‘I’m down for it’: Why Italian right-to-die activists are embracing civil disobedience

Over the last couple of months, several right-to-die activists have self-reported to Italian authorities for having helped people access foreign assisted suicide facilities despite the threat of criminal charges.

Virginia Fiume, Felicetta Maltese and Marco Cappato did just that on the morning of Feb 9, telling the main police station in Bologna they had helped an 89-year-old terminally ill woman to die in Switzerland.

“Indirect euthanasia,” or “assisted suicide” — a last resort for people who have been suffering unbearable physical or psychological pain for longer than they can endure, and want to leave this world under the supervision of medical professionals through the self-administration of a lethal substance — is not allowed in Italy and people who aid others to access the procedure can be jailed for up to 12 years for “encouraging or abetting suicide.”

Self-reporting is for these activists a means to raise awareness about their fight for the legalisation of assisted suicide in Italy, amid opposition from both the political class and the civil sector.

A historic ruling

The right-to-die movement in Italy gained traction in 2017, when Fabiano Antoniani, also known as DJ Fabo, willingly died in a Swiss facility, three years after becoming blind and tetraplegic in a dramatic car accident. He was aided by Marco Cappato, a former member of the European Parliament and current treasurer of the Associazione Luca Coscioni, with a long history of advocating for assisted suicide.

Cappato self-reported himself to Italian authorities then which triggered a long legal proceeding that ended with a historic ruling. 

In 2019, the Italian Constitutional Court established that assisted suicide could be allowed in certain circumstances: the patient must be fully capable of understanding and willing, must have an irreversible pathology that causes unbearable physical or psychological pain, and must survive thanks to life-support treatments, such as ventilators. 

Since Antoniani satisfied all these requirements, Cappato was eventually acquitted and the court established that “the crime was not committed.”

Even though it represented a huge step forward, many activists consider the requirements imposed by the Constitutional Court as too narrow.

“One the most important issues is the need for patients to be tied to life-saving machines, which creates unfair, absurd, and immoral discriminations among different kinds of medical treatments,” Chiara Lalli, a journalist and researcher who self-reported to the police in December 2022 for aiding a terminally ill man to die in Switzerland, told Euronews.

Furthermore, the ruling doesn’t specify any timeframe for carrying out the procedures after a patient files a request for assisted suicide, potentially leading to years of grueling wait. 

Federico Carboni was the first patient to legally carry out assisted suicide in Italy in June 2022, after more than a year of legal battles and bureaucratic delays. When he drew his last breath, he had spent the last 12 years of his life paralysed in his bed following a car accident.

“Today, the authorisations needed to access assisted suicide are often too slow and depend on the political orientation of local governments,” Filomena Gallo, a lawyer and Secretary for the Associazione Luca Coscioni, said. 

In an attempt to amend this issue, last December the association launched a proposal for a regional law that sets the maximum timeframe for health authorities to evaluate requests for assisted suicide to 20 days. To come into force, the bill needs to gather at least 5,000 signatures and then be approved by regional councils in each of the 20 Italian regions.

Political standstill

At the national level though, the Constitutional Court’s ruling has never been turned into a proper law.

Over the past four years, all attempts to fully legalise assisted suicide or similar practices have failed. This includes a campaign by the Associazione Luca Coscioni to organise a public referendum for the legalisation of direct euthanasia — the medical procedure where a doctor administers a lethal drug to a patient who willingly requests it. The practice is currently prosecutable as consensual homicide.

A bill to legalise assisted suicide under the requirements posed by the 2019 Constitutional Court’s ruling was passed by the Chamber of Deputies – the lower house of the Parliament – in March 2022. But it did not make it to the Senate as a political crisis over the summer led to the establishment of a new far-right government led by Giorgia Meloni, which dramatically lowered chances for on a law on this issue to even be discussed. 

Right-to-die activists feel discouraged by the political standstill that surrounds assisted suicide in the country.

“The Italian Parliament hasn’t done anything in years despite all the initiatives we organised,” Virginia Fiume said. Fiume is co-president of the European advocacy association Eumans and one of the activists who self-reported in February for helping Paola, an 89-year-old woman with Parkison’s disease, to die in Switzerland.

On the other hand, pro-life activists sighed in relief when the Parliament stopped discussing the bill. 

“The State should offer assistance, and not prospect death, to its citizens,” Jacopo Coghe, spokesperson for the Associazione Pro Vita & Famiglia, a conservative group that supports the right to life and the so-called traditional family, told Euronews. 

Instead of assisted suicide, the association advocates for making access to palliative care easier and safer, and hopes that the government will increase funding for this sector.

Embracing civil disobedience

In response to a static political scenario, civil disobedience is growing common in the country. 

Since last August, at least four Italian people have been accompanied to Swiss clinics to spend their last hours with activists Lalli, Maltese, Fiume, and Cappato and the support of Gallo and the Associazione Luca Coscioni. 

“The movement needed something more. If there was anything I could do to help people and keep the fight alive, I was down for it,” Fiume explained when asked what inspired her to take action.

“The goal of these actions is to beg the political class to take its own responsibilities. But since everything is silent at the moment, we want to obtain new rulings and improve what we already got,” right-to-die supporter Lalli said.

At the same time, pro-life groups consider instances of civil disobedience as mere performances. “All of these actions are thoroughly planned, both from a legal and mediatic perspective,” Coghe, from the conservative group Associazione Pro Vita & Famiglia, said. 

“Since they [right-to-die supporters] can’t obtain a proper law, they are trying to pass from the Courts to create one,” he added.

But right-to-die activists see progress has been made even though they recognise that much remains to be done.  

“Today the fight for assisted suicide is part of the public debate, thanks to all the people who decided to share their stories and the role of activists,” Fiume said. 

“The need for a change is self-evident, but we need a proper law. We are ready.”