JUDGMENT NO. 152

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 pronounced the following

JUDGMENT

in proceedings concerning the constitutional legitimacy of Article 580 of the Penal Code, raised by the Judge for Preliminary Investigations at the Ordinary Court of Bologna in the criminal proceedings against M. C., F. M., and V. F., by order of September 29, 2025, registered under no. 223 of the 2025 register of orders and published in the Official Gazette of the Republic, special 1st series, no. 47, of the year 2025.

Having regard to the appearance in proceedings of M. C., F. M., and V. F., as well as the intervention briefs filed by A. D.B., by M. D.B. in their capacity as heir of A. D.B., by B. S., by M. D. in their capacity as heir of B. S., M. G., C. G., R. E., P. F., R. I., D. M., L. M., A. P., M.L. R., E. S., and by the President of the Council of Ministers;

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

having heard attorneys Filomena Gallo, Benedetta Maria Cosetta Liberali, and Francesco Di Paola for M. C. and the other intervening parties, Irene Pellizzone for R. F. and the other intervening parties, Carmelo Domenico Leotta and Mario Esposito for R. E. and the other intervening parties, and State Counsel Gianna Maria De Socio for the President of the Council of Ministers;

having deliberated in the chamber of council on June 23, 2026.

RITENUTO IN FATTO (Summary of the Facts)

1.– By order of September 29, 2025, registered under no. 223 of the 2025 register of orders, the Judge for Preliminary Investigations at the Ordinary Court of Bologna raised questions concerning the constitutional legitimacy of Article 580 of the Penal Code, as resulting from this Court’s Judgment No. 242 of 2019, "strictly limited to the words ‘kept alive by life-support treatments’”, with reference to Articles 2, 3, 13, 32(2), and 117(1) of the Constitution, the latter in relation to Article 8 of the European Convention on Human Rights.

The referring judge is called upon to rule on the request for dismissal filed by the public prosecutor on February 13, 2023, in the criminal proceedings against M. C., F. M., and V. F. for the offense of aiding and abetting suicide pursuant to Article 580 of the Penal Code, in relation to the death of P. R., given that the suspects had organized and executed a journey to the Swiss facility of association D., where P. R. met her death on February 8, 2023, by self-administering a lethal drug.

1.1.– The order reports that the woman, suffering from an advanced form of progressive supranuclear palsy parkinsonism that appeared in 2012, solely took medication to reduce tremors and limb rigidity, but had to "rely on the assistance of third parties for every basic need”.

In this regard, the order specifies that the woman, "although still able to chew (predominantly semi-solid foods), was no longer able to bring them to her mouth by herself; similarly, she maintained fecal and urinary continence, but could not go to the bathroom independently for that purpose, nor perform hygiene functions ancillary to the act; likewise, until a few months before her death she managed to move a few meters with a walker, but was unable to reach it independently or steadily maintain control of it”.

The referring judge further reports that the neurological and neuropsychological technical opinion and the psychiatric report drawn up by the two independent professionals consulted by P. R. reveal a neurological and cognitive picture compatible with preserved self-determination capacity and a "free and conscious” will.

1.2.– As regards the events forming the subject matter of the criminal proceedings, the order reports that in November 2022 P. R. had sent M. C. a request to be assisted in carrying out her intention to take her own life by traveling to Switzerland, where she had already made contact with association D. After receiving initial authorization for assisted suicide from the latter, she recontacted C., who on February 3, 2023, went to meet her at her home, "thereby becoming aware of R.’s total and continuous dependence on third parties as well as her awareness of not being kept alive by life-support treatments”, as identified by this Court’s Judgment No. 242 of 2019.

On February 6, 2023, F. M. and V. F. accompanied P. R. to the Swiss town of Pfäffikon aboard a vehicle rented at the expense and under the management of an association of which M. C. is the legal representative. At the designated facility, the woman subsequently held two successive interviews with a physician. Finally, on February 8, 2023, she self-administered the lethal drug by activating an infusion pump.

1.3.– This having been premised, the *a quo* judge excludes that the case at hand can be immediately resolved by applying the principles affirmed by Judgment No. 242 of 2019, "due to the overriding and peaceful finding of the lack of the requirement” that the person be "kept alive by means of life-support treatments”. In fact, as the public prosecutor's request for dismissal itself emphasizes, "the lady was suffering from an irreversible pathology which, however, did not entail the use of life-support treatment means, since the maintenance of life, notwithstanding the ascertained and worsening conditions, was not conditional upon such methods”.

This "fragment of a rule” would therefore be decisive for the purposes of the judgment, given that, as matters stand, the request for dismissal would have to be rejected, necessarily setting in motion the path to trial; whereas "a potential declaration of constitutional illeghtimacy of the indicated part of the rule would allow the suspects' conduct to be subsumed within the area of non-punishability of Article 580 of the Penal Code already traced out by Judgment No. 242/2019”.

The issues would, moreover, be admissible because it would not be possible through interpretation to overcome the doubts of constitutional legitimacy regarding the normative data, whose reading would not appear to allow the inclusion within the notion of life-support treatments of "even the administration of drugs that are not immediately ‘life-saving’”. The "high rank of the legal interests and rights at stake, coupled with the specificity of the subject matter”, would "deter any fatiguing constitutionally-oriented reading”, in favor of "an authoritative intervention by the Court”.

1.4.– As to the non-manifestly unfounded nature of the raised issues, the order first observes that the requirement of subjection to life-support treatments identified in Judgment No. 242 of 2019 gives rise to discriminatory treatment between different types of sick individuals, in violation of the principle of equality referred to in Article 3 of the Constitution.

Indeed, a subject "who has freely and autonomously determined to put an end to their own existence, fully capable of making free and conscious decisions, as well as afflicted by an irreversible pathology causing severe physical or psychological suffering yet not kept alive by life-support treatments *stricto sensu* understood” could experience "a situation of clinically verifiable irreversible pathology just as painful as that of another patient who avails themselves of such treatments”. Indeed, the requirement in question would in no way contribute "to measuring the capacity to understand and will, the freedom and autonomy of choice, or the physical or psychological suffering of sick subjects, while also proving irrelevant for the purpose of demonstrating the existence of a pathology and its irreversibility”. It would therefore prove to be "completely indifferent with respect to the requirements of protecting the life of the sick person from abuse or undue influence”, nor would it be "functional to protecting the psychiatric patient or one who has determined themselves in a rash manner to end their life due to transient pathological conditions”, since "the objective presence of a serious, concretely verifiable pathology” is "already fully ensured by the requirement of irreversible pathology as well as that of severe physical or psychological suffering”.

