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Assisted Dying in Italy 
Italy is in the midst of a major transformation led by civil society. While medical assisted dying remains illegal, voluntary assisted dying has been decriminalised by the Constitutional Court, and the “Liberi Subito” campaign is successfully establishing regional laws to guarantee patient access.
Legal Status: Legal (Decriminalized by Court)
“Medically Assisted Suicide” is permitted under conditions defined by Constitutional Court Ruling 242/2019 and expanded by Ruling 135/2024. Active euthanasia (homicide of the consenting) remains a crime (Art. 579).
Key Legislation:Ruling 242/2019 (decriminalization) and Law 219/2017 (living wills/palliative care)
In 2025, Tuscany became the first region to pass the “Liberi Subito” law, setting strict timelines for health authorities.
Eligibility
Access is limited to capable adults with an irreversible pathology causing intolerable suffering, who are “dependent on life-sustaining treatments” (broadened in 2024 to include vital nursing care).
Summary
In Italy, the right to die has been secured not by Parliament, but by the civil disobedience of the Associazione Luca Coscioni (ALC). Through high-profile self-denunciations (such as the cases of DJ Fabo and Marco Cappato), the Constitutional Court was forced to intervene, ruling that assisting a person to die is not punishable when specific medical criteria are met.
However, a “right” on paper often faced obstruction in practice. Health authorities (ASL) frequently delayed approvals for months. To combat this, the ALC launched the “Liberi Subito” (Free Immediately) campaign, filing popular initiative laws in every Italian region to impose a maximum wait time of 20 days for checking patient eligibility. This strategy succeeded in Tuscany in 2025, creating a legal precedent for the rest of the country.
Quick Overview
Italy finds itself in a complex legal situation. While the Parliament has repeatedly failed to pass a national “End of Life” law, the Constitutional Court intervened in 2019 to declare that helping a person die is not punishable if specific conditions are met. This effectively decriminalised assisted dying (but not medical assisted dying).
Judgement No 135/2024
Click to view
The Italian system relies on the National Health Service (SSN) verifying that a patient meets four strict criteria. Before 2025, there was no law dictating how long this verification should take, leaving patients like Federico Carboni (“Mario”) waiting two years for authorization.
The “Liberi Subito” campaign changed this dynamic by pushing regional assemblies to regulate the process. Additionally, the ALC operates the “Numero Bianco” (06 9931 3409), a helpline that guides citizens through the legal complexities of living wills (DAT), palliative care, and assisted dying requests.
For those who do not meet the strict Italian criteria (e.g., those not on life support), the ALC continues acts of Civil Disobedience, helping patients travel to Switzerland and facing trial to further challenge the law.
Visit Associazone Luca Coscioni (Federation Member)
for more info.
History and Legislation
Italy’s path has been defined by the clash between political inertia and judicial activism.
Ruling 242/2019 (The Cappato/Antoniani Case): Following Marco Cappato’s self-reporting for helping Fabiano Antoniani (DJ Fabo) die in Switzerland, the Court ruled that Article 580 (Instigation to Suicide) is unconstitutional when applied to mentally competent patients dependent on life support with irreversible conditions.
Referendum & “Eutanasia Legale” (2021-2022): The ALC collected over 1.2 million signatures to hold a referendum to fully legalize medical assisted dying. In 2022, the Constitutional Court controversially blocked the referendum, deeming it inadmissible. This forced the movement to pivot back to regional legislative action (“Liberi Subito”).
Ruling 135/2024 (Defining “Life Support”): In July 2024, the Court issued a vital clarification. Previously, “life-sustaining treatment” was interpreted strictly as machinery (ventilators). Ruling 135/2024 expanded this to include vital nursing assistance (e.g., manual bowel evacuation, suctioning, catheterization) if its interruption would lead to death. This opened access to many patients previously excluded.
2025 Developments:
- Senate Initiative: A new popular initiative law with 74,000 signatures was deposited in the Senate.
- Tuscany Victory: The first regional law passed, mandating that health authorities must complete verification procedures within strict time limits.
Who is Eligible?
Criteria under Ruling 242 & 135; A patient must meet all four conditions to access voluntary assisted dying :
- Capacity: Fully capable of making free and informed decisions.
- Pathology: Affected by an irreversible pathology.
- Suffering: The condition causes physical or psychological suffering that the patient deems intolerable.
- Dependence: The patient must be “dependent on life-sustaining treatment.”
- Update (2024): Under Ruling 135/2024, this includes not just machines (ventilators/PEG), but also necessary procedures performed by caregivers (manual evacuation, suctioning) if stopping them would result in death.
- Civil Disobedience (The “Swiss Route”):Patients who do not meet these criteria (e.g., cancer patients not yet on life support) are currently excluded. The ALC continues to support these “exiles” via civil disobedience actions (e.g., the cases of Sibilla Barbieri and Massimiliano), aiming to remove the “life support” requirement in future court rulings.
Members
Our Italian Members
We currently have 63 are members of the World Federation, with 1 based in Italy.
latest news
The latest news from our members and from around the world
Our members produce helpful factsheets and newsletters. The Federation is always happy to share other sources of information in favour of our joint mission to advance assisted dying around the world.
