The Senate has definitively approved the Bill n°. 2801, titled “Rules on informed consent and advance treatment provisions” (DAT). Some political and social movements commended the adoption of the Bill, deemed a step forward for our Country’s growth in the area of civil rights. Others – including us – consider the approval of the Bill, in its definitive version, “a missed opportunity” under various angles. First of all, if given prevalence, common sense would have enabled, through a set of amendments to the text of the draft-law, to separate the regulation of such a delicate and complex issue from the sterile, reductive fury of ideology. Unfortunately, that was not the case. Moreover,
It’s a missed opportunity for policy-makers – or rather, for a number of them – who on this occasion, instead of focusing their attention on the true needs of people burdened by sickness and suffering, were probably misled by the demeaning rationale of petty electoral convenience, giving the impression to be more than willing to subject their conscience to short-sighted interests and “Party orders.” Another reason for our bitter disappointment is the feeling, prevailing today, that in all likelihood the political energies and time spent in ensuring the adoption of this Law have “exhausted” the possibility of focusing on the approval of other bills – much more useful and urgent – providing support to the sick and to those who care for them on a daily basis (i.e. the Law envisaging contributions for the daily and routine care at home for chronically ill persons). Over the past months the DAT draft-bill has been the object of in-depth reflections and analyses, thus it would be useless to attempt to further underline today a set of aspects that have already been amply discussed. We are left with the humble task of reiterating the major problems of this regulation, whose final text, in our opinion
is bound to be of little use to doctors and patients; is dangerous owing to pro-euthanasia interpretations of the text and is harbinger of legal and insurance disputes due to the ambiguity of some of its provisions.
Thus, without further delaying a detailed reading of its eight Articles, it should be remembered that the modifications introduced by this law, contrary to what is stated in its Preamble, ultimately undermine the very foundation of doctor-patient relations, which, previously understood as an alliance for life and for health, now risks turning into a constant, mutual “redde rationem” (“giving an account”), envenomed with suspicions and defence mechanisms. The patient will thus have to worry about reaffirming his right to absolute self-determination while the doctor is reduced to the “executor of the will”, legally bound (but … without being exposed to civil or criminal liability!) to ignore, when requested, his own human and professional conscience. Far from “honourable and conscientious” treatment! The other major inconsistency of the law is that
It fails to envisage the link (never even by referring to it) with the present clinical condition of the patient, and thus the expression of his/her treatment decisions have no specific timeframe (“now for a later moment”). It thereby fails to consider the importance of detailed information, the psychological conditions of the declarant, the stage of the disease and the proportionate value of proportionality of treatment.
All of this is marked by a great deal of sophism whereby reality seems to be only made up of words. An evidence of this is the fact that the draft –bill defines artificial nutrition and hydration as “medical treatment”, which is enough to allow for their interruption and discontinuation, once again without requesting to examine the clinical situation requiring such interventions. In short, this Law is a mockery and its application will probably make many people unhappy, perhaps the majority! Is this the task we assigned to our representatives in Parliament? Or should we get used to the idea that human needs are less important than political emergencies?