Constitutional Court: the life support requirement in assisted suicide

1. The facts

   The story originates from the initiatives of some activists who assisted terminal patients in reaching Swiss clinics for assisted suicide. Specifically, the case of a patient suffering from multiple sclerosis and that of a well-known director with an oncological pathology highlighted a regulatory gap: both patients, despite being in conditions of extreme suffering and irreversibility, were not connected to mechanical ventilation machines. The local Health Authority had denied access to the procedure precisely due to the lack of the technical requirement of life support. The criminal proceedings for facilitating suicide, initiated following the activists' self-reports, saw the intervention of the GIP of Florence, who raised questions of constitutional legitimacy, and the GIP of Rome. The procedural stage definitively concluded in April 2026, when the GIP of Rome dismissed the proceedings against the director's companions by applying Constitutional Court ruling 135/2024, which redefined the boundaries of non-punishability for those providing assistance in such dramatic circumstances.

2. 

   The rules at play

   The regulatory core is Article 580 of the Penal Code, which punishes the instigation or facilitation of suicide with imprisonment from 5 to 12 years. However, this rule must be read in conjunction with Law 219/2017, which governs informed consent and the right to refuse medical treatments. The function of constitutional jurisprudence has been to introduce a specific cause of non-punishability based on four pillars:

   1. The patient's full capacity to understand and will.
   2. The presence of an irreversible pathology.
   3. Intolerable physical or psychological suffering.
   4. Dependence on life support treatments. The violation of even one of these requirements exposes the assistant to criminal sanctions, making it crucial to define what actually constitutes a life-saving treatment.

3. Case law orientation

   Constitutional jurisprudence initially drew a sharp line, equating assisted suicide with the right to discontinue treatment. At first, the core principle limited immunity only to cases of dependence on technological machinery. However, the most recent orientation has clarified that the concept of life support must not be understood in a purely mechanistic sense. The Court established that manual or pharmacological medical procedures, the omission of which would lead to the patient's death in a short time, also fall into this category. There has thus been a shift from a restrictive view to a functional one, where the essence is the causal link between the treatment (even if manual, such as mucus aspiration or assisted evacuation) and the patient's survival. This evolution shifts the focus from the machine to the overall medical procedure.

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8. What it teaches professionals

   1. Always verify the nature of assistance services, distinguishing between basic care and procedures that function as life support according to the new jurisprudential criteria.
   2. Produce detailed medical documentation on the timing of death in the event of treatment interruption.
   3. Monitor potential legislative inertia that could lead to new questions of constitutional legitimacy in the absence of an organic law on the end of life.

References: Articolo 580 Codice PenaleLegge 219/2017Articolo 2 CostituzioneArticolo 3 CostituzioneSentenza 135/2024 Corte Costituzionale

Editorial oversight: Avv. Federico Papa·ICAMUpdated 17 September 2026Content drafted with AI support and subject to editorial source checks. Despite these controls, inaccuracies may remain: reports and rectification requests are welcome. Report a correction