Consequently, sick individuals who do not have to avail themselves of a medical device or a pharmacological treatment supporting an organ would today "necessarily face the prospect of waiting for the worsening of the pathological conditions from which they suffer”, being able to access the assisted suicide procedure "only following the onset of dependence on a life-support treatment”.

This assessment is confirmed by the opinion rendered by the National Bioethics Committee on July 18, 2019, regarding medically assisted suicide ("Bioethical reflections on medically assisted suicide”), to the effect that the presence of a life-support treatment should be considered an "additional, merely eventual condition”: "conversely, considering it necessary would create an unreasonable and unconstitutional discrimination ‘between those who are artificially kept alive and those who, although suffering from a pathology that may even be very severe and involve intense suffering, are not or are not yet so’”.

The denounced arbitrariness of the provision of the requirement in question would also emerge in light of constitutional jurisprudence according to which "in balancing operations there can be no decrease in the protection of a fundamental right if it is not matched by a corresponding increase in the protection of another interest of equal rank” (citing, among others, this Court’s Judgment No. 143 of 2013). In the present case, assuming the persistence of the other requirements, "the protection of the freedom to avail oneself of assistance in putting an end to one's life in a dignified manner” would be sacrificed "without any counterpart in terms of the elevation of other constitutional rights”.

1.5.– The requirement of the necessary existence of life-support treatments would also violate the personalist principle referred to in Article 2 of the Constitution, personal freedom referred to in Article 13 of the Constitution, and the freedom of self-determination in the therapeutic sphere referred to in Articles 2, 13, and 32(2) of the Constitution.

The personalist principle and the aforementioned freedom of self-determination should extend "to the moment of end-of-life choices”, to the point of "embracing, within a medicalized relationship, the choice to take leave of life in the case of an irreversible pathology causing severe physical or psychological suffering, without prejudice to the full capacity to understand and will and the freedom and autonomy of the choice itself”. The provision of the requirement of subjection to life-support treatments, as resulting from the current wording of Article 580 of the Penal Code, would instead stand "in stark contrast to the exercise of such freedom”. The prospect of criminal sanction for facilitators would in fact preclude "patients in the same conditions as R. from availing themselves of external assistance” in the dramatic choice to take leave of life, where the latter constitutes "an essential and incoercible mode of asserting one's personality, over which the individual must be able to freely self-determine”.

"Decisive” should rather be "the very concept of ‘pathology’, and not the treatment it receives, which may at most be relevant as an index of the severity or advanced stage of the pathology”.

On the other hand, it would be unreasonable to recognize to the patient, pursuant to Article 1(5) of Law No. 219 of December 22, 2017 (Norms on informed consent and advance treatment provisions), the right to refuse from the outset "any” health treatment, including life-support treatment, whereas, to access medically assisted suicide, "a patient who had always refused any care would first have to ask to be subjected to a treatment and then renounce it”.

If, moreover, the requirement in question was intended to "reserve assisted suicide only to patients now close to death from natural causes or whose disease, *ex se*, would in any case lead to a lethal outcome”, then "it would perhaps be more consistent to introduce an additional and different requirement”, and in any case to excise a constraint—which moreover constitutes a unique occurrence at the international level—such as to expose one in practice "to the risk of the pointed-out substantive injustices”.

2.– The President of the Council of Ministers entered an appearance in the proceedings, represented and defended by the State Attorney General's Office, which concluded for the manifest unfoundedness of the raised questions.

2.1.– The State defense observes first of all that questions exactly superimposable upon those at bar have already been declared unfounded in this Court’s recent Judgments No. 135 of 2024 and No. 66 of 2025.

In particular, the latter pronouncement expressly took into consideration the category of sick persons with a "short-term poor prognosis”, which, in the view of the State defense, "completely corresponds” to the one the current referring judge intends to refer to by mentioning patients in a state of "non-terminal pathology”. In this regard, the pronouncement clarified that in the absence of an ongoing life-support treatment, or at least of a medical indication regarding the necessity to activate it, the patient's situation "is not assimilable to that of a patient whose life now depends on the treatment in question”, with the consequent unfoundedness of the censure alleging violation of Article 3 of the Constitution.

The censures alleging infringement of the principle of self-determination are likewise re-proposed in terms already punctually scrutinized by the aforementioned Judgment No. 66 of 2025. In that pronouncement, once the error in the interpretive premise from which the censures moved was corrected, it is observed how in this manner "the risk, also feared by the present referring judge, of an undesired subjection to such treatments solely to achieve the possibility of accessing assisted suicide is overcome”.

On this point, moreover, the judgment stated that where a medical indication regarding a life-support treatment is lacking, that broad margin of discretion vested in the legislature expands (recognized also by the jurisprudence of the European Court of Human Rights, most recently in the judgment of June 13, 2024, Dániel Karsai v. Hungary), which "makes constitutionally non-mandatory the choice [...] to allow access to assisted suicide also to patients capable of making free and responsible decisions, afflicted by irreversible pathologies causing them intolerable suffering, but whose vital functions do not depend on life-support treatments”. Consequently, residual margins of intervention for the constitutional judge in this matter are not configurable.

2.2.– The State defense further emphasizes how—contrary to what is maintained by the *a quo* judge—the requirement of life-support treatment "is clearly distinguished” from that of irreversible pathology, "since it marks the degree of advancement of the pathology itself and makes it possible to circumscribe the area of non-punishability of assistance to suicide solely with reference to those who ‘could already alternatively let themselves die by renouncing health treatments necessary for their survival’”, pursuant to Article 1(5) of Law No. 219 of 2017, in conformity with the principles dictated by Judgment No. 242 of 2019. If such a requirement were eliminated, access to medically assisted suicide could also be gained by "subjects—perhaps particularly fragile and therefore more exposed to experiencing suffering deemed intolerable—who have been diagnosed with only the initial onset of an irreversible disease”.

Similarly, the referring judge would have fallen into a "reconstructive error” by denying that the limitation of the non-terminal patient's right to self-determination is balanced by a correlative elevation of other constitutional rights. On the contrary, in the specific case there exists an "elevation of protection for the superior legal value represented by the good of life”. Constitutional jurisprudence has assigned to the requirement of the patient's dependence on life-support treatments, "in the absence of legislative intervention, a pivotal role in the logic of the solution adopted with Order No. 207 of 2018, later taken up in Judgment No. 242 of 2019” (citing Judgment No. 135 of 2024). Thus, within the current regulatory framework, the requirement does not admit substitutes.

3.– M. C., F. M., and V. F., as persons under investigation, entered an appearance in the proceedings, concluding for a declaration of constitutional illegitimacy, "even by way of interpretation”, of Article 580 of the Penal Code, under the terms set forth in the referral order.

