Turillazzi Emanuela, Morena Donato, Iacoponi Naomi, Fineschi Vittorio
Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
Department of Anatomical, Histological, Forensic and Orthopedic Science, Sapienza University of Rome, Rome, Italy.
Front Psychiatry. 2025 Jul 9;16:1606036. doi: 10.3389/fpsyt.2025.1606036. eCollection 2025.
Physician-assisted suicide (PAS) remains a subject of global debate and ethical controversy, alongside other end-of-life issues such as euthanasia, palliative care, access to health and social care services, and, importantly, patient autonomy. Within this context, PAS is defined as the practice in which a physician, at the explicit request of a competent patient, prescribes a lethal medication that the patient may self-administer to end their own life. This definition clearly distinguishes PAS from euthanasia, wherein the physician directly administers the life-ending drug. Despite ongoing efforts to establish a unified definition, significant variability remains across jurisdictions with regard to eligibility criteria, procedural safeguards, and the overarching legal and ethical frameworks governing PAS. In Italy, there is currently no effective legislation regulating euthanasia or PAS, which remain practices punishable under Articles 579 (homicide of a consenting person) and 580 (instigation or assistance in suicide) of the Italian Criminal Code. The Tuscany Region has prepared a regulatory attempt at the regional level, which has, however, limited itself to proposing an operational protocol that distinguishes the operational responsibilities that the PAS procedure applicant will face. However, following several relevant cases that profoundly influenced the Italian debate, significant attention has been directed toward end-of-life issues.
医生协助自杀（PAS）仍然是全球辩论和伦理争议的主题，与安乐死、姑息治疗、获得健康和社会护理服务等其他临终问题，以及重要的患者自主权问题一并存在。在此背景下，PAS被定义为医生应具备行为能力的患者明确请求，开具致命药物，由患者自行服用以结束生命的行为。这一定义明确区分了PAS与安乐死，安乐死是医生直接给予结束生命的药物。尽管一直在努力确立统一的定义，但在资格标准、程序保障以及管辖PAS的总体法律和伦理框架方面，不同司法管辖区仍存在很大差异。在意大利，目前没有有效的立法规范安乐死或PAS，根据意大利《刑法典》第579条（同意他人杀人）和第580条（教唆或协助自杀），这些行为仍应受处罚。托斯卡纳大区已在区域层面进行了监管尝试，但仅限于提出一项操作协议，该协议区分了PAS程序申请人将面临的操作责任。然而，在几起深刻影响意大利辩论的相关案件之后，人们对临终问题给予了极大关注。
