Consiglio di Stato 4460/2014 : sentenza no 4460 : Council of State, Italy : 2 September 2014

Right to health – Patient’s right to self-determination – Cessation of life-sustaining treatment – Court of Appeals of Milan declaring legitimacy of cessation of life-sustaining treatment of patient in permanent vegetative state – Parent of patient requiring health service to cease life-sustaining treatment – Regional Directorate-General for Health (Lombardy Region) rejecting request pursuant to (1) LEA (Essential Levels of Care) established by decree of the President of Council of Ministers (2) the professional and ethical duties of health personnel, which included the provision of life-sustaining treatment and (upon appeal) (3) withdrawal of life-sustaining treatment amounting to murder of a consenting adult – Regional Administration supporting Court of Appeals judgment, but failing to require cessation of life-sustaining treatment – Upon parent’s appeal Regional Administrative Court (TAR) annulling Regional Directorate-General’s refusal on grounds of infringement of patient’s right to health – In addition ruling patient entitled to be cared for by public health service even when refusing life-sustaining treatment – Lombardy Region appealing – Whether life-sustaining treatment being a ‘medical treatment’ – Whether public health service compelled to interrupt life-sustaining treatment – Whether health personnel guilty of criminal offence if carrying out patient’s wishes for interruption of life-sustaining treatment – Whether regional health administration entitled to refuse interruption of treatment on grounds of professional ethics – Italian Constitution arts 2, 3, and 32 – Criminal Code arts 51 and 579 – Legislative decree no 502/1992 – Decree of the President of the Council of Ministers of 29 November 2001.