3.1.– Pointing out that the criminal proceedings were initiated through a self-denunciation spontaneously presented by them the day following P. R.'s death, the parties reconstruct the phases of the affair in a manner substantially analogous to what was represented by the referral order, highlighting that P. R.'s clinical picture was "the result of verifications and interviews conducted by doctors of the National Health Service” and that on January 18, 2023, i.e., a few days before death, the psychiatrist had stated that "Mrs. P. R. maintains critical capacity regarding her own situation, is oriented towards herself, in time and space, and above all persists in a lucid and coherent manner in her end-of-life volition”.

They further specify that, "although not technically kept alive by a life-support treatment in its clinical acceptation, if left alone, meaning without the necessary assistance, she would have died of starvation in a bed amidst her urine and feces”.

3.2.– The parties deem the raised issues admissible, since the censured normative fragment is decisive for the purposes of the *a quo* judgment, as the presence of all the other requirements for the non-punishability of the offense referred to in Article 580 of the Penal Code would be "already demonstrated *per tabulas*”.

The merits of the censures are argued by developing the profiles highlighted by the referring judge, with reference both to the discrimination between sick persons and the unreasonableness of the life-support treatment requirement, and to the violation of the personalistic principle and the freedom of self-determination in treatment.

The parties' defense also deems Article 117(1) of the Constitution to be violated, in relation to Article 8 of the ECHR, citing in this regard the judgment of the European Court of Human Rights of April 29, 2002, Pretty v. the United Kingdom, concerning the case of a woman suffering from amyotrophic lateral sclerosis, in which the Court allegedly stated that "the mode chosen for taking leave of life is an act that forms part of life and it is the applicant's right to ask that it be respected”.

Lastly, the parties highlight that in the referral order "no reference appears to Judgments No. 135 of 2024 and No. 66 of 2025” of this Court. While hypothesizing that the *a quo* judge did not intend "to be bound by interpretations [...] contained in dismissal pronouncements”, the parties' defense notes that from the two cited judgments it would emerge that a constitutionally compliant interpretation of the life-support treatment requirement could have avoided the creation of unreasonable disparities in treatment among sick persons in accessing medically assisted suicide.

Nevertheless, the parties conclude, "the cases arising after the judgments” cited would prove the persistence of such discriminations and make evident the necessity of an upholding pronouncement, including an interpretive one, by this Court.

4.– R. E., P. F., R. I., D. M., L. M., A. P., M.L. R., and E. S., all afflicted by irreversible pathologies, have filed intervention briefs *ad opponendum*, declaring themselves to be "in certain of the conditions that integrate the hypothesis of non-punishability for aiding suicide as a result of Judgment No. 242 of 2019”, without however being subjected to life-support treatments, in the sense referred to in the cited Judgment No. 135 of 2024. The intervenors, assuming they hold a qualified interest pursuant to Article 4(3) of the Supplementary Norms for Proceedings before the Constitutional Court, asked this Court to declare the issues inadmissible or unfounded.

5.– By separate briefs, R. F., B. S., and A. D.B. intervened *ad adiuvandum*; they are afflicted by irreversible pathologies—respectively, diffuse glioma, progressive supranuclear palsy, and multiple system atrophy—who activated the procedure for access to medically assisted suicide, but received a refusal from the competent local health authority units, motivated by the current lack of the requirement of subjection to life-support treatment.

All conclude for the acceptance of the questions of constitutional legitimacy raised by the GIP of Bologna.

6.– Likewise *ad adiuvandum*, C. G. and M. G. intervened via a joint brief; both are afflicted by amyotrophic lateral sclerosis and at present have not requested to access medically assisted suicide. They likewise conclude for the well-foundedness of the proposed issues.

7.– Six *amicus curiae* written opinions were received, admitted by Presidential Decree of May 6, 2026.

7.1.– The Association Luca Coscioni for Freedom of Scientific Research APS remarks, on the one hand, that none of the foreign regulations governing medically assisted suicide provide as an access requirement that of being kept alive by a life-support treatment; on the other hand, that in the absence of a binding definition of the latter notion, its identification would be "still today remitted to the discretion” of the medical commissions of local health units, resulting in "unjustified discriminations among sick persons on a purely random basis”.

The opinion, considering that the criterion in question violates the parameters invoked by the referring judge, urges its removal by this Court. Such a solution would guarantee "the adaptation of national legislation” to that of countries that have regulated the matter. This all the more so since the baseline text of the bill under examination by the Senate of the Republic would prove "inadequate to eliminate discriminations among sick persons and to guarantee respect for end-of-life choices”. Indeed, by establishing that only persons kept alive by a mechanical device replacing a vital function can access medically assisted suicide, it would "completely nullify the principle of self-determination in the healthcare sphere”, requiring the "necessary activation” of treatments as a condition for the sick person to submit a request to verify the conditions for accessing the medicalized procedure.

7.2.– In a contrary sense, the opinion of the Association Nonni 2.0, the Observatory on Parliamentary Activity "Vera lex?”, and the Bioethics Observatory of Siena remarks the necessity of maintaining the requirement of dependence on life-support treatments to distinguish suicide as the fruit of individual self-determination, which is not constitutionally protected, from death as a consequence of the refusal of health treatments, which is instead considered, within certain limits, by Article 32 of the Constitution. Were the requirement to be eliminated, access to suicide could be gained not only by "almost all elderly persons and all disabled subjects, but also by subjects afflicted by incurable—yet treatable—pathologies and even non-disabling ones”, with the re-emergence of the risks of abuses repeatedly highlighted by this Court.

The opinion further notes that, since the censure referring to the violation of Article 117(1) of the Constitution in relation to Article 8 of the ECHR is in no way argued in the referral order, it should be declared inadmissible. The censure would in any case be manifestly unfounded, having already been examined and rejected in the aforementioned Judgments No. 135 of 2024 and No. 66 of 2025.

7.3.– The opinion of the Movement for Life Italian APS-Federation of Movements for Life and Life Aid Centers of Italy, the Association of Italian Catholic Physicians (AMCI), the Committee for the Subsidiary and Shared Public Agenda "Tell it from the rooftops (Mt 10, 27)” - PASC, and the association Lab-Ora Conserve the Future primarily projects the manifest inadmissibility of the issues, on the assumption that the intervention requested of this Court by the referring judge would lead to the elimination of "a requirement that corresponds to an essential passage of the previous Judgment No. 242/2019, covered by the constitutional *res judicata*” and, in any event, to the "creation of a new and additional normative type”.

