JUDGMENT NO. 148

YEAR 2026

ITALIAN REPUBLIC

IN THE NAME OF THE ITALIAN PEOPLE

THE CONSTITUTIONAL COURT

composed of:

President: Giovanni AMOROSO;

Judges: Francesco VIGANÒ, Luca ANTONINI, Stefano PETITTI, Angelo BUSCEMA, Emanuela NAVARRETTA, Maria Rosaria SAN GIORGIO, Filippo PATRONI GRIFFI, Marco D’ALBERTI, Antonella SCIARRONE ALIBRANDI, Massimo LUCIANI, Maria Alessandra SANDULLI, Roberto Nicola CASSINELLI, Francesco Saverio MARINI,

has delivered the following

JUDGMENT

in proceedings concerning the constitutionality of Autonomous Region of Sardinia Law No. 26 of September 18, 2025 (Procedures and timelines for regional healthcare assistance for medically assisted suicide pursuant to and as a result of Constitutional Court Judgment No. 242 of 2019), and in particular Articles 1, 2, 3, 4, 6, and 7, brought by the President of the Council of Ministers by means of a recourse notified on November 24, 2025, filed with the registry on November 27, 2025, registered under No. 43 of the Recourse Register of 2025, and published in the Official Gazette of the Republic No. 50, First Special Series, for the year 2025.

Having regard to the appearance entered by the Autonomous Region of Sardinia;

having heard in the public hearing of June 23, 2026, the Reporting Judges Francesco Viganò and Luca Antonini;

having heard State Counsel Giancarlo Caselli and Marco La Greca for the President of the Council of Ministers, as well as attorneys Mattia Pani and Alessandra Braglia for the Autonomous Region of Sardinia;

having deliberated in the chambers on June 23, 2026.

Raben in Fact

1.– By means of a recourse notified on November 24, 2025, filed with the registry on November 27, 2025, and registered under No. 43 of the Recourse Register of 2025, the President of the Council of Ministers, represented and defended by the State Attorney General’s Office, challenged the entirety of Autonomous Region of Sardinia Law No. 26 of September 18, 2025 (Procedures and timelines for regional healthcare assistance for medically assisted suicide pursuant to and as a result of Constitutional Court Judgment No. 242 of 2019), as well as Articles 1 to 4, 6, and 7 thereof, with reference, overall, to Article 117, second paragraph, letters l) and m), and third paragraph, of the Constitution, and to Articles 3 and 4, letter i), of Constitutional Law No. 3 of February 26, 1948 (Special Statute for Sardinia).

1.1.– The recourse summarizes the contents of the provisions of the challenged regional law, Article 1 of which (Purpose) states that "[t]he Region, in compliance with its competencies and the principles established by Constitutional Court Judgment No. 242 of 2019, for the purpose of guaranteeing the necessary healthcare assistance to persons intending to access medically assisted suicide, in conformity with the provisions of Article 2, defines timelines and organizational methods for the provision of the related treatments.”

The aforementioned Article 2, in paragraph 1, establishes that the services and treatments referred to in the regional law may be accessed by "persons possessing the requirements indicated by the jurisprudence of the Constitutional Court,” in compliance with the provisions of Articles 1 and 2 of Law No. 219 of December 22, 2017 (Provisions concerning informed consent and advance healthcare directives); paragraph 2 specifies that such requirements "are subject to verification carried out pursuant to Articles 3 and 4.”

Article 3 provides for the establishment of the Permanent Multidisciplinary Commission, regulating it in the following terms:

"1. Within fifteen days from the entry into force of this law, the regional healthcare enterprises shall establish a Permanent Multidisciplinary Commission for the verification of the existence of the requirements referred to in Article 2, paragraph 1.

2. The Commission provided for in paragraph 1 shall be composed of: a) a palliative care physician; b) a neurologist; c) a psychiatrist; d) an anaesthesiologist; e) a nurse; f) a psychologist.

3. The members shall be identified, on a voluntary basis, from among the personnel employed by the regional healthcare enterprise. In the event of the unavailability of internal personnel, members may be identified among employees of other enterprises or entities of the regional health service.

4. The Commission may be supplemented from time to time by a medical specialist in the pathology afflicting the person interested in accessing medically assisted suicide.

5. The regional healthcare enterprises shall ensure adequate specific training in palliative care for the members.

6. Participation in the Commission shall not entail the payment of fees, attendance tokens, or other allowances however denominated, without prejudice to the reimbursement of expenses incurred, within the limits provided for employed personnel, which shall be borne by the regional healthcare enterprise within which the Commission is established.”

The subsequent Article 4 sets out the phases of the procedure for verifying the requirements for access to medically assisted suicide, set forth as follows:

"1. The procedure for verifying the possession of the requirements referred to in Article 2, paragraph 1, shall be concluded within the overall term of thirty days from the submission of the application by the interested person to the territorially competent healthcare enterprise. The term may be suspended only once, for a period not exceeding five days, for any further verifications.

2. The application referred to in paragraph 1 shall be accompanied by the medical documentation necessary for the verification of the requirements referred to in Article 2, paragraph 1, by the Commission.

3. Within five days from the submission of the application referred to in paragraph 1, the territorially competent healthcare enterprise shall convene the Permanent Multidisciplinary Commission referred to in Article 3, paragraph 1, for the performance of the verification of the possession of the requirements for access to medically assisted suicide.

4. The Commission shall ensure personal and direct dialogue with the applicant. The Commission shall preliminarily verify that the applicant has received clear and adequate information on the possibility of accessing a pathway of palliative care, including continuous deep palliative sedation, as well as on their right to refuse or revoke consent to any medical treatment, including life-support treatment, pursuant to Law No. 219 of 2017.

5. In the event of refusal of palliative care and any other practicable solution in accordance with the provisions of Law No. 219 of 2017, if the applicant confirms the intention to access medically assisted suicide, the Commission shall proceed to verify the requirements. To this end, the Commission shall examine the documentation produced and carry out any necessary verifications, including with the support of the structures of the regional health service, having consulted the trusted physician possibly indicated by the person themselves. The expression of will concerning access to medically assisted suicide must be expressed in a free and informed manner and shall be acquired and documented in accordance with the provisions of Article 1, paragraph 4, of Law No. 219 of 2017.

6. The Commission shall also define the methods to ensure that persons possessing the requirements referred to in Article 2, paragraph 1, who are interested in accessing medically assisted suicide, experience an end of life that is as painless and dignified as possible.

7. The Commission shall perform the duties referred to in paragraphs 4, 5, and 6 within the term of ten days from convocation by the healthcare enterprise. Within the same term, the Commission shall transmit the outcome of the verifications carried out and the determinations adopted regarding the methods of implementing medically assisted suicide to the territorially competent ethics committee, which shall have ten days to transmit its opinion to the Commission.

