A review and analysis of new Italian law 219/2017: ‘provisions for informed consent and advance directives treatment’

BACKGROUND: In December 2017, Law 219/2017, ‘Provisions for informed consent and advance directives’, was approved in Italy. The law is the culmination of a year-long process and the subject of heated debate throughout Italian society. Contentious issues (advance directives, the possibility to refus...

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Autores principales: Di Paolo, Marco, Gori, Federica, Papi, Luigi, Turillazzi, Emanuela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399822/
https://www.ncbi.nlm.nih.gov/pubmed/30832644
http://dx.doi.org/10.1186/s12910-019-0353-2
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author Di Paolo, Marco
Gori, Federica
Papi, Luigi
Turillazzi, Emanuela
author_facet Di Paolo, Marco
Gori, Federica
Papi, Luigi
Turillazzi, Emanuela
author_sort Di Paolo, Marco
collection PubMed
description BACKGROUND: In December 2017, Law 219/2017, ‘Provisions for informed consent and advance directives’, was approved in Italy. The law is the culmination of a year-long process and the subject of heated debate throughout Italian society. Contentious issues (advance directives, the possibility to refuse medical treatment, the withdrawal of medical treatment, nutrition and hydration) are addressed in the law. MAIN TEXT: What emerges clearly are concepts such as quality of life, autonomy, and the right to accept or refuse any medical treatment – concepts that should be part of an optimal relationship between the patient and healthcare professionals. The law maximizes the value of the patient’s time to decide. Every patient is allowed to make choices for the present (consenting to or refusing current treatment) as well as for the future, conceived as a continuation of the present, and to decide what comes next, based on what he/she already knows. The law identifies three distinct but converging paths towards the affirmation of a care relationship based on reciprocal trust and respect: the possibility to consent to or refuse treatment, the shared care planning, and advance directives. CONCLUSIONS: The fundamental point to emerge from the new Italian law is that consensus is an essential connotation of the treatment relationship. Consensus is not limited to the acceptance/rejection of medical treatment but is ongoing. It is projected into the future through shared care planning and advance directives which act as tools for self-determination and the manifestation of the beliefs and preferences of persons unable to express their will. These principles are in line with the idea of appropriate care as evaluated from two different perspectives, one of scientific adequacy and the other commensurate with the individual’s resources, fragility, values, and beliefs. Surely, however, the new law is not the end of the matter on issues such as conscientious objection, which is deeply rooted within the Italian cultural and political debate. In this regard, healthcare institutions and policymakers will be called upon to develop and implement organizational policies aimed at the management of foreseeable conscientious objection in this field.
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spelling pubmed-63998222019-03-13 A review and analysis of new Italian law 219/2017: ‘provisions for informed consent and advance directives treatment’ Di Paolo, Marco Gori, Federica Papi, Luigi Turillazzi, Emanuela BMC Med Ethics Debate BACKGROUND: In December 2017, Law 219/2017, ‘Provisions for informed consent and advance directives’, was approved in Italy. The law is the culmination of a year-long process and the subject of heated debate throughout Italian society. Contentious issues (advance directives, the possibility to refuse medical treatment, the withdrawal of medical treatment, nutrition and hydration) are addressed in the law. MAIN TEXT: What emerges clearly are concepts such as quality of life, autonomy, and the right to accept or refuse any medical treatment – concepts that should be part of an optimal relationship between the patient and healthcare professionals. The law maximizes the value of the patient’s time to decide. Every patient is allowed to make choices for the present (consenting to or refusing current treatment) as well as for the future, conceived as a continuation of the present, and to decide what comes next, based on what he/she already knows. The law identifies three distinct but converging paths towards the affirmation of a care relationship based on reciprocal trust and respect: the possibility to consent to or refuse treatment, the shared care planning, and advance directives. CONCLUSIONS: The fundamental point to emerge from the new Italian law is that consensus is an essential connotation of the treatment relationship. Consensus is not limited to the acceptance/rejection of medical treatment but is ongoing. It is projected into the future through shared care planning and advance directives which act as tools for self-determination and the manifestation of the beliefs and preferences of persons unable to express their will. These principles are in line with the idea of appropriate care as evaluated from two different perspectives, one of scientific adequacy and the other commensurate with the individual’s resources, fragility, values, and beliefs. Surely, however, the new law is not the end of the matter on issues such as conscientious objection, which is deeply rooted within the Italian cultural and political debate. In this regard, healthcare institutions and policymakers will be called upon to develop and implement organizational policies aimed at the management of foreseeable conscientious objection in this field. BioMed Central 2019-03-04 /pmc/articles/PMC6399822/ /pubmed/30832644 http://dx.doi.org/10.1186/s12910-019-0353-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Debate
Di Paolo, Marco
Gori, Federica
Papi, Luigi
Turillazzi, Emanuela
A review and analysis of new Italian law 219/2017: ‘provisions for informed consent and advance directives treatment’
title A review and analysis of new Italian law 219/2017: ‘provisions for informed consent and advance directives treatment’
title_full A review and analysis of new Italian law 219/2017: ‘provisions for informed consent and advance directives treatment’
title_fullStr A review and analysis of new Italian law 219/2017: ‘provisions for informed consent and advance directives treatment’
title_full_unstemmed A review and analysis of new Italian law 219/2017: ‘provisions for informed consent and advance directives treatment’
title_short A review and analysis of new Italian law 219/2017: ‘provisions for informed consent and advance directives treatment’
title_sort review and analysis of new italian law 219/2017: ‘provisions for informed consent and advance directives treatment’
topic Debate
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399822/
https://www.ncbi.nlm.nih.gov/pubmed/30832644
http://dx.doi.org/10.1186/s12910-019-0353-2
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