The issues would also be inadmissible due to the error in a factual presupposition, capable of undermining the coherence and completeness of the reasoning on the non-manifest unfoundedness: in particular, the order invokes the opinion of the National Bioethics Committee of July 18, 2019, citing it in a wholly partial manner (having reported the considerations on life-support treatment of only one of the component groups of the Committee) and in any case without accounting for the opinion rendered by the same Committee on June 20, 2024, i.e., subsequent to Judgment No. 242 of 2019.

As to the merits, the opinion excludes that life-support treatments can be eliminated from the perimeter of non-punishability for the offense referred to in Article 580 of the Penal Code; this is because the balancing performed by Judgment No. 242 of 2019 between the protection of life and the dignity of the suffering person was carefully calibrated through the "fixing of rigorous and cumulative conditions”.

The elimination of even just one of such requirements, which were considered "the constitutional maximum possible retreat with respect to the defense of fragile life”, would determine an area in which the pathology, even when very far from its outcome, would be deprived of minimum protection by institutions.

7.4.– The opinion of the "Rosario Livatino” Study Center first spots the inadmissibility of the raised issues for violation of Article 137(3) of the Constitution, given that, without even mentioning this Court’s Judgments No. 135 of 2024 and No. 66 of 2025, the referring judge aims at a "surreptitious challenge” to the cited Judgment No. 242 of 2019, which, together with the subsequent two, admits "a limited space in which the protection of life can yield in the face of the sick person's request to escape an artificial maintenance of life that is no longer desired”.

This opinion also considers that the order, by misrepresenting the National Bioethics Committee's 2019 opinion and omitting to cite that of 2024, presents a serious deficiency of reasoning on the non-manifest unfoundedness and on the relevance of the raised issues, which should be declared inadmissible.

An examination on the merits would in any case be precluded by further profiles of inadmissibility.

The issues would first of all be irrelevant, as it can be held that the Court of Bologna lacks territorial jurisdiction to judge the facts contested against the suspects in the *a quo* proceedings. In this regard, the opinion points out that, in the proceedings from which the constitutional incident decided by Judgment No. 135 of 2024 originated, the Ordinary Court of Florence recently declared its lack of territorial jurisdiction in favor of the Ordinary Court of Varese; a circumstance that today allows *ictu oculi* the detection of the referring judge's lack of territorial jurisdiction.

In any event, the irrelevance of the issues would derive from the failure to comply with the procedural conditions of non-punishability, so that no effect could derive from a potential decision by this Court for the purposes of ascertaining the criminal liability of the suspects.

7.5.– In the same terms as the preceding one, the opinion of the "Science & Life” Study Center and the Union of Italian Catholic Jurists (UGCI) likewise projects the inadmissibility of the raised issues.

On the merits, the arguments expressed in Judgment No. 135 of 2024 would impose the rejection of today's censures as well.

The *a quo* judge also omitted to consider the significance to be attributed to palliative care, which represents the constitutionally oriented response to suffering, in fulfillment of duties of solidarity.

7.6.– The opinion of the Association Family Day-Defend Our Children APS likewise highlights the inadmissibility of the issues for violation of Article 137 of the Constitution and argues in any case their lack of foundation, recalling the reasoning of Judgment No. 135 of 2024.

8.– Following the fixing—by Presidential Decree of May 21, 2026—of the chamber of council for the decision on the admissibility of interventions, pursuant to Article 5 of the Supplementary Norms for Proceedings before the Constitutional Court, as amended by the resolution of March 12, 2026, M. D.B. and M. D., in their capacity as heirs respectively of A. D.B. (who died pending the proceedings due to the worsening of his pathology) and of B. S. (who died by self-administration of a lethal drug, having been in the meantime authorized for medically assisted suicide by the competent health authority), filed briefs on May 27, 2026, asking to intervene in the proceedings.

9.– By Order No. 101 of June 9, 2026, this Court declared admissible the interventions of R. F., C. G., and M. G., as well as of the intervenors *ad opponendum*. Conversely, it deemed inadmissible the interventions of the heirs of A. D.B. and B. S.

10.– In proximity to the public hearing, M. C., F. M., and V. F. filed an illustrative brief, insisting upon a declaration of constitutional illegitimacy, "even by way of interpretation”, of Article 580 of the Penal Code.

The parties emphasize how, as matters stand, there is a lack of "real predictability of the outcome of the health evaluation and, with it, interpretive certainty regarding the requirement” of dependence on life-support treatments: elements that would prove "indispensable to ensure equivalent treatment to all patients who choose, or at least intend to be able to choose, to access the procedure” in question.

Today's issues are not superimposable upon those scrutinized by Judgments No. 135 of 2024 and No. 66 of 2025, because they "do not aim [...] to expand the core of therapeutic self-determination already recognized by constitutional jurisprudence, but to verify whether the requirement of life-support treatment continues to represent a criterion coherent with the principles underlying that same jurisprudence or whether, on the contrary, it has become a source of unreasonable disparities in treatment among persons who present substantially homogeneous conditions under the profile of the irreversibility of the pathology, suffering, and capacity for self-determination”.

In the specific case, the exclusion of P. R.'s assistance in suicide from the area of non-punishability carved out by Judgment No. 242 of 2019 does not derive from "interpretive uncertainties” concerning the meaning of the requirement of subjection to life-support treatments—as occurred in the *a quibus* proceedings underlying Judgments No. 135 of 2024 and No. 66 of 2025—but "exclusively from its very existence as an autonomous condition of access” to the medically assisted suicide procedure.

Contrary to what is maintained by the State Attorney General's Office, the requirement of dependence on life-support treatments—which "relates to the applicant's clinical condition”—would not be indispensable to protect the vulnerable person from external pressures or conditioning, this function being performed by the "ensemble of further substantive and procedural safeguards identified by constitutional jurisprudence and by the discipline on informed consent”.

Maintaining "a restrictive reading of the requirement of life-support treatment in the name of protecting fragile persons” would instead determine "a distortive effect”, not truly strengthening the guarantees against abuses or undue pressures, but ending solely up excluding a determined category of patients from access to the medically assisted suicide procedure "according to variable and sometimes merely formalistic interpretations”.

Constitutional jurisprudence has itself, moreover, already significantly expanded the notion of "life-support treatments”. Nor can it be held that the question concerning the necessity of such requirement is totally remitted to the discretion of the legislature, since "the regulation of assistance to suicide directly involves fundamental rights of the person and requires that the balancing performed by the legislature and by constitutional jurisprudence itself respects the principles of reasonableness, equality, and protection of individual self-determination”.

11.– The President of the Council of Ministers also filed a brief, in which he considers "absolutely inescapable” the requirement of dependence on a life-support treatment, in light of the *ratio* of the declaration of constitutional illegitimacy of Article 580 of the Penal Code set forth in Judgment No. 242 of 2019.