8. Within three days from the acquisition of the ethics committee’s opinion, the Commission shall draw up the final report on the outcomes of the verification of the existence of the requirements for access to the treatment relating to medically assisted suicide. Within the subsequent two days, the enterprise shall communicate to the interested person the findings of the requirement verification procedure and, in the event of a positive outcome of the verification, the methods for the provision of the medically assisted suicide treatment.

9. The interested party may proceed to request the provision of the medically assisted suicide treatment within seven days from the communication by the healthcare enterprise of the positive outcome of the verification procedure. The request shall be made in the manners and according to the forms provided for by Article 1, paragraph 4, of Law No. 219 of 2017.

10. The self-administration procedure referred to in Article 5 shall take place within the term of seven days from the request for the provision of the medically assisted suicide treatment.

11. In the event of a negative outcome of the verification procedure, it shall be possible to submit a new application for access to medically assisted suicide following a change in the conditions of the subject concerned.

12. A person possessing the requirements who is authorized to access medically assisted suicide may decide at any time to suspend or cancel the provision of the treatment. In such cases, the relative expression of will shall be acquired in the manners and according to the forms provided for by Article 1, paragraph 4, of Law No. 219 of 2017.”

Article 5 is dedicated to the "[m]ethods of implementation” of assisted suicide, pursuant to which "[t]he regional healthcare enterprises shall provide technical and pharmacological support and medical assistance for the preparation of the self-administration of the authorized drug at a hospital facility, hospice, or, if requested, at home. Assistance shall be provided by healthcare personnel on a voluntary basis and shall be considered an institutional activity to be carried out during working hours.”

The remaining provisions of the challenged regional law enshrine the gratuitous nature of the services and treatments provided thereunder (Article 6), quantify and cover the charges deriving from the aforementioned Article 5 (Article 7), provide for the clause of yielding of the regional law’s provisions "[w]ith effect from the entry into force of state regulations on the matter” (Article 8), and regulate the entry into force (Article 9).

1.2.– The first ground of recourse alleges the violation, by the entirety of Reg. Law of Sardinia No. 26 of 2025 and Article 1 thereof, of Article 117, second paragraph, letter l), of the Constitution, concerning the matter of "civil and criminal jurisdiction,” and, in the alternative, of Article 117, third paragraph, of the Constitution, with reference to the matter of "protection of health,” as well as Articles 3 and 4 of the Special Statute.

According to the appellant, the regulation of medically assisted suicide falls within the matter referred to in the aforementioned second paragraph, letter l), of Article 117 of the Constitution, reserved to the exclusive legislative competence of the State, as it impacts highly personal rights such as the right to life and physical integrity. By addressing the prerequisites and execution methods for rendering assistance to suicide non-punishable, such regulation outlines a "legal institution which, on the one hand, innovates civil law and, on the other hand, finds direct application within the sphere of criminal law.”

The intervention of the regional legislator would therefore be prohibited, as "[a]ll the subjects impacted and the principles underlying the matter in question” must be traced back to the exclusive State competence in the matter of civil and criminal jurisdiction, with respect to which there is an "evident need for uniformity and homogeneity of regulation throughout the national territory that only the intervention of the state legislator can ensure.”

On the other hand, to exclude that regions may be assigned "a ‘substitute’ role with respect to the state legislator,” the State Attorney General’s Office recalls Judgment No. 262 of 2016, by which this Court declared the constitutional illegitimacy of the provisions of the Autonomous Region of Friuli-Venezia Giulia concerning advance health treatment directives, affirming that the absence of specific national legislation "does not in any way justify the interference of regional legislation in a matter entrusted exclusively to the competence of the State.”

Furthermore, the regulation of the substantive and procedural conditions that exonerate assistance to a third party’s suicide from criminal liability, as well as that of the methods for verifying the existence of the prerequisites legitimizing the act, cannot fall within the concurrent legislative competence of "protection of health” referred to in Article 117, third paragraph, of the Constitution, nor within that of "hygiene and public health” referred to in Article 4 of the Special Statute, since "the serious impairment of health is merely a concrete antecedent that exonerates [...] otherwise criminally sanctioned conduct; and the medical verification of the prerequisites for access to medically assisted suicide is merely the methodological assessment of the prerequisites deemed indispensable.”

In any event, even assuming that "some aspects relating to the exemption from criminal liability” of assistance to suicide pertain to the matter of the protection of health, the fact remains that, pursuant to the aforementioned Article 117, third paragraph, of the Constitution, the determination of fundamental principles is reserved to state legislation, thereby precluding regions from the possibility "of intervening without the prior provision of those fundamental principles,” both because these depend on the civil and criminal law framework of the institution, and to avoid the outcome whereby it is recognized "in a disparate manner across the national territory.” Consequently, "any ‘supplementary’ or ‘substitutive’ regional legislative activity” in the absence of fundamental principles would invade the state reserve in setting them (reference is made to Judgment No. 438 of 2008 of this Court).

From this perspective, Article 1 of the regional law would be "tainted by the constitutional violations in question, even considered individually,” as it—by explicitly stating the law’s purpose of defining "timelines and organizational methods for the provision” of medically assisted suicide treatments—would essentially intend to "prepare the operational tools so that a ground of non-punibility can operate,” moreover only on a part of the national territory, "thus giving substance to a disparity in treatment between citizens that the legal system cannot permit.”

The same outcome should likewise be reached were the attribution provided by Article 4, letter i), of the Special Statute, concerning "hygiene and public health,” to be considered "pertinent and prevalent,” since this too concerns a concurrent legislative competence, with respect to which "there is a lack of prior and necessary determination, by state legislation, of the fundamental principles of the matter.” Hence, there is also a violation of the Special Statute, under Articles 3 and 4, which do not attribute to the Autonomous Region of Sardinia legislative competencies in any of the matters reserved to the exclusive legislative competence of the State.

1.3.– The second ground of recourse alleges the violation, by the entirety of the regional law and, more specifically, by Articles 2, 6, and 7 thereof, of the exclusive state legislative competence concerning the determination of the essential levels of services concerning civil and social rights, pursuant to Article 117, second paragraph, letter m), of the Constitution.

The State Attorney’s Office argues that only state law has the competence to regulate medically assisted suicide, as it is an institution affecting the right to life, which is "the primary civil right guaranteed by the Constitution.” Nor can the exclusivity of state legislative competence "be evaded” by the qualification—derivable from the financial coverage provision of the challenged Article 7—of the services and treatments provided at the expense of regional healthcare enterprises as a level of assistance superior to the essential ones.

On the other hand, constitutional jurisprudence itself, besides failing to affirm "the existence of a ‘right’ to suicide, as a service guaranteed by state legislation,” while limiting itself to fixing the cases of operativeness of the justification for conduct assisting suicide, has auspicated legislative intervention on the matter, addressing itself moreover "solely and exclusively to the national legislator.” Regions therefore cannot "modify, limit, or condition the essential levels of services [...] and, specifically, regulate cases and procedures in which the right to life is disposed of.”

