Italy's Terry Schiavo

There was a case like Terry Schiavo's in Italy that is triggering a genuine constitutional crisis.

Eluana Englaro, who had been on a feeding tube in a persistent vegetative state, for 17 years passed away last night after her father ordered her feeding tube removed. But this was not before Silvio Berlusconi attempted to pass an emergency law banning the removal. The law triggered a crisis because the Italy's President Giorgio Napolitano refused to sign it arguing that it was unconstitutional.

Englaro's passing may not be the end of the issue, however. Berlusconi and his party seem to still be out for blood, and the Vatican is getting involved.

From the Times:

The Senate interrupted the debate and observed a minute's silence as a mark of respect. After the silence came recriminations. "She didn't die. She was killed," Gaetano Quagliarello, a centre-right senator, shouted, while others screamed "murderers, murderers" towards the Opposition benches.

Mr Berlusconi's law would make it illegal for carers of people "unable to take care of themselves" to suspend artificial feeding. Euthanasia is illegal in Italy but refusing treatment is not.

The Prime Minister expressed "deep pain and regret" that he had failed to save Ms Englaro's life but government officials vowed to push the Bill through. "I hope the Senate can proceed on the established calendar so that this sacrifice wasn't completely in vain," Maurizio Sacconi, the Health Minister, told legislators minutes after she died.

Mr Berlusconi drew up the Bill after President Napolitano refused to sign an emergency decree last week on constitutional grounds. Mr Napolitano said that the decree contradicted a Supreme Court ruling last November that gave Ms Englaro's father permission to find doctors who would end her life.

The Vatican and Roman Catholic Church had opposed the ruling fiercely and were swift to respond to news of Ms Englaro's death. Cardinal Javier Lozano Barragán, the Vatican Health Minister, said: "I will continue to regard her death as a crime." Earlier Cardinal Angelo Bagnasco, head of the Italian Episcopal Conference, declared that refusing food and water to Ms Englaro was murder. "A light is going out, the light of a life," he said.

For the third day in succession Pope Benedict XVI referred indirectly to the case, declaring yesterday that "the sanctity of life must be safeguarded from conception to its natural end".

The tussle over Ms Englaro's life has revived accusations that the Vatican is dictating Italian politics. Mr Berlusconi, who had previously stayed out of the controversy, reportedly reacted after Cardinal Tarcisio Bertone, the Vatican Secretary of State, implored him to "stop this crime against humanity".

Several comments:

1) Berlusconi was saying that there was still a chance the future technology might heal this poor woman. That is nonsense for reasons I explain at length here. There has never been a single recorded case of someone recovering from a persistent vegetative state. Ever. All that is left in this condition is the housekeeping functions of the brain that allow for breathing and homeostasis. There is no higher brain functions left to recover. The person that you knew is already dead.

2) If you think Terry Schiavo was controversial here, just think of how bad it is in Italy. At least the Pope doesn't live here.

3) The Italian public seems to be much more divided about this issue than Americans:

In response to accusations that he was bowing to pressure from the Church, the Prime Minister said that he represented the feelings of most Italians. Opinion polls suggested that Italians were divided, with 47 per cent in favour of Ms Englaro's right to die, 47 per cent against and 6 per cent undecided.

4) How Berlusconi intends to dissociate the right to dictate one's own medical care from the right to refuse treatment is beyond me? The right to refuse care is a core principle in patient autonomy -- up to and including the patient's death. And closely associated with that is the right to confer decision-making authority to whomever you choose. In short, if you do not have the right to choose to die, then you do not have the right to choose anything else about your care either. The two are inseparably linked.

But considering that Berlusconi gets laws passed to give him immunity when he would otherwise be prosecuted for corruption, I doubt he cares about the contradiction.