Published online by Cambridge University Press: 28 May 2010
The international media recently reported the case of Eluana Englaro, a 38-year-old woman in a permanent vegetative state (PVS) who died in February 2009 following withdrawal of her feeding tube. At the time of her death, she had been unconscious for 17 years. For many years, her father had been seeking permission to allow her to die. His request was rejected by the courts several times on different grounds, until the Italian Supreme Court finally granted it. The case caused considerable political turmoil. The government, the president, the Constitutional Court, and the European Court of Human Rights got involved. This paper gives an account of the history of the case, enriched by personal communications with the people directly involved and a memoir by the father of Eluana.
1. Englaro, B, Nave, E. Eluana. La libertà e la vita [Eluana, or: on life and liberty]. Milano: Rizzoli; 2008Google Scholar.
2. Moratti, S. Italy. In: Griffiths, J, Weyers, H, Adams, M, eds. Euthanasia and Law in Europe. Oxford: Hart; 2008:395–423, at p. 399Google Scholar.
3. Comitato Nazionale di Bioetica [National Bioethics Committee]. Dichiarazioni anticipate di trattamento [Advance Treatment Directives], available at http://www.governo.it/bioetica/pareri.html (last accessed 6 Jul 2009).
4. See note 2, Moratti 2008:408–9.
5. Law of 9 January 2004, no 6. Gazzetta Ufficiale 2004:14.
6. Ordine dei Medici [College of Physicians]. Codice di deontologia medica [Code of Medical Ethics]. Torino: Edizioni Medico-scientifiche; 2006Google Scholar.
7. See note 1, Englaro, Nave 2008:24–5.
8. See note 1, Englaro, Nave 2008:12–5 and 33–5.
9. See note 1, Englaro, Nave 2008:37–8.
10. See note 2, Moratti 2008:398.
11. The Multi-Society Task Force on PVS. Medical aspects of the persistent vegetative state—Second of two parts. New England Journal of Medicine 1994;330:1572–9.
12. Ministerial Commission on the Vegetative State. Final report, 14 December 2005, available at http://archivio.medicinaepersona.org/__C1256C23002924DE.nsf/wAll/IDCW-6LKTUS/$file/commissione%20tecnico-scientifica.pdf (last accessed 6 Jul 2009).
13. See note 1, Englaro, Nave 2008:39.
14. See note 12, Ministerial Commission 2005:15.
15. See note 1, Englaro, Nave 2008:47–8.
16. See note 1, Englaro, Nave 2008:41.
17. See note 1, Englaro, Nave 2008:49.
19. Supreme Court, first Civil Chamber, 6 October 2007, no. 21748. Il foro italiano 2007(1):3025.
20. Court of Appeals of Milan, first Civil Chamber, 9 July 2008, no. 88. Guida al diritto 2008(1):30.
21. Beppino Englaro: Ora la vicenda torni nel privato [Beppino Englaro asks not to give his daughter’s case further publicity], available at http://www.aduc.it/dyn/salute/noti.php?id=226352 (last accessed 6 Jul 2009).
22. Constitutional Court, 8 October 2008, no. 334, available at http://radicalilecco.org/rad/modules/mastop_publish/files/files_49d084d0c3ad2.pdf (last accessed 6 Jul 2009).
23. Supreme Court, 14 November 2008, no. 27147, available at http://www.federalismi.it/applMostraDoc.cfm?Artid=11321&edoc=14112008163515.pdf&tit=Le%20SS.UU.%20sul%20caso%20Englaro (last accessed 6 Jul 2009).
24. Englaro: Arriva lo stop della regione [Englaro case: Governor of Lombardy is opposed to treatment withdrawal]. Corriere della Sera 2008 Sep 3.
25. Eluana: Si offre il Piemonte [Englaro case: Withdrawal of treatment could take place in Piedmont]. Corriere della Sera 2008 Nov 16.
26. Ministry of Health. Orientamento di carattere generale [Recommendations to NHS-bound healthcare institutions], available at http://www.aduc.it/dyn/salute/noti.php?id=243842 (last accessed 6 Jul 2009).
27. Eluana: Tondo (FVG), sistema sanitario qui della regione [Englaro case: Governor of Friuli-Venezia Giulia says decisions over regional healthcare system must be made at the regional level]. Il Piccolo 2008 Dec 18.
28. Rossi and Others v. Italy (dec.), nos. 55185/08, 55483/08, 55516/08, 55519/08, 56010/08, 56278/08, 58420/08 and 58424/08, ECHR 2008–, 22 Dec 2008, available at http://cmiskp.echr.coe.int/tkp197/view.asp?action=open&documentId=848707&portal=hbkm&source=externalbydocnumber&table=F69A27FD8FB86142BF01C1166DEA398649 (last accessed 6 Jul 2009).
29. Lei non è più quella delle fotografie [She is not the girl in the pictures anymore]. Corriere della Sera 2009 Feb 4.
30. Eluana, Napolitano non firma il decreto; il governo approva DDL in tempo record [Englaro case: Napolitano will not sign the bill, Government planning to pass emergency decree]. Corriere della Sera 2009 Feb 6.
31. The letter of the president is available online at http://radicalilecco.org/rad/modules/mastop_publish/files/files_49d087530c845.pdf (last accessed 6 Jul 2009).
32. The decree is available online at http://radicalilecco.org/rad/modules/mastop_publish/files/files_49d07f6fc038c.pdf (last accessed 6 Jul 2009).
33. Beppino Englaro: Napolitano e Berlusconi vengano a vedere Eluana [Napolitano and Berlusconi should come to see Eluana, Mr. Englaro says]. Corriere della Sera 2009 Feb 7.
34. Udine: Eluana Englaro è morta [Eluana Englaro died in Udine]. Corriere della Sera 2009 Feb 9.
35. Sampedro, R. Cartas desde el infierno [Letters from hell]. Barcelona: Editorial Planeta; 2005Google Scholar. Sampedro was a quadriplegic patient and the protagonist of a Spanish right-to-die case.
36. Moratti, S. The development of ‘medical futility’: Towards a procedural approach based on the role of the medical profession. Journal of Medical Ethics 2009;35:369–72CrossRefGoogle Scholar.
37. Disposizioni in materia di alleanza terapeutica, di consenso informato e di dichiarazioni anticipate di trattamento [Regulation of informed consent and advance treatment directives], available at http://www.senato.it/leg/16/BGT/Schede/Ddliter/29638.htm (last accessed 10 Jul 2009).
38. Ordine dei Medici [College of Physicians]. Dichiarazione sulle direttive anticipate [Position statement on advance treatment directives], 13 June 2009, available at http://www2.fnomceo.it/PortaleFnomceo/downloadFile.dwn?id=66101&version=4 (last accessed 10 Jul 2009).
39. Dubbi sulla costituzionalità del ddl Calabrò [The Calabrò bill is unconstitutional, some MPs argue]. Il Foglio 2009 Feb 25, available at http://www.ilfoglio.it/soloqui/1931 (last accessed 10 Jul 2009).
40. See note 2, Moratti 2008:353, 384, and 426.
41. Perry, JE, Churchill, LR, Kirshner, HS. The Terri Schiavo case: Legal, ethical, and medical perspectives. Annals of Internal Medicine 2005;143:744–8CrossRefGoogle ScholarPubMed.
42. Jennet, B. The Vegetative State. Medical Facts, Ethical and Legal Dilemmas. Cambridge, UK: Cambridge University Press; 2002CrossRefGoogle Scholar.