In any event, the aforementioned approach of the regional law, aimed at considering the services introduced as additional services compared to the essential levels provided by state law, would be erroneous because "the state legislator has not fixed any minimum level of service to be guaranteed.” The regional law would thus end up "independently disposing of the aforementioned service levels,” in contrast with the requirements of "indispensable homogeneity at the national level of regulations concerning the ‘end of life’.”

Nor can the aforementioned minimum levels be derived from Judgments No. 242 of 2019 and No. 135 of 2024 of this Court, to which should not be attributed "a scope that does not belong to them, and which they have indeed expressly excluded,” auspicated prompt and comprehensive regulation of the matter by the legislator.

Finally, regional law could not in any case carry out the "structural and organizational interventions” necessary for the performance of the activities of ascertaining the conditions for access to medically assisted suicide by the entities of the National Health Service, within the terms identified by this Court. This is because "choices that are anything but merely organizational are implicated, but rather choices capable of directly impacting the right to life,” which therefore fall within the exclusive competence of the state legislator.

The State Attorney’s Office further notes that "in favor of regional regulation of the ‘end of life’,” the applicability of the "principle of ‘inverted yielding’ [...] in the face of the inertia of the state legislator,” as provided for by the challenged regional law in Article 8, does not argue.

Indeed, recalling Judgments No. 1 of 2019 and No. 398 of 2006 of this Court, the state defense observes that "regulatory yielding” may be provided by regions in matters of their own legislative competence, whereas it is not permitted with regard to aspects pertaining to the exclusive competence of the state legislator.

On the other hand, the precepts laid down by the pronouncements of this Court in the matter of medically assisted suicide do not require a regional law to be rendered immediately operational, as is confirmed by the fact that in some cases they have already been applied.

For the considerations set forth, Article 117, second paragraph, letter m), of the Constitution is violated both by Reg. Law of Sardinia No. 26 of 2025 as a whole and by Articles 2, 6, and 7, considered individually, as the former regulates the requirements for access to medically assisted suicide, and the other two, in combination with each other, regulate the gratuitousness of the services and the coverage of the burdens for their implementation.

1.4.– Finally, in the alternative with respect to the first two grounds of recourse, Articles 3 and 4 of Reg. Law of Sardinia No. 26 of 2025 are challenged—for their alleged contrast with all the constitutional and statutory parameters examined up to this point—which respectively establish a permanent multidisciplinary commission within each regional healthcare enterprise for the verification of the existence of the requirements for access to medically assisted suicide and regulate the related verification procedure.

The appellant argues that tasks and functions relating to "rights and claims enforceable against the NHS not provided [...] and in any case not yet regulated by any state law provision” are attributed to such a commission.

In this regard, the state defense recalls that Judgment No. 242 of 2019 of this Court deemed it necessary, pending intervention by the legislator, to involve specific ethics committees for the purpose of expressing an opinion on the conditions of persons requesting access to medically assisted suicide, identifying them as those established pursuant to the Decree of the Minister of Health of February 8, 2013 (Criteria for the composition and functioning of ethics committees), implementing Article 12, paragraph 10, of Decree-Law No. 158 of September 13, 2012 (Urgent provisions to promote the country’s development through a higher level of health protection), converted, with amendments, into Law No. 189 of November 8, 2012.

Following the amendments that have intervened, the regulation of such territorial ethics committees is today dictated by the decrees of the Minister of Health of January 26, 2023 (Identification of forty territorial ethics committees) and January 30, 2023 (Definition of criteria for the composition and functioning of territorial ethics committees), implementing Article 2, paragraph 7, of Law No. 3 of January 11, 2018 (Delegation to the Government regarding clinical trials of medicinal products as well as provisions for the reorganization of health professions and health management of the Ministry of Health).

In the appellant’s opinion, these ethics committees would be the only bodies competent to render any evaluations requested by the aforementioned judgment of this Court, relevant for the purpose of the non-punibility of conduct assisting suicide.

Instead, the challenged provisions would attribute to the established multidisciplinary commission tasks and functions "destined to overlap with the competencies indisputably reserved by state law” to the aforementioned territorial ethics committees, thus conflicting with the exclusive state legislative competence in the matter of "civil and criminal jurisdiction,” pursuant to Article 117, second paragraph, letter l), of the Constitution, in relation to the aforementioned Article 2, paragraph 7, of Law No. 3 of 2018.

They would also violate the exclusive state legislative competence in the matter referred to in letter m) of the aforementioned second paragraph of Article 117 of the Constitution, in relation to Article 1, paragraphs 556, 557, and 558, of Law No. 208 of December 28, 2015, bearing "Provisions for the formation of the annual and multi-year state budget (Stability Law 2016),” which regulates the methods, necessarily shared between the State and the regions, for defining and updating the essential levels of assistance.

In support of the censure, the recourse observes that Article 3 of Reg. Law of Sardinia No. 26 of 2025 does not clarify the "decisive profile” of whether the multidisciplinary commission must express itself unanimously or by majority, and provides for a composition thereof that is "radically different” from that fixed by state provisions.

Similarly, Article 4, paragraph 7, does not specify the nature of the opinion that the territorially competent ethics committee must render to the multidisciplinary commission, as it might even be considered that "such opinion may be dispensed with if it is not rendered” within the term of ten days from the transmission of the request. These elements would emerge to show how purportedly organizational choices would instead entail decisions of general scope regarding the connotation of the legal institution of medically assisted suicide.

Furthermore, the provision of paragraph 1 of the same Article 4—which entrusts the initiation of the procedure to an "application by the interested person,” not further specified in its characteristics of content and form—would conflict with the competence in the matter of civil jurisdiction, thereby rendering uncertain the relationship with the much more precise forms dictated by Law No. 219 of 2017 for acquiring consent to a medical treatment.

Equally "doubtful” would be the fact that the regulation of the content and form of the "extremely significant prerogative of the interested party” to suspend or cancel the provision of the treatment, provided for by Article 4, paragraph 12, is dictated by a mere cross-reference to Article 1, paragraph 4, of Law No. 219 of 2017, since this would concern informed consent to a medical treatment of "much less important, delicate, and invasive content than a procedure” such as the suspension or cancellation of the execution of medically assisted suicide.

2.– The Autonomous Region of Sardinia has entered an appearance in the proceedings, asking that the questions of constitutional legitimacy raised by the Government be declared inadmissible or unfounded.

It premises that it adopted the challenged regional law to define the prerequisites for an individual’s access to medically assisted suicide, "for the purpose of conforming to the indications that constitutional jurisprudence has attributed to healthcare enterprises in the matter in question.”

2.1.– Regarding the first ground of challenge, the regional defense objects that the violation of Article 117 of the Constitution is contested without an adequate comparison with the provisions of the Special Statute to be taken as a parameter.

Furthermore, the censures would lack argumentative depth and adequate supporting motivation, proving inadmissible as they are formulated in a generic and assertive manner (reference is made to Judgment No. 255 of 2022 of this Court).

