The topic of end-of-life care today requires the ability to combine spiritual sensitivity with knowledge of current regulations. In Italy, the matter is regulated by Law No. 219 of December 22, 2017, which protects the right to life, health, dignity, and self-determination.

1. The legal framework: Law 219/2017

The Italian legislation is based on the principle of informed consent: no medical treatment can be started or continued without the free and informed consent of the person.

• The DAT (Art. 4): every person of legal age and capable of understanding and willing may draw up their own Advance Healthcare Directives. In these, they indicate their wishes regarding the acceptance or refusal of diagnostic tests, therapeutic choices, and individual medical treatments (including, by law, artificial nutrition and hydration).
• The Role of the Trustee (Fiduciario): the law provides for the appointment of a figure who acts on behalf of the patient in relationships with doctors and healthcare facilities when the signatory is no longer able to express themselves.
• Obligations for the physician: the doctor is required to respect the DAT, unless they appear clearly incongruous or inconsistent with the patient’s current clinical condition, or if treatments unpredictable at the time of signing become available.

2. How are DATs formalized in Italy?

To be valid, DATs must be drafted in one of the following ways:

1. Public deed or authenticated private agreement (before a Notary).
2. Private agreement personally delivered to the Civil Status Office of the Municipality of residence.
3. At healthcare facilities (in Regions that have regulated the collection).

All DATs are recorded in the National Database, which can be consulted by doctors in case of emergency and patient incapacity.

3. A community commitment

Informing oneself about DATs is not just a bureaucratic requirement, but a way to bear witness to a faith that does not fear fragility and seeks, until the end, the dignity of the person. In this regard, Monsignor Vincenzo Paglia, President of the Pontifical Academy for Life, stated: “The Church looks with favor on legislation that respects the will of the patient, provided that this does not turn into a request for euthanasia, but remains a request for proportionate care and human accompaniment”.

4. What can be decided?

Through the DATs you can express your acceptance or refusal regarding:

• Diagnostic tests or specific therapeutic choices.
• Individual medical treatments (for example: mechanical ventilation, dialysis).
• Artificial nutrition and hydration, which Italian law expressly defines as medical treatments.

5. The figure of the trustee (fiduciario)

In the DATs, it is advisable (but not mandatory) to appoint a trustee: a person you trust who can represent you in relationships with the doctor and healthcare facilities.

• The trustee must be of legal age and must accept the appointment by signing the document.
• In the absence of a trustee, the DATs still remain effective.

6. Are DATs revocable?

Yes, DATs are always revocable or modifiable. If, due to an emergency, it is not possible to do so in writing, the directives can also be revoked through a verbal declaration in front of two witnesses or via video recording.

7. Why are they important?

They guarantee respect for dignity and freedom of choice, relieving family members of the burden of having to make difficult decisions without knowing the true wishes of the person concerned.

8. Don’t face this choice alone: request a dedicated advice

Navigating the subsections of Law 219/2017 and the moral implications of end-of-life care requires technical expertise and deep sensitivity. Defining your DAT is not a mere bureaucratic task, but an act of protection for yourself and of peace of mind for your loved ones.

If you wish to examine the legal profile in depth, correctly draft your directives, or appoint a trustee with the certainty that every word faithfully reflects your will and your values, we are at your disposal for a specific legal advice.

What we can do for you:

• Personalized legal analysis: verifying the consistency of your wishes with current Italian regulations.
• Drafting support: technical writing of the clauses to avoid interpretative ambiguities by physicians.
• Assistance in the filing procedure: guidance on the steps to take at the Civil Status Office or before a Notary.

Contact us to schedule an individual informative meeting or for your community organization by writing an email to: info@fiatlux.legal

Acting today with awareness is the greatest legacy you can leave to those you