Italy struggles with euthanasia

It’s a very public drama unfolding for some months now in Italy over the realities, laws and ethics of ending one’s life. Because the drama centers around a dying poet and his correspondence with the Italian government, taking issue with the law there, it’s gripping that country in the angst of finding answers to end of life struggles.

Many patients on respirators are not conscious and so cannot say whether they want to live or die. But Piergiorgio Welby is still full of words, hard and touching ones, that may be changing the way Italy thinks about euthanasia and other choices for the sick to end their own lives.

“I love life, Mr. President,” Mr. Welby, 60, who has battled muscular dystrophy for 40 years, wrote to Italy’s president, Giorgio Napolitano, in September. “Life is the woman who loves you, the wind through your hair, the sun on your face, an evening stroll with a friend.

“Life is also a woman who leaves you, a rainy day, a friend who deceives you. I am neither melancholic nor manic-depressive. I find the idea of dying horrible. But what is left to me is no longer a life.”

Now Mr. Welby’s long drama appears to be nearing its final act. Last weekend, an Italian court denied legal permission for a doctor to sedate him and remove him from his respirator. Fully lucid but losing his capacity to speak and eat, he is deciding whether to appeal or to perform an act of civil disobedience that will kill him.

He is doing so in a very public way. Until a recent steep decline in his condition, he used a little stick to rapidly peck out blog entries with one hand. His book, “Let Me Die,” was just released. Near daily front-page stories chronicle the political, ethical and, with the Catholic Church a vital force here, religious issues his case presents.

It is gripping the nation, particularly Romans.

“Dear Welby: Wait Before Taking Yourself Off” the respirator, read a front-page headline on Tuesday in La Repubblica, written by a top Italian surgeon, Dr. Ignazio Marino, who is also a senator for the Democrats of the Left. He had visited Mr. Welby the day before.

What has given the case a particular political twist is that Mr. Welby, attached to a respirator for nine years, has long been a spokesman for euthanasia and is a central part of the Radical Party’s effort to have it legalized. In fact, members of the Radical Party have offered to personally remove his respirator if asked — and may do so any day now in a frontal challenge to Italian law.

But the Catholic Church and many of this traditionally minded nation’s politicians on the left and the right not only oppose euthanasia generally but are also not entirely sure what to do about Mr. Welby’s case. He says he is not seeking to commit suicide but to remove himself from medical treatment he does not want.

It’s a dilemma more countries are grappling with, and certainly ours in a very vigorous ongoing battle to legalize euthanasia. Fine-tuning the law, however, is dicey.

To decline forced medical treatment is allowed under Italian law, experts say, but Italy has another law that makes it a crime to assist in a death, even with consent. So a doctor could not detach the respirator without risking prosecution.

The church, too, has conflicting teachings about what to do in this case, and what the Vatican thinks has a deep impact not only on the nation’s political class but also on doctors tied to the scores of Catholic-run hospitals around Italy.

The defense of life is central to the social doctrine of the church, and so it opposes abortion and capital punishment. Only last week Pope Benedict XVI reaffirmed his opposition to euthanasia, saying governments should find ways to let the terminally ill “face death with dignity.”

Last week Benedict issued his message for the 15th World Day of the Sick to be celebrated in South Korea in February. Vatican Information Service released a portion of it:

In his Message, published in English and dated December 8, the Holy Father writes that “despite the advances of science, a cure cannot be found for every illness. … Many millions of people in our world still experience insanitary living conditions and lack access to much-needed medical resources, often of the most basic kind, with the result that the number of human beings considered ‘incurable’ is greatly increased.”

After highlighting the “need to promote policies which create conditions where human beings can bear even incurable illnesses and death in a dignified manner,” Benedict XVI dwells upon the necessity “to stress once again the need for more palliative care centers which provide integral care, offering the sick the human assistance and spiritual accompaniment they need. This is a right belonging to every human being, one which we must all be committed to defend.”

Here’s Benedict’s message in its fullness.