In any event, the regulation laid down by the challenged regional law, "far from falling within the matter of ‘civil jurisdiction,’ of exclusive legislative competence of the State, [would] rather fall within the matter of ‘protection of health,’ of concurrent legislative competence.” Regional legislative intervention would therefore be possible "above all, but not only,” in the absence of state intervention, which has defaulted on the requests contained in Order No. 207 of 2018 and Judgment No. 242 of 2019 of this Court.

2.2.– The second ground of challenge would likewise present profiles of inadmissibility and unfoundation.

The premise that Reg. Law of Sardinia No. 26 of 2025 recognizes "an unprecedented ‘right’ in our legal system and never recognized by the national legislator” would be erroneous, it being true rather that it merely values the patient’s freedom of choice, enshrined and recognized in its fundamental aspects by Judgment No. 242 of 2019.

Furthermore, the absence of service levels fixed by the State would not preclude the Region’s possibility of choosing to provide such a service because, on the one hand, constitutional jurisprudence allows regions to extend assistance using their own resources; on the other hand, the Autonomous Region of Sardinia fully finances its own healthcare, pursuant to Article 1, paragraphs 834 to 840, of Law No. 296 of December 27, 2006, bearing "Provisions for the formation of the annual and multi-year state budget (Financial Law 2007).”

2.3.– The regional defense also deems the third ground of recourse inadmissible and in any case unfounded, as regional legislative intervention falls within the concurrent competence in the matter of "protection of health,” without encroaching upon state prerogatives.

Furthermore, "some censures” would appear generic, failing to specifically account for the reasons for the potential impact of the challenged provisions "on the definition of the right in question, with the consequence that there [would be] no demonstration of the unreasonableness of the challenged regulations and the unfoundation of the censures.”

3.– Two opinions have been filed in the proceedings, pursuant to Article 6 of the Supplementary Rules for Proceedings before the Constitutional Court, by the "Scienza & Vita” Study Centre and the "Family Day-Difendiamo i nostri figli APS” Association, admitted by Presidential Decree of April 24, 2026.

Arguing in favor of the foundation of the raised questions, the opinions premise that Reg. Law of Sardinia No. 26 of 2025 presupposes the existence of a right to death vested in the individual, which is not in fact recognized by the aforementioned Judgment No. 242 of 2019; moreover, the regulation of the end of life cannot fall within the competence of the regional legislator, concerning instead criminal and civil jurisdiction, which fall within the purview of the state legislator.

In this regard, the Study Centre’s opinion, recalling Judgment No. 204 of 2025 of this Court, considers that the Sardinian regional law, by providing for a right to gratuitous assisted suicide services, has regulated rights not yet recognized in state legislation, thereby creating a situation similar to that in relation to which Judgment No. 262 of 2016 of this Court declared constitutionally illegitimate regional provisions anticipating state regulation.

Furthermore, both opinions contest that medically assisted suicide falls within the matter of "protection of health,” of concurrent legislative competence, as it cannot be considered a medical practice or act, nor is it possible for the notion of health, under Article 32 of the Constitution, to come to include that of death.

Finally, recalling data on the coverage of the need for palliative care in Italian regions, which would place Sardinia among those with the lowest percentage, the Study Centre’s opinion considers that the absolute priority of regional health policies regarding the end of life should be that of providing relief from pain "with total, simultaneous, and early care for the patient and the caregiver,” recalling on this point the statement of Judgment No. 204 of 2025 on the person’s right "to be treated effectively, according to the canons of science and the medical art, also through the concrete provision of effective palliative care.”

4.– Close to the public hearing, the respondent Region filed a brief, extensively recalling Judgment No. 204 of 2025, by which this Court decided the questions of constitutional legitimacy of Tuscany Region Law No. 16 of March 14, 2025 (Organizational methods for the implementation of Constitutional Court Judgments 242/2019 and 135/2024), brought by the President of the Council of Ministers.

As there appears to be both "a certain correspondence of contents” between the provisions of the Tuscan law and those of Reg. Law of Sardinia No. 26 of 2025, and "an identity of the criticisms” formulated in the state recourses, the regional defense considers first of all that "the conclusions on the constitutional legitimacy” of the Tuscan law, reached by Judgment No. 204 of 2025, can be "extended” to the law under examination.

On the other hand, the brief points out the "significant differences” that the challenged Article 2 presents compared to the provision of Article 2 of Tuscany Reg. Law No. 16 of 2025, which was declared constitutionally illegitimate. While the latter indicated the requirements for access to medically assisted suicide by operating "a so-called ‘fixed’ cross-reference” to Judgments No. 242 of 2019 and No. 135 of 2024 of this Court, "the analogous Article 2” of the Sardinian law, by making "a [...] ‘mobile’ cross-reference” to constitutional jurisprudence, "does not produce the effect of defining and crystallizing in regional legislation, rigidifying them once and for all, the requirements for access to assisted suicide, as the rule follows the evolution of the Court’s jurisprudence and adapts to it”; therefore, the violation of state legislative competence under Article 117, second paragraph, letter l), of the Constitution, in the matter of civil and criminal jurisdiction, must be ruled out.

As for Article 4 of Reg. Law of Sardinia No. 26 of 2025—which regulates the procedures for verifying the requirements for access to assisted suicide and for determining the relative methods of implementation—the regional defense does not consider discernible the profiles that led to the declaration of constitutional illegitimacy of specific contents of Articles 5 and 6 of Tuscany Reg. Law No. 16 of 2025.

The challenged provision, by setting out the verification procedure and its phases, would indicate "only the operational methods of the assisted suicide procedure without violating the balancing” of the principles identified by Judgment No. 204 of 2025, namely, on the one hand, the duty to protect human life deriving from Article 2 of the Constitution and, on the other hand, patient autonomy in decisions involving one’s own body.

In this regard, the regional defense highlights that the request to initiate the procedure occurs "always after a long reflection” by the interested party, who "is no longer able to endure further years of physical and psychological suffering caused by a totally disabling illness.” Therefore, "unduly dilating the temporal level of the procedure [...] by establishing much longer terms than those provided for in the law under examination, would in fact determine further suffering for the applicant who could remain in a limbo for a very long period.”

Furthermore, while the provisions of the Tuscany Region law, as noted by Judgment No. 204 of 2025, overlooked the need for careful medical verification of the existence of the requirements for access to medically assisted suicide, the challenged regional law has "adequately regulated” this aspect by establishing "a multidisciplinary medical commission, composed of various professionals, capable of making such assessments.”

In particular, pursuant to Article 4 of Reg. Law of Sardinia No. 26 of 2025, the commission is required to ensure direct dialogue with the applicant, preliminarily verifying that they have received clear and adequate information on the possibility of accessing a pathway of palliative care, including deep palliative sedation, as well as on their right to refuse or revoke consent to any medical treatment. Only if such a pathway is refused does the commission proceed to further verifications.

In any event, "the temporal sequence” indicated by the provision in question pertains to concurrent legislative competence in the matter of the protection of health and does not violate exclusive state legislative competence.