The State Attorney General's Office discerns in the requirement in question an "autonomous significance, of an exquisitely constitutive and founding nature, within the abstract normative type of the justification”, so much so that its elimination, besides conflicting with the "pivotal role” assigned to it by this Court, would introduce into the structure of the norm "an unacceptable element of uncertainty”.

On one hand, the acceptance of the proposed issues would make it possible to provide assistance in suicide to persons who "are in an initial stage of the onset of irreversible pathologies”; which would end "by lowering greatly the holding capacity of the ‘protective belt’ of the good of life” reaffirmed by this Court in the previously cited judgments.

On the other hand, even if a different requirement were hypothesized, referring "to patients now close to death from natural causes or whose disease, *ex se*, would in any case lead to a lethal outcome”, there would be left "an excessively broad scope to interpreters and operators” in the application of such a justification, with an "inadmissible indeterminateness of the normative precept which would end up rendering uncertain the very delimitation of the criminally prohibited conduct, compromising the predictability of the legal system's response in the face of the conduct of one who assists another in suicide at a stage of non-terminal illness”.

Were the possibility of access to assisted suicide by persons afflicted by irreversible pathologies, but only at the initial stage, to be admitted, there could be created, in subjects in a condition of fragility or loneliness, "as an inevitable reflected effect, precisely that feared ‘indirect social pressure’ already previewed” by previous pronouncements of this Court.

Only the requirement whose elimination is now hoped for would instead allow the justifying norm to be structured with sufficient determinateness, "defining with extreme precision at what stage of the disease assistance to suicide can be justified, which stage must coincide, precisely, with the onset of the necessity, for survival, of resorting to life-support treatments”.

On the other hand, the Attorney General's Office continues, such a requirement would not conflict at all with conventional principles, as summarized in the recent ECHR judgment Dániel Karsai v. Hungary of 2024.

Finally, the *a quo* judge omitted to consider the significance to be attributed to palliative care, which represents the constitutionally oriented response to suffering, in fulfillment of duties of solidarity.

12.– In his brief filed in proximity to the hearing, R. F. reported that the Ordinary Court of Padua, by order of May 27, 2026, rejected his appeal against the denial of his request for access to the medically assisted suicide procedure presented to the competent health authority. He also filed medical documentation concerning the worsening of the oncological pathology from which he suffers, underlining the existence of the imminent risk of an unforeseeable adverse event or of the definitive loss of his residual cognitive and executive capacities.

The intervenor underlines the "centrality of the time factor”, highlighting how the current configuration of the life-support treatment requirement forces the patient "to a wait incompatible with the progression of the pathology, compelling him to endure further and severe suffering or to undertake complex administrative and judicial paths during the progressive deterioration of his health conditions”; a situation, moreover, very frequent in oncological pathologies, which often do not determine the necessity of resorting to life-support treatments, despite being characterized by a poor prognosis and irreversibility.

He represents, in this regard, having refused to undergo surgery due to the high risk of very severe functional impairments. In similar situations, in which furthermore pain management therapies prove ineffective, the requirement of dependence on life-support treatment should be flanked by a different requirement, represented by the "poor short-term prognosis, together with the concrete risk of rapid and irreversible deterioration of clinical conditions”: a requirement that could well perform a function substantially equivalent to that which the current regulatory asset attributes to dependence on life-support treatments, as an index of the severity of the pathological condition and the imminent impairment of the person's self-determination.

The intervenor concludes by asking this Court to declare "the constitutional illegitimacy of Article 580 of the Penal Code, insofar as, by subordinating the non-punishability of assistance to suicide to the condition that the sick person be ‘kept alive by life-support treatments’, it does not provide for the wording ‘or in the presence of a short-term poor prognosis’” or, in the alternative, to declare the same provision constitutionally illegitimate to the extent that the requirement of dependence on life-support treatments is not interpreted as including a short-term poor prognosis.

13.– In their illustrative brief filed in proximity to the hearing, C. G. and M. G., recalling their conditions as patients suffering from a very rare form of infantile-onset amyotrophic lateral sclerosis, which caused them the loss of ambulation, speech, and any motor autonomy while not making it necessary to undergo life-support treatments, highlight how this latter requirement selects persons entitled to access the medically assisted suicide procedure not based on "the degree of vulnerability of the person, but [on] the instrument through which vulnerability is managed”, with an "evident alteration of the constitutional logic underlying Judgment No. 242 of 2019”.

The requirement of dependence on life-support treatments would thus have transformed from a procedural safeguard into a "discriminatory barrier of access to the freedom to take leave of life”, characterized among other things by "margins of intrinsic application arbitrariness”, demonstrated by the inhomogeneity of interpretations adopted by medically competent commissions and territorial ethics committees.

The intervenors—who depend absolutely and continuously on the assistance of third parties for feeding, daily hygiene, administration of medications, and movement—would see their dignity and constitutional right to self-determination infringed due to "a purely accidental and contingent element”, namely dependence "on other human beings” and not on a machine.

The protection of fragile persons could not, on the other hand, resolve itself in the "denial of their constitutional subjectivity” nor in the "withdrawal of spaces of self-determination recognized to other individuals in analogous conditions”, under penalty of introducing "a presumption of incapacity or lesser decision-making freedom founded on disability or assistance dependence”, in contrast with Articles 2 and 3 of the Constitution and with the principles affirmed by the United Nations Convention on the Rights of Persons with Disabilities, approved by the General Assembly on December 13, 2006, ratified and made executive by Law No. 18 of March 3, 2009 (Ratification and execution of the United Nations Convention on the Rights of Persons with Disabilities, with Optional Protocol, made in New York on December 13, 2006, and establishment of the National Observatory on the Condition of Persons with Disabilities).

The ECHR as well, while recognizing a margin of appreciation to States in regulating the end-of-life matter, has constantly affirmed the necessity that any limitations be coherent, non-arbitrary, and proportionate with respect to the fundamental rights involved (citing Dániel Karsai v. Hungary; July 19, 2012, Koch v. Germany; January 20, 2011, Haas v. Switzerland; Pretty v. the United Kingdom).

The recognition of a space of self-determination also in favor of persons afflicted by very severe pathologies would constitute an expression of the personalist principle, equal social dignity, and the development of the human person, enshrined in Articles 2 and 3 of the Constitution. Human dignity would not in fact be protected "through an absolute unavailability of the existential path imposed in a heteronomous manner, or dropped from above in an arbitrary way”, but by the recognition of the capacity to make free and conscious decisions "in the extreme situations of one's existence”.

