A centre-right proposal on end-of-life care has also emerged in Sicily

Following Veneto, the first centre-right region to pass a law on end-of-life care, the debate is now also opening up in Sicily, led by Renato Schifani. A draft bill signed by Stefano Pellegrino and Salvo Tomarchio, both of Forza Italia, has been tabled in the Sicilian Regional Assembly: the measure aims to establish clear procedures and timeframes for the regional health service regarding medically assisted suicide. Unlike in Veneto, the debate amongst the majority allies in Sicily appears to be moving towards reaching a consensus.

In Sicily, this issue is not new, but it has always remained deadlocked. Two proposals from opposing sides of the political spectrum have been pending in the Sicilian Regional Assembly (Ars) for some time: one from the Democratic Party, with Giovanni Burtone as the lead signatory, tabled in March 2024, which endorses the ‘Liberi Subito’ citizens’ initiative bill promoted by the Luca Coscioni Association; and one from the M5S, signed by Luigi Sunseri, presented last year.

A year and a half ago, the Health Committee came within a hair’s breadth of giving the green light, only for the final vote to be called off at the last moment. It is against this backdrop of deadlock that Forza Italia’s proposal now comes into play, seeking to reopen the debate by building on the model that the centre-right has already trialled elsewhere. Pellegrino and Tomarchio are advocating a framework that does not introduce new rights but instead reforms the organisation of the regional health service, modelled on what has already been done in Puglia by Marcello Lanotte (Forza Italia) and Napoleone Cera (Lega).

The debate has flared up again in Piedmont too. The Coscioni-led citizens’ initiative bill has already secured the necessary number of signatures to proceed, whilst in an unprecedented alliance, the PD and the Lega are working within the Regional Council to finalise a joint text. The case in Veneto, however, remains the most contentious precedent, not least because of the internal tensions it has caused: the ‘Liberi Subito’ citizens’ initiative bill was passed on 2 September with 32 votes in favour, 14 against and 5 abstentions, but the centre-right bloc split: Fratelli d’Italia voted unanimously against it, whilst the Lega was divided between Zaia’s pro-legislation wing and those opposed, led by group leader Riccardo Barbisan. Forza Italia was also split.

A model which, in Palermo, does not seem – for the time being – to be causing the same divisions: when interviewed by Il Foglio, the majority group leaders expressed caution rather than outright opposition. Speaking on behalf of Fratelli d’Italia is group leader Giorgio Assenza, who is biding his time ahead of the bill’s arrival in the chamber: “We have not yet held a meeting to assess the bill, but our position will be in line with the national one: we are against futile medical treatment but at the same time against euthanasia. Perhaps by assessing it together or making a few amendments, we can arrive at a shared proposal”.

Meanwhile, the Lega is taking a more open stance. “We are approaching this issue with a great sense of responsibility,” explained Salvo Geraci, the Lega’s group leader in the Sicilian Regional Assembly, “aware that this is an ethically sensitive matter that demands respect. We believe that any action must be strictly consistent with the regulatory framework and the rulings of the Constitutional Court, without the regions overstepping their powers. The bill tabled by Forza Italia in the Sicilian Regional Assembly represents a contribution to the debate and deserves in-depth discussion in committee.”

There are also signs of willingness to engage from the opposition. Giovanni Burtone, of the PD, confirms that Forza Italia’s draft bill will be discussed on Tuesday in the Health Committee. The MP says he “trusts the work of his colleagues in Forza Italia, convinced that efforts will be made within the centre-right coalition to reach an agreement”. He sets out one condition, however: his and the PD’s objective, he explains, is to arrive at “a serious and respectful law”, not “just any law on end-of-life issues”. For this reason, he adds, discussions with Forza Italia will also resume on the basis of the old 2024 draft bill, in an attempt to forge a path “shared between the majority and the opposition”.

Behind the initiative lie the figures for a problem that remains largely hidden in Sicily more than elsewhere: around 130 phone calls a month – over 1,500 a year – are received by the Luca Coscioni Association from people seeking information on end-of-life care. Advance healthcare directives (ADTs) have risen to 15,538 – one for every 226 adults – representing a 15 per cent increase over two years, but they remain far below the national average of one for every 166 inhabitants. Whether the bill drafted by Pellegrino and Tomarchio will succeed in paving the way for a majority agreement – as Assenza himself hopes – or whether it will remain yet another proposal gathering dust in a drawer at the Regional Assembly, will become clear in the coming weeks, when the FdI and Lega groups make their positions known. “Veneto certainly serves as a benchmark for the approach it has taken to this issue,” concludes Lega member Geraci, “but there are no models to be copied automatically. Sicily has its own healthcare and institutional context and will need to develop a strategy consistent with the needs of the region.”