Considered in Law

5.– By the recourse indicated in the heading (Reg. Rec. No. 43 of 2025), the President of the Council of Ministers challenged the entirety of Reg. Law of Sardinia No. 26 of 2025, and more specifically a series of provisions thereof, alleging overall conflict with Article 117, second paragraph, letters l) and m), and third paragraph, of the Constitution—the latter with reference to the matter of the protection of health—or, alternatively, with Articles 3 and 4, letter i), of the Special Statute, with reference to the matter of hygiene and public health.

The challenged regional law, the contents of which are analytically illustrated in point 1, is entitled "Procedures and timelines for regional healthcare assistance for medically assisted suicide pursuant to and as a result of Constitutional Court Judgment No. 242 of 2019.” According to the appellant:

– firstly, the regional law as a whole, and notably Article 1 thereof, invades the exclusive legislative competence of the State in the matter of civil and criminal jurisdiction pursuant to Article 117, second paragraph, letter l), of the Constitution, and in any case—in the alternative—the concurrent state legislative competence in the matter of the protection of health pursuant to Article 117, third paragraph, of the Constitution, or alternatively transgresses the limits to which the issuance of legislative norms by the Region in the matter of hygiene and public health is subject pursuant to Article 4, letter i), of the Special Statute, it being precluded for regions to intervene by law in such matters where state law has not provided for the determination of fundamental principles;

– secondly, the regional law as a whole, and notably Articles 2, 6, and 7 thereof—which regulate, respectively, the requirements for access to medically assisted suicide, and the other two, in combination with each other, the gratuitousness of the services and the coverage of the charges for their implementation—invade the exclusive legislative competence of墓 the State in the matter of determining the essential levels of services pursuant to Article 117, second paragraph, letter m), of the Constitution;

– finally, and in the alternative, Articles 3 and 4 of the challenged regional law, to the extent that they establish and regulate the permanent multidisciplinary commission and provide for the consultative role of the territorial ethics committee, invade the exclusive legislative competence of the State in the matter of civil jurisdiction pursuant to Article 117, second paragraph, letter l), of the Constitution, in relation to the interposed parameter represented by Article 2, paragraph 7, of Law No. 3 of 2018, which dictates the regulation of ethics committees, as well as the exclusive legislative competence of the State in the matter of determining the essential levels of services pursuant to Article 117, second paragraph, letter m), of the Constitution, in relation to the interposed parameter referred to in Article 1, paragraphs 556, 557, and 558, of Law No. 208 of 2015; these latter provisions regulate "the methods, necessarily shared between the State and the Regions, for defining and updating the essential levels of healthcare assistance.” The same regional provisions would also violate the aforementioned concurrent legislative competence titles referred to in Article 117, third paragraph, of the Constitution or Articles 3 and 4 of the Special Statute.

6.– Preliminarily, the objection of inadmissibility raised by the regional defense—according to which the violation of Article 117 of the Constitution is contested without an adequate comparison with the provisions of the Special Statute to be taken as a parameter—must be dismissed.

In this case, the grounds of recourse attribute the entire regional law and the individual specifically challenged provisions to areas of exclusive state legislative competence, considering that the Special Statute does not attribute competencies in these matters to the Autonomous Region of Sardinia.

The principle constantly affirmed by this Court in proceedings where the law of a special-autonomy Region is challenged therefore finds application, whereby the appellant may well "postulate that the challenged regional or provincial legislation exceeds its statutory competencies when it is in no way attributable to the latter” (Judgment No. 39 of 2022, point 2.2. of the Law Considered and prior precedents cited therein).

The objection is also unfounded when considering the violation of Article 117, third paragraph, of the Constitution, alleged, in the alternative, with reference to the concurrent competence in the matter of the protection of health, since, contrary to what the respondent assumes, the recourse engages with the provisions of the Special Statute, so much so as to assert their violation in any case should the matter of "hygiene and public health,” provided for therein under Article 4, first paragraph, letter i), be considered "pertinent and prevalent” in this case, as it remains a concurrent competence to be exercised within the limits of "the principles established by the laws of the State,” in addition to those referred to in the preceding Article 3.

6.1.– Equally unfounded is the objection of inadmissibility of the state censures on the grounds that they were formulated in a generic and assertive manner.

In reality, the grounds of challenge adequately argue the reasons that would lead to ascribing the provisions of the regional law to the areas of exclusive state legislative competence whose invasion is alleged, and also illustrate why, alternatively, the state reserve in determining the fundamental principles of the concurrent matter of the protection of health would be violated.

This allows the threshold of admissibility of the raised questions to be deemed passed, leaving the verification of the foundation or otherwise of the reasons adduced in their support to the examination on the merits.

7.– On the merits, it is appropriate to premise that the state recourse was filed prior to the publication of Judgment No. 204 of 2025, by which this Court scrutinized the constitutional legitimacy of Tuscany Reg. Law No. 16 of 2025, responding to substantially analogous state censures. Reference will therefore be made to that pronouncement.

First of all, the first two grounds of recourse can be examined jointly, by which the President of the Council of Ministers challenges the entire regional law, alleging, principally, the invasion of exclusive state legislative competence in the matters of "civil and criminal jurisdiction” and "determination of essential levels of services,” as well as, alternatively, concurrent state legislative competence in the matter of the protection of health, or, in any case, that in the matter of "hygiene and public health,” pursuant to Articles 3 and 4, letter i), of the Special Statute, because the region intervened in a sphere where state law had not yet determined the fundamental principles.

7.1.– First and foremost, the censure leveled against the entire regional law alleging violation of exclusive state legislative competence in the matter of criminal jurisdiction is unfounded.

The challenged regional law as a whole, except for what will be said infra (point 10), produces no encroachment upon the evoked competence in criminal matters, as it does not modify at all the area of non-punibility of conduct abstractly subsumable under the criminal offense of incitement or assistance to suicide referred to in Article 580 of the Criminal Code, which remains, in fact, that determined by "Judgment No. 242 of 2019, which in its operative part identified six requirements—four substantive and two procedural—in the presence of which the application of the criminal norm would produce a result incompatible with the Constitution” (Judgment No. 204 of 2025, point 2.4. of the Law Considered).

7.2.– Nor does the alleged violation by the regional law as a whole of the exclusive state competence in the matter of civil jurisdiction subsist.

In the same terms clarified in Judgment No. 204 of 2025, it must be considered that Reg. Law of Sardinia No. 26 of 2025 does not operate in a situation of "regulatory vacuum,” since "state law already punctually regulates the possibility and methods of renunciation or refusal by the patient of medical treatments necessary for survival (Articles 1 and 2 of Law No. 219 of 2017); and precisely such regulation was extended by this Court, in Judgment No. 242 of 2019, to the medicalized procedure of assistance to suicide.” Therefore, the regional law "declaredly aims to regulate in detail the methods for the implementation of guarantees and procedures, whose essential traits—uniform throughout the national territory—are already found [...] in the current legal system in light of the judgments of this Court No. 242 of 2019 and No. 135 of 2024” (Judgment No. 204 of 2025, point 2.5. of the Law Considered).