The requirement of dependence on life-support treatments would perform no protective function with respect to the risk that the vulnerable person might be subjected to external pressures or might determine themselves to a premature renunciation of living, since such drifts are screened by the additional requirements to which this Court has subordinated access to medically assisted suicide, namely the existence of the capacity to make autonomous, free, and conscious decisions, an irreversible pathology, and intolerable suffering.

The requirement in question would end up rendering "constitutionally relevant not the person's freedom, but the moment in which their body reaches a further level of impairment, being further acted upon by medical-health treatments”, thereby introducing "a sort of ‘biological threshold’ of self-determination”, which finds no foundation in the principles affirmed by constitutional jurisprudence.

The intervenors therefore ask this Court to declare the constitutional illegitimacy of Article 580 of the Penal Code, insofar as it provides for the non-punishability of assistance to suicide the requirement of dependence on life-support treatments, or, in the alternative, to the extent that the requirement of dependence on life-support treatments is not interpreted as including irreversible neurodegenerative pathologies in which the person's survival depends continuously and indispensably on the assistance of third parties.

14.– In their illustrative brief filed in proximity to the hearing, the intervenors *ad opponendum* ask that the questions of constitutional legitimacy be declared inadmissible or in any case unfounded.

14.1.– Inadmissibility would stem from the lack of territorial jurisdiction—a matter concerning the principle of the natural judge pre-established by law—of the referring judge. In the alternative, the issue would be inadmissible due to the absence of any reasoning regarding territorial jurisdiction.

In the view of the intervenors' defense, unlike what happened in the proceedings decided by Judgments No. 135 of 2024 and No. 66 of 2025, in the present case the defect of territorial jurisdiction is discernible *ictu oculi*. From the self-denunciation presented by the persons investigated in the *a quo* proceedings to the Public Prosecutor's Office of Bologna, it would emerge in fact that, to reach the Swiss locality of Pfäffikon from Bologna, F. M. and V. F. passed through the town of Chiasso, located in the district of the Ordinary Court of Como. The latter judicial office should therefore be deemed territorially competent as the "judge of the last place in which a part of the action or omission occurred”, pursuant to Article 9(1) of the Code of Criminal Procedure, applicable subsidiary to Article 8 of the same code.

Such a solution was followed, in relation to a wholly similar case, by the judgment of the Judge for Preliminary Hearings of the Court of Florence, June 4, 2025, No. 769, prior to the adoption of the referral order, which declined its territorial jurisdiction in favor precisely of the Court of Como.

In any event, since "[i]n the referral order, however, this topic was completely omitted”, the raised doubt of constitutional legitimacy would prove inadmissible for lack of reasoning on relevance.

14.2.– The issues would likewise be inadmissible or, in the alternative, unfounded, since they constitute a "surreptitious attempt to challenge the constitutional judgments No. 135 of 2024 and No. 66 of 2025”, as would emerge from the circumstance that the order did not take into consideration such pronouncements, despite the fact that these "expressed themselves precisely on the same topic with respect to which the Bolognese judge believes the doubt of unconstitutionality of Article 580 of the Penal Code is founded”. The referring judge built his reasoning on a hermeneutical presupposition already devoid of foundation on the basis of precedents in terms, without adducing any new and different factual or normative element compared to those already widely considered and evaluated by this Court.

14.3.– Finally, symptomatic of the irremediable logical flaw of the order, and of the consequent inadmissibility of the issues, would be both the misrepresentation of the National Bioethics Committee's 2019 opinion—cited in the part reporting the position expressed by only some of the members, without mentioning the text shared by the Committee—and the omitted reference to the response to the question on life-support treatments rendered by it in 2024 to the Territorial Ethics Committee of Umbria: an omission which contributes to misrepresenting the Committee's position on the topic in question.

CONSIDERATO IN DIRITTO (Considerations in Law)

15.– The GIP of the Court of Bologna raised questions concerning the constitutional legitimacy of Article 580 of the Penal Code, as resulting following this Court’s Judgment No. 242 of 2019, "strictly limited to the words ‘kept alive by life-support treatments’”, with reference to Articles 2, 3, 13, 32(2), and 117(1) of the Constitution, the latter in relation to Article 8 of the ECHR.

The *a quo* judge thus hopes for the identification—by this Court—of a further area of lawfulness for the conduct of facilitating another's suicide, compared to the one already outlined in Judgment No. 242 of 2019. More specifically, this area of lawfulness should extend to situations in which the conduct is performed in favor of a person whose intention has formed autonomously and freely, who is afflicted by an irreversible pathology, the source of physical or psychological suffering that they deem intolerable, and is fully capable of making free and conscious decisions, following verification of these conditions by a public facility of the national health service and upon the opinion of the territorially competent ethics committee, even though the additional requirement posed by Judgment No. 242 of 2019—namely the subjection of the person to life-support treatments—is lacking.

The referral order does not conversely urge this Court, as hoped for by the intervenor R. F., to flank—alternatively to the subjection of the person to life-support treatment—the different requirement of a "short-term poor prognosis” mentioned for other purposes (namely regarding the prohibition of unreasonable obstinacy in care) by Article 2(2) of Law No. 219 of 2017; nor does it urge it, as instead hoped for by intervenors C. G. and M. G., to include within the area of lawfulness irreversible neurodegenerative pathologies determining a situation of continuous dependence on third-party assistance.

The order is in fact unequivocal in requesting solely the radical ablation of the requirement in question (for an identical finding, Judgment No. 66 of 2025, point 4.2. of the Considerations in Law).

16.– As to the admissibility of the issues, the following observations must be made.

16.1.– The intervenors *ad opponendum*, taking up and developing arguments already formulated in the opinion of the "Rosario Livatino” Study Center and in that of the "Science & Life” Study Center and the UGCI, excepted the inadmissibility of the issues for lack of relevance, by reason of the referring judge's lack of territorial jurisdiction.

Competent to take cognizance of the facts charged against the persons investigated would in fact be, pursuant to Article 9(1) of the Code of Criminal Procedure, the judge of the last place in which a part of the conduct occurred: a place that should be identified, on the basis of what can be inferred from the self-denunciation of the suspects themselves present in the file of the *a quo* proceedings, in the territory adjacent to the border crossing of Chiasso, located within the district of the Court of Como.

The exception cannot be accepted.

As already observed in Judgment No. 135 of 2024, "[p]er consistent jurisprudence of this Court, in light of the principle of autonomy of the incidental proceeding of constitutional legitimacy from the main process, the lack of competence of the *a quo* judge—like the lack of jurisdiction—constitutes a cause of inadmissibility of the issue only if manifest, i.e., discernible *ictu oculi* (among others, Judgments No. 68 of 2021 and No. 136 of 2008, Order No. 134 of 2000)” (point 4 of the Considerations in Law; analogously, Judgment No. 66 of 2025, point 3.2. of the Considerations in Law). Such *ictu oculi* discernibility must, as a rule, be based on the elements offered to this Court by the referral order itself, in light of the principle of its self-sufficiency, also constantly affirmed by constitutional jurisprudence (on this point, *ex multis*, Order No. 127 of 2024).

