in a permanent vegetative state in Italy: some considerations on the Englaro Case

This paper discusses some issues related to end-of-life decisions in Italy: in particular, it addresses the question of withdrawal of artificial nutrition and hydration from a patient in a permanent vegetative state, investigated through the examination of the so-called Englaro case. The acknowledgment of the right to withdraw this kind of treatment is analyzed focusing on three issues: the qualification of artificial hydration and nutrition as medical treatment; the maintenance of the right to refuse and stop this treatment as a corollary of the principle of self determination, sealed and implemented by the principle of informed consent; the possibility to claim this right by decisionally incapable individuals. The article has a comparative approach: it compares the Englaro case with the U.S. Terri Schiavo case (sometimes, Eluana Englaro is called the “Italian Terri Schiavo”) and examines the influence of U.S. case law on the former. Finally, it expresses some considerations on the criticalities that have arisen in the Italian Parliamentary debate regarding living wills. It also tackles the question of the opportunity to enact a law on advance directives in Italy and of the features of such a regulation.