7.3.– Similar considerations lead to the rejection of the further censure of violation of exclusive state legislative competence in the matter of determining the essential levels of services.

Just like the cited Tuscan law, indeed, the challenged Sardinian regional law as a whole also "regulates the activity that the regional health service is required to perform according to the current legal system, as shaped by the systemic principles enunciated by the aforementioned judgments of this Court. From this perspective, it therefore introduces no new essential level of assistance, nor does it modify the corresponding state regulation” (Judgment No. 204 of 2025, point 2.6. of the Law Considered).

7.4.– As for the censure concerning the failure of state legislation to provide fundamental principles in the matter of the protection of health or hygiene and public health, it must be considered that the regional law limits itself to regulating the activity of local health enterprises.

From this perspective, it pertains to the matter of the protection of health, which is the subject of concurrent legislative competence pursuant to Article 117, third paragraph, of the Constitution, given that in this sphere the statutory competencies of the Autonomous Region of Sardinia with reference to the matter of hygiene and public health are, in any case, "less broad than those identified by the constitutional text (Judgment No. 231 of 2017)” (ex plurimis, Judgment No. 209 of 2021, point 3.1. of the Law Considered).

In this regard, the recourse fails to consider that "the fundamental principles of the matter relating to the regulation of access procedures to medically assisted suicide can be inferred from the current state legislation, read in light of the judgments of this Court.

In particular, the following are relevant here:

– Articles 1 and 2 of Law No. 219 of 2017, which regulate the method of refusal and interruption of life-support treatments, and which were used by Judgment of this Court No. 242 of 2019 as reference points already present in the current legislation for the purpose of configuring the medicalized procedure for assessing the request for assisted suicide, pending the auspicated intervention of the state legislator;

– Law No. 38 of March 15, 2010 (Provisions to guarantee access to palliative care and pain therapy), which protects and guarantees access to palliative care and pain therapy by the sick person by including them within the essential levels of assistance, and which was likewise recalled by the aforementioned Judgment No. 242 of 2019 and subsequent Judgments No. 135 of 2024 and No. 66 of 2025 in order to emphasize the mandatory and effective provision of such services;

– Article 14, third paragraph, letter q), of Law No. 833 of December 23, 1978 (Establishment of the National Health Service), pursuant to which local health unit enterprises provide, inter alia, for "verifications, certifications, and any other medico-legal service belonging to the national health service”: assessments, prescriptions, and services among which are those necessary, according to the judgments of this Court, within the framework of the medicalized procedure of assistance to suicide” (Judgment No. 204 of 2025, point 2.2. of the Law Considered).

Therefore, contrary to what is claimed in the state recourse, the exercise of concurrent competence in this sphere cannot in itself be deemed precluded to the regional legislator by the circumstance that the State has not yet proceeded, despite the numerous invitations formulated by this Court, to approve a law regulating access to the medicalized procedure of assistance to suicide in an organic manner throughout the national territory.

8.– Having clarified the unfoundation of all censures directed against the entire regional law, its individual provisions must now be analytically examined—as was done in Judgment No. 204 of 2025—in order to verify whether any of them actually incurs the vices alleged by the appellant.

9.– Article 1 evades all the censures formulated by the appellant, as it simply states the purpose of providing detailed operational indications to the regional health service in order to ensure assistance to persons finding themselves in the conditions indicated by Judgment No. 242 of 2019.

10.– A different conclusion must instead be reached regarding Article 2 of the challenged regional law, which, in paragraph 1, admits to the services and treatments provided therein "persons possessing the requirements indicated by the jurisprudence of the Constitutional Court” and, in paragraph 2, provides that such requirements "are subject to verification carried out pursuant to Articles 3 and 4.”

The provision of paragraph 1, although formulated in a partially different manner from that which was the subject of Judgment No. 204 of 2025, nevertheless conflicts with Article 117, second paragraph, letter l), of the Constitution, with reference to exclusive state legislative competence in the matter of civil and criminal jurisdiction.

The reference to "constitutional jurisprudence,” upon closer inspection, far from being generic, is certainly referred to Judgment No. 242 of 2019, mentioned both in the title of the challenged regional law and in Article 1, and, in any case, is suitable to attract also subsequent pronouncements in which clarifications of the requirements for access to medically assisted suicide have been provided, such as Judgment No. 135 of 2024 and the most recent No. 66 of 2025.

This Court has clarified that "Judgments No. 242 of 2019 and No. 135 of 2024, by defining the scope of application of the ground of non-punibility for assistance to suicide and enunciating its access requirements, have innovated civil and criminal law,” whereby regional laws’ reference to their own judgments "effects a novation of the systemic principles contained therein, which produces the effect of defining within regional legislation, rigidifying them, the requirements for access to assisted suicide and, indirectly, the contours of the exemption to Article 580 of the Criminal Code as identified by the judgments of this Court” (Judgment No. 204 of 2025, point 4 of the Law Considered).

From this point of view, regional legislation, in relation to the "delicate balances” concerning medically assisted suicide, "cannot pretend to act supplementarily to state legislation, not even on a transitory basis, so to speak ‘taking possession’ of the systemic principles identified by this Court,” crystallizing them in its own provisions (Judgment No. 204 of 2025, point 4 of the Law Considered).

Article 2, paragraph 1, of the challenged regional law must therefore be declared constitutionally illegitimate for violation of Article 117, second paragraph, letter l), of the Constitution, with the remaining censures absorbed.

10.1.– For the same reasons, constitutional illegitimacy must also be declared regarding:

a) the subsequent paragraph 2 of Article 2, to the extent that it refers to requirements "referred to in paragraph 1,” rather than "for access to medically assisted suicide”;

b) Article 3, paragraph 1, to the extent that it refers to requirements "referred to in Article 2, paragraph 1,” rather than "for access to medically assisted suicide,” and Article 4, paragraphs 2 and 6, to the extent that they refer to requirements "referred to in Article 2, paragraph 1,” rather than "for access to medically assisted suicide.”

11.– Article 3, except for paragraph 1, to the extent indicated supra, point 10.1., b), of the challenged regional law is instead immune from all the censures brought forward.

The provision provides for the establishment, at local health enterprises, of permanent multidisciplinary commissions tasked with examining the existence of the requirements for access to medically assisted suicide and, pursuant to the subsequent Article 4, verifying or defining the relative methods of implementation.

In these terms, "the challenged provisions do not pertain to the exclusive state competencies evoked by the appellant, but are configured as organizational provisions, attributable to detailed regulation in the matter of the protection of health, and thus of regional competence as they implement fundamental principles which, also in light of the judgments of this Court No. 242 of 2019 and No. 135 of 2024, the Region was able to infer from various state laws governing specific assessment activities” (Judgment No. 204 of 2025, point 5 of the Law Considered).