In any event, precisely the principle of procedural legality, upon which the defense of the intervenors *ad opponendum* insisted in oral argument, imposes special caution on this Court in raising *ex officio* any lack of territorial jurisdiction on the part of the *a quo* judge. In criminal proceedings, in effect, such a finding is possible—on the initiative of the proceeding judge themselves, or upon exception by one of the parties to the criminal proceedings—only under the modalities and within the timeframes punctually identified by the procedural code (Articles 21–25). Absent this, the competence of the proceeding judge crystallizes and can no longer be called into question, in homage to requirements of procedural economy for which the legislature itself has taken responsibility.

It will therefore be up to the *a quo* judge, as well as to the parties to the main proceedings, to perform the necessary verifications and assessments regarding territorial jurisdiction concerning the hypothetical offense for which proceedings are brought, under the terms and with the effects provided by current procedural rules.

16.2.– The intervenors *ad opponendum* likewise, in consonance with what was already observed in the opinions of the "Rosario Livatino” Study Center, the "Science & Life” Study Center and the UGCI, and the Family Day Association, except that the issues now proposed would constitute a surreptitious attempt to challenge this Court's previous judgments on the matter, in violation of Article 137 of the Constitution, or in any case (thus the opinions of the Movement for Life Italian APS-Federation of Movements for Life and Life Aid Centers of Italy, the AMCI, the "Tell it from the rooftops (Mt 10, 27)” - PASC Committee, and the Lab-Ora Association) an inadmissible solicitation to modify the perimeter of the area of lawfulness identified with Judgment No. 242 of 2019.

A similar exception, with specific reference to Judgment No. 242 of 2019, was already examined and rejected in Judgment No. 135 of 2024 with the following arguments, which are worth reiterating in full here: "Judgment No. 242 of 2019 is a pronouncement of partial upholding. The issues decided with it were, in fact, directed at achieving, in substance, the complete ablation of the criminalizing provision on assistance to suicide: a request that this Court welcomed only in part, removing from punishability a circumscribed class of cases, identified also through the requirement upon which today's referring judge's censures focus. For the rest, the issues were therefore rejected. This having been established, it must be excluded that such a pronouncement definitively prevents this Court from adding a further class of cases to those already removed from punishability: which is precisely the effect that would follow from the hoped-for ablation of the requirement in question. The object of constitutional scrutiny can, on the other hand, well be a provision of law as resulting from a ‘manipulative’ judgment of this Court (for example, Judgments No. 131 of 2022 and No. 286 of 2016)” (point 3.2. of the Considerations in Law).

An analogous discourse applies with respect to Judgments No. 135 of 2024 and No. 66 of 2025, with which the issues then proposed were instead judged wholly unfounded: which, obviously, does not preclude the issues from being re-proposed to this Court.

16.3.– The defense of the intervenors *ad opponendum* raised a further exception during oral argument, retaking various points contained in the opinions filed by the "Rosario Livatino” Study Center and the "Science & Life” Study Center and UGCI: the issues would be inadmissible for irrelevance, by reason of the failure to comply, in the case forming the subject of the *a quo* proceedings, with the procedural conditions of non-punishability, which would deprive any potential decision by this Court of any effect for the purposes of ascertaining the criminal liability of the suspects.

This exception must also be rejected, for the same reasons already set forth in Judgment No. 135 of 2024 (point 3.1. of the Considerations in Law, and previous citations therein) and Judgment No. 66 of 2025 (point 3.1. of the Considerations in Law): the acceptance of the issues would in fact affect at least the motivational iter of the decision that the referring judge is called upon to adopt. Indeed, the GIP could not reject the request for dismissal, as he now believes he must do, due to the non-existence of one of the substantive conditions of non-punishability, but at most solely due to the failure to comply with the procedural conditions fixed by Judgment No. 242 of 2019.

16.4.– As projected by the Nonni 2.0 Association, the Observatory on Parliamentary Activity "Vera lex?”, and the Bioethics Observatory of Siena, it must instead be noted *ex officio* that the censure concerning the violation of Article 117(1) of the Constitution in relation to Article 8 of the ECHR is entirely devoid of reasoning.

Such a lacuna is particularly significant here, since the ECHR, in the aforementioned judgment Dániel Karsai v. Hungary, recently excluded that the impossibility of accessing assisted suicide in situations analogous to those discussed herein is contrary to Articles 8 and 14 of the ECHR.

The inadmissibility of the relative censure must therefore be declared.

17.– On the merits, this Court can only reiterate the evaluation of the unfoundedness of the censures, for the same arguments already developed in Judgments No. 135 of 2024 and No. 66 of 2025, in the face of almost superimposable censures: arguments, moreover, with which the referring judge completely omits to engage in his otherwise articulated order.

17.1.– As to the projected violation of Article 3 of the Constitution, in the opinion of the *a quo* judge, the requirement of subjection of the person asking to be able to conclude their life to life-support treatments would create an unreasonable disparity in treatment among patients afflicted by very severe pathologies.

In response to an identical censure, this Court has already underlined that it is "fully aware of the intense suffering and prostration experienced by one who, afflicted for years by degenerative pathologies of the nervous system, and now arrived at an advanced state of the disease, associated with almost total immobility and consequent dependence on the assistance of third persons for the most basic needs of daily life, experiences this situation as intolerable”. Nonetheless, this Court continued, "the requirement of the patient's dependence on life-support treatments [...] performs, in the absence of legislative intervention, a pivotal role in the logic of the solution adopted with Order No. 207 of 2018, later taken up in Judgment No. 242 of 2019. [...] [I]n fact, this Court did not recognize a general right to terminate one's life in any situation of intolerable suffering, physical or psychological, determined by an irreversible pathology, but only deemed it unreasonable to preclude access to assisted suicide by patients who—while being in those conditions, and keeping their decision-making capacities intact—already have the right, recognized to them by Law No. 219 of 2017 in conformity with Article 32(2) of the Constitution, to decide to put an end to their life by refusing the treatment necessary to ensure survival. Such a *ratio*, evidently, does not extend to patients who do not depend on life-support treatments, who do not have (or do not yet have) the possibility of letting themselves die simply by refusing care. The two situations are, therefore, different from the point of view of the *ratio* adopted in the two mentioned decisions; thus the very premise of the censure alleging unreasonable disparity in treatment of analogous situations, formulated with reference to Article 3 of the Constitution, falls away” (Judgment No. 135 of 2024, point 7.1. of the Considerations in Law, as well as—in superimposable terms—Judgment No. 66 of 2025, point 6.1. of the Considerations in Law).

