• Journal of critical care · Dec 2018

    The Italian law on informed consent and advance directives: New rules of conduct for the autonomy of doctors and patients in end-of-life care.

    • Rosagemma Ciliberti, Ilaria Gorini, Valentina Gazzaniga, Francesco De Stefano, and Matteo Gulino.
    • Department of Health Sciences, Section of Forensic Medicine and Bioethics, University of Genova, 12 Via De Toni, 16132 Genoa, Italy. Electronic address: rosellaciliberti@yahoo.it.
    • J Crit Care. 2018 Dec 1; 48: 178-182.

    PurposeItaly has long lacked a law regulating patients' informed consent and advance directives (ADs). All previous attempts to introduce a law on this matter failed to reach positive outcomes, and aroused heated ideological debate over the exact meaning of life and death. We report on the new law on informed consent and ADs approved by the Italian Parliament on 14th December 2017.Materials And MethodsWe analyse the new law and discuss the main ethical points connected with it, in the Italian context and in comparison with the international situation.ResultsThe law provides for fundamental ethical principles and important guidelines: respect for patients' self-determination in all phases of life, option to refuse or interrupt life-sustaining treatments, including artificial nutrition and hydration, the legitimacy of end-of-life decisions, and the implementation of palliative care to ease suffering and pain.ConclusionsThe effects of the new law must be tested in the field. Its objectives will be achieved if, in clinical practice, ADs are able to satisfactorily represent informed personal preferences through patients' relationships with their physicians, as part of personalized advance care planning. Future studies are necessary to assess the impact of the new law in Italy.Copyright © 2018 Elsevier Inc. All rights reserved.

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