Moreover, the regional provision, in paragraph 3, provides for participation in the commission on a voluntary basis, in coherence with this Court’s statement on the non-existence of "an obligation to proceed with assisted suicide on the part of physicians, leaving it to ‘the conscience of the individual physician to choose whether to lend themselves, or not, to fulfilling the patient’s request’ (Judgment No. 242 of 2019, point 6 of the Law Considered)” (thus, once again, the cited Judgment No. 204 of 2025, point 5 of the Law Considered).

12.– Article 4 of Reg. Law of Sardinia No. 26 of 2025 intended to regulate the procedure for verifying the possession of requirements for access to medically assisted suicide, governing the duties that the multidisciplinary commission is required to perform and also providing for the necessary acquisition of the territorial ethics committee’s opinion.

However, specific provisions set stringent terms for carrying out the entire procedure and individual phases.

In particular, paragraph 1 establishes thirty days as the term for concluding the entire procedure for verifying the requirements for access to medically assisted suicide and permits only one suspension, limited to no more than five days, for any further verifications.

Paragraph 7 provides a term of ten days both for the performance by the multidisciplinary commission of all duties incumbent upon it and for the involvement of the territorial ethics committee, and for the expression of the opinion by the latter.

Paragraph 8 provides, in the first period, that within three days from acquiring the ethics committee’s opinion, the commission shall draw up the final report on the outcomes of verifying the existence of the requirements for access to the treatment relating to medically assisted suicide.

Paragraph 9, first period, fixes at seven days, from the communication by the healthcare enterprise of the positive outcome of the verification procedure, the term for the interested party to request the provision of the medically assisted suicide treatment.

12.1.– The regulatory fragments now recalled violate exclusive state legislative competence in the matter of civil jurisdiction pursuant to Article 117, second paragraph, letter l), of the Constitution and concurrent state competence relating to the determination of fundamental principles in the matter of the protection of health pursuant to Article 117, third paragraph, of the Constitution.

With reference to the first parameter, it must be noted that such sequences of terms involve choices that "require ‘uniformity of treatment across the national territory’” (Judgment No. 204 of 2025, point 7.1. of the Law Considered).

Regarding the second parameter, it must be considered that these stringent provisions "overlook the fact that accompanying requests for access to medically assisted suicide necessarily requires careful medical verification of the existence of the relative requirements, both from the perspective of the interested party’s health condition and from that of the formation of will in a free and autonomous manner. Without prejudice to the need for prompt taking-in-charge of the applicant’s request, the possibility of carrying out all those clinical and diagnostic investigations that the Commission—multidisciplinary and involving various competencies (including psychiatric, palliative, psychological, medico-legal, etc.)—deems appropriate must therefore always be permitted, potentially also adopting interlocutory decisions, which may require verification times incompatible with the stringent terms fixed by the challenged provisions” (Judgment No. 204 of 2025, in the aforementioned point 7.1. of the Law Considered).

It is also appropriate to reiterate that the fundamental principles inferable from Law No. 219 of 2017 itself value and promote "the so-called therapeutic alliance,” which stands between the protection of a person’s self-determination "and their right to be treated effectively, according to the canons of science and the medical art, also through the concrete provision of effective palliative care” (Judgment No. 204 of 2025, point 7.1. of the Law Considered).

12.2.– Consequently, the following paragraphs of Article 4 must be declared constitutionally illegitimate, for violation of Article 117, second paragraph, letter l), of the Constitution, with reference to the matter of "civil jurisdiction,” and of Article 117, third paragraph, of the Constitution, with reference to the matter of "protection of health”:

– paragraph 1;

– paragraph 7, first period, and second period, limited to the words "Within the same term,” and to the extent that it provides ", which shall have ten days to transmit its opinion to the Commission,” rather than ", which transmits its opinion to the Commission”;

– paragraph 8, to the extent that it provides, in the first period, "Within three days from the acquisition,” rather than "After the acquisition”;

– paragraph 9, first period, to the extent that it provides "within seven days from,” rather than "after.”

12.3.– Once paragraph 1 of Article 4 has fallen, constitutional illegitimacy must also be declared regarding subsequent paragraphs 2 and 3, to the extent that they provide "referred to in paragraph 1,” rather than "for access to medically assisted suicide.”

12.4.– Article 4, paragraph 12 ("A person possessing the requirements who is authorized to access medically assisted suicide may decide at any time to suspend or cancel the provision of the treatment. In such cases, the relative expression of will shall be acquired in the manners and according to the forms provided for by Article 1, paragraph 4, of Law No. 219 of 2017”) must then be declared constitutionally illegitimate for conflict with the fundamental principles in the matter of the protection of health of current state legislation, interpreted in light of constitutional jurisprudence.

Just like the analogous provision of Article 7, paragraph 3, of Tuscany Reg. Law No. 16 of 2025, already declared constitutionally illegitimate by Judgment No. 204 of 2025, this provision too appears, in fact, "completely incoherent with the very structure of medically assisted suicide,” in which "there is properly no ‘provision’ of a treatment that can be suspended or cancelled (as is instead the case in hypotheses of active euthanasia, traceable within the Italian legal system to the offense of homicide of a consenting person), but rather assistance by healthcare personnel to a person who must independently perform the final conduct that directly causes their own death” (Judgment No. 204 of 2025, point 8.4. of the Law Considered).

12.5.– The remaining provisions of Article 4 of the challenged regional law, which regulate the verification of requirements for access to medically assisted suicide and the determination of relative methods of implementation—ensuring in particular the necessary personal and direct dialogue with the person requesting the procedure as well as the possibility of submitting a new application for access to medically assisted suicide (paragraphs 3, 4, 5, 11)—evade instead state censures, remaining within the scope of detailed regulation in the matter of the protection of health, within the limits fixed by fundamental principles inferable from state legislation, in the sense specified above.

In particular, the five-day term from submission of the application for convening the Commission and the two-day term for communicating the decisions of the Commission itself to the interested party, referred to in paragraphs 3 and 8, second period, evade constitutional illegitimacy censures, as they are mere terms aimed at ensuring, respectively, the prompt taking-in-charge of the request and the prompt communication of the evaluation outcome to the interested party.

13.– Article 5 of Reg. Law of Sardinia No. 26 of 2025 must now be examined, according to which regional healthcare enterprises provide technical and pharmacological support and medical assistance for the preparation of the self-administration of the authorized drug (first period), also specifying that assistance is provided by healthcare personnel on a voluntary basis and is considered an institutional activity to be carried out during working hours (second period).

Closely connected with these provisions is the content of paragraph 10 of the preceding Article 4, pursuant to which "[t]he self-administration procedure referred to in Article 5 shall take place within the term of seven days from the request for the provision of the medically assisted suicide treatment.”

Such provisions are entirely analogous to Article 7, paragraph 1, of Tuscany Reg. Law No. 16 of 2025, already declared constitutionally illegitimate by this Court in Judgment No. 204 of 2025, which found an invasion of the state reserve for setting fundamental principles in the matter of the protection of health.