As regards the passages, cited by the referral order, of the National Bioethics Committee's opinion of July 18, 2019, it is first necessary to note—as punctually observed by the interventions *ad opponendum* and various *amici curiae*—that the Committee published a new and more articulated document in 2024 specifically on the topic of the relevance of the patient's subjection to life-support treatments when requesting access to assisted suicide, which the *a quo* judge fails to take into account (National Bioethics Committee, response of June 20, 2024, to the query of the Territorial Ethics Committee of the Umbria Region of November 3, 2023). In the majority report contained in that document, no indication is found concerning the alleged discriminations to which the requirement in question would give rise.

The evaluations expressed in previous Judgments No. 135 of 2024 and No. 66 of 2025 in relation to the censure under examination must therefore find full confirmation herein as well.

17.2.– As to, then, the censures alleging violation of the personalist principle, personal freedom, and freedom of self-determination in the therapeutic sphere, which the referring judge anchors as a whole to Articles 2, 13, and 32 of the Constitution, this Court has already underlined how there is no doubt "that from the three mentioned constitutional norms flows the patient's fundamental right to refuse any medical treatment, including those necessary to guarantee survival [...]; a right upon which the evaluation of unreasonableness of the prohibition of assistance to suicide provided in favor of one who already has the possibility of putting an end to their life by refusing a life-support treatment is founded” (Judgment No. 135 of 2024, point 7.2. of the Considerations in Law).

It has however also specified that it is "precisely the protection of the freedom of self-determination that justifies, first of all so that it is genuine and responsible, its balancing with the State's duty to protect life, which ‘occupies an apical position within the fundamental rights of the person’ (Judgments No. 135 of 2024, point 5.1. of the Considerations in Law, and No. 50 of 2022, point 5.2. of the Considerations in Law, which specifies, then, at point 5.3.: ‘When the good of human life comes into play, therefore, the freedom of self-determination can never unconditionally prevail over the reasons for protecting the same good, resulting, on the contrary, always constitutionally necessary a balancing that ensures its minimum protection’)” (Judgment No. 66 of 2025, point 7 of the Considerations in Law).

"If it is true”, it was observed in this perspective, "that every choice to legalize practices of assisted suicide or euthanasia broadens the spaces recognized to the person's autonomy in freely deciding on their own destiny, it creates—at the same time—risks that the legal system has the duty to avoid, in fulfillment of the duty to protect human life which, itself, flows from Article 2 of the Constitution [...]. The risks in question do not concern only the possibility that overtly abusive conduct might be performed by third parties to the detriment of the single person who makes the choice to put an end to their existence, but concern also [...] the possibility that, in the presence of permissive legislation not accompanied by the necessary substantive and procedural safeguards, an ‘indirect social pressure’ might be created on other sick or simply elderly and lonely persons, who might convince themselves that they have now become a burden to their family members and to society as a whole, and thus decide to step aside prematurely” (Judgment No. 135 of 2024, point 7.2. of the Considerations in Law).

"[T]he task of this Court”—Judgment No. 135 of 2024 continued—"is therefore not that of substituting itself for the legislature in identifying the abstractly most appropriate point of equilibrium between each individual's right to self-determination over their own existence and the counterposed instances of protection of human life, their own and that of third parties; but rather, solely, that of fixing the minimum limit, constitutionally imposed in light of the legislative framework under scrutiny, of the protection of each of these principles, leaving then firm the possibility for the legislature to identify solutions that ensure more intense protection to one or the other”.

In short, "[s]uch a margin of discretion makes constitutionally non-mandatory the choice—not precluded, hypothetically, to the legislature, provided it deploys the necessary guarantees against risks of abuse and abandonment of the sick person [...]—to allow access to assisted suicide also to patients capable of making free and responsible decisions, afflicted by irreversible pathologies causing them intolerable suffering, but whose vital functions do not depend on life-support treatments” (Judgment No. 66 of 2025, point 6.2. of the Considerations in Law).

Without prejudice, however, to "the Republic's duty to respond to the appeal that springs from fragility, so that a sick person may perceive solidarity around them not in patches, not at prolonged intermittences, but on a continuous basis, through a path of effective taking-in-charge by the health and social system” (Judgment No. 66 of 2025, point 7.2. of the Considerations in Law), as well as by means of "an adequate development of palliative care networks [...], in order to avoid improper recourse to assisted suicide” (again Judgment No. 66 of 2025, point 7.3. of the Considerations in Law).

On this occasion as well, it is nonetheless appropriate to underline how the referring judge's assumption according to which, in order to legitimately access assisted suicide, the sick person should "first ask to be subjected to a treatment [of life support] and then renounce it” is not shareable. As already highlighted in Judgments No. 135 of 2024 and No. 66 of 2025, "the fundamental right stemming from Articles 2, 13, and 32(2) of the Constitution, in the face of which this Court has deemed an absolute prohibition of assistance to suicide not justifiable on a constitutional plane, also includes—even before the right to interrupt ongoing medical treatments, albeit necessary for survival—that of refusing *ab origine* the activation of the treatments themselves. From a constitutional standpoint, there can therefore be no distinction between the situation of the patient already subjected to life-support treatments, whose interruption they can demand, and that of the patient who, to survive, needs, on the basis of medical evaluation, the activation of similar treatments, which however they can refuse” (Judgment No. 135 of 2024, point 7.2. of the Considerations in Law; analogously, Judgment No. 66 of 2025, point 5.1. of the Considerations in Law).

Therefore, the questions concerning the constitutional legitimacy of Article 580 of the Penal Code, raised with reference to Articles 2, 3, 13, and 32(2) of the Constitution, must be declared unfounded.

on these grounds

THE CONSTITUTIONAL COURT

1) declares inadmissible the question concerning the constitutional legitimacy of Article 580 of the Penal Code, raised, with reference to Article 117(1) of the Constitution, in relation to Article 8 of the European Convention on Human Rights, by the Judge for Preliminary Investigations at the Ordinary Court of Bologna, by the order indicated in the headpiece;

2) declares unfounded the questions concerning the constitutional legitimacy of Article 580 of the Penal Code, raised, with reference to Articles 2, 3, 13, and 32(2) of the Constitution, by the Judge for Preliminary Investigations at the Ordinary Court of Bologna, by the order indicated in the headpiece.

So 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, Rapporteurs

Valeria EMMA, Registrar

Filed in the Registry on July 24, 2026

 

The anonymized version conforms, in its text, to the original