The aforementioned provisions must therefore be declared constitutionally illegitimate, with any further censure profile absorbed, as the same considerations apply: the Region here did not limit itself to fixing detailed regulation, but "in reality appropriated fundamental principles, determining a vulnus to the reserve, established by Article 117, third paragraph, of the Constitution, for state legislation to determine them” (Judgment No. 204 of 2025, point 8.1. of the Law Considered).

It must also be recalled on this occasion that the aforementioned declaration of constitutional illegitimacy "leaves intact the right of the person, in relation to whom the conditions for access to medically assisted suicide have been positively verified, to obtain from the enterprises of the National Health Service the drug, the devices possibly required for self-administration, as well as healthcare assistance even during the execution of this procedure, as indeed affirmed in [...] Judgment No. 132 of 2025, which possesses, from this point of view, self-executing scope. It remains understood, however, that healthcare personnel, faced with the irreversibility of the consequences of the suicidal act, must exercise special care in verifying the persistence of the person’s full and conscious will to end their own life and the absence of undue conditioning at the moment of execution” (Judgment No. 204 of 2025, point 8.1. of the Law Considered).

14.– Article 6 of the challenged regional law evades the appellant’s censures.

The choice to establish the gratuitousness of services and treatments performed "within the framework of the therapeutic-assistance pathway of medically assisted suicide” is manifestly not in conflict with any of the parameters evoked by the state recourse.

15.– As for Article 7, it must be noted that it is a financial provision merely accessory to the preceding one, establishing the financial coverage of charges deriving in particular from the implementation of Article 5 of the challenged regional law. Here too, no conflict with the parameters evoked by the appellant is configured.

16.– Article 8, finally, according to which "[w]ith effect from the entry into force of state regulations on the matter, the provisions of this law shall apply only insofar as compatible,” following the declarations of constitutional illegitimacy now pronounced, no longer configures any inverted yielding—which would not actually be permitted, as the state recourse correctly notes (on this profile, recently, Judgment No. 196 of 2025, point 4.1. of the Law Considered)—but rather only a physiological compatibility clause with reference to potential modification at the state level of the fundamental principles to which the same regional law made reference.

From this perspective, nor does it appear to conflict with the parameters evoked by the state recourse.

17.– It remains at this point to examine the third ground of recourse of the President of the Council of Ministers, which is specifically directed against Articles 3 and 4 of the challenged regional law, alleging their conflict with Article 117, second paragraph, letter l), in relation to Article 2, paragraph 7, of Law No. 3 of 2018, and letter m), of the Constitution, in relation to Article 1, paragraphs 556, 557, and 558 of Law No. 208 of 2015, as well as, once again, with Article 117, third paragraph, of the Constitution or with Articles 3 and 4 of the Special Statute.

17.1.– Here too, these are censures entirely analogous to those leveled against the provisions of the Tuscan regional law already scrutinized by this Court.

Therefore, their unfoundation must be reaffirmed for the same reasons.

The role of the multidisciplinary commissions provided for by the regional law does not determine, in fact, any "undue overlap” (Judgment No. 204 of 2025, point 11.1. of the Law Considered) with that proper to territorial ethics committees.

17.2.– Equally unfounded prove to be the state censures assuming the conflict of the aforementioned provisions with Article 117, second paragraph, letter m), of the Constitution, in relation to Article 1, paragraphs 556, 557, and 558 of Law No. 208 of 2015, since, as in the previous case, the provisions of the regional law challenged here do not provide "an essential level of assistance, limiting themselves to regulating organizational profiles of regional health structures” (Judgment No. 204 of 2025, point 11.2. of the Law Considered).

17.3.– In these terms, as the competence in the matter of the protection of health pursuant to Article 117, third paragraph, of the Constitution is not violated for the reasons already illustrated, the censures raised under the third and final ground of recourse must be deemed unfounded as a whole.

on these grounds

THE CONSTITUTIONAL COURT

1) declares the constitutional illegitimacy of Articles 2, paragraphs 1 and 2, the latter to the extent that it provides "referred to in paragraph 1” instead of "for access to medically assisted suicide,” 3, paragraph 1, to the extent that it provides "referred to in Article 2, paragraph 1” instead of "for access to medically assisted suicide,” and 4, paragraphs 2 and 6, to the extent that they provide "referred to in Article 2, paragraph 1,” instead of "for access to medically assisted suicide,” of Autonomous Region of Sardinia Law No. 26 of September 18, 2025 (Procedures and timelines for regional healthcare assistance for medically assisted suicide pursuant to and as a result of Constitutional Court Judgment No. 242 of 2019);

2) declares the constitutional illegitimacy of Article 4, paragraphs 1, 2, and 3, the latter two to the extent that they provide "referred to in paragraph 1” instead of "for access to medically assisted suicide,” 7, first period, and second period, limited to the words "Within the same term,” as well as to the extent that it provides ", which shall have ten days to transmit its opinion to the Commission,” instead of ", which transmits its opinion to the Commission,” 8, to the extent that it provides "Within three days from the acquisition,” instead of "After the acquisition,” 9, first period, to the extent that it provides "within seven days from” instead of "after,” and 12, of Reg. Law of Sardinia No. 26 of 2025;

3) declares the constitutional illegitimacy of Articles 4, paragraph 10, and 5 of Reg. Law of Sardinia No. 26 of 2025;

4) declares unfounded the questions of constitutional legitimacy of the entirety of Reg. Law of Sardinia No. 26 of 2025, as well as of Article 1 of Reg. Law of Sardinia No. 26 of 2025, raised, with reference to Article 117, second paragraph, letter l), and third paragraph, of the Constitution, as well as Articles 3 and 4, letter i), of Constitutional Law No. 3 of February 26, 1948 (Special Statute for Sardinia), by the President of the Council of Ministers with the recourse indicated in the heading;

5) declares unfounded the questions of constitutional legitimacy of the entirety of Reg. Law of Sardinia No. 26 of 2025, as well as of Articles 6 and 7 of Reg. Law of Sardinia No. 26 of 2025, raised, with reference to Article 117, second paragraph, letter m), of the Constitution, by the President of the Council of Ministers with the recourse indicated in the heading;

6) declares unfounded the questions of constitutional legitimacy of Articles 3 and 4 of Reg. Law of Sardinia No. 26 of 2025, raised, with reference to Article 117, second paragraph, letters l) and m), and third paragraph, of the Constitution, as well as Articles 3 and 4, letter i), of the Special Statute, by the President of the Council of Ministers with the recourse indicated in the heading.

Thus decided in Rome, at the seat of the Constitutional Court, Palazzo della Consulta, on June 23, 2026.

Signed:

Giovanni AMOROSO, President

Francesco VIGANÒ

Luca ANTONINI, Reporting Judges

Valeria EMMA, Registrar

Filed with the Registry on July 24, 2026