BMJ  2007;334:9 (6 January), doi:10.1136/bmj.39079.456400.DB

News

Anaesthetist helps Italian patient who wanted to die

¹ Milan

Piergiorgio Welby, the terminally ill Italian man with muscular dystrophy who in an open letter to the Italian president pleaded for his right to die, has died.

A few days before Christmas, after a long battle against the illness, he was sedated by an anaesthetist, who unplugged the mechanical ventilator that had kept him alive against his will.

"My dream, my desire, my request—which I want to put to any authority, from political to judicial ones—is today in my mind more clear and precise than ever: being able to obtain euthanasia," Mr Welby had written from the bed in which he spent his last months, unable to eat, speak, or breathe by himself.

His open letter to President Giorgio Napolitano put the personal battle at the centre of a heated political debate about advance directives, assisted suicide, and euthanasia (BMJ 2006;333:719). Mr Welby's lawyers asked a court in Rome to allow his ventilator to be turned off, but in mid-December the answer revealed a legal loophole: although Italian patients have the constitutional right to refuse treatment, no doctor is obliged to respect such refusal, and assisted suicide and euthanasia are punishable by prison terms of up to 15 years.

After this legal attempt failed, Mario Riccio, an anaesthetist working in a hospital in Cremona, in northern Italy, volunteered to carry out Mr Welby's wish.

"I got to know Piergiorgio Welby," he said. "We had a long talk in which he confirmed fully his will that the therapy be interrupted."

In Mr Welby's apartment in Rome, in the presence of dozens of Mr Welby's relatives and friends—among them law makers from the centre left majority parties—Dr Riccio sedated him intravenously for about 40 minutes as the respirator that had kept him alive since 1997 was disconnected.

Dr Riccio told reporters that he did not fear legal consequences. He said, "In Italian hospitals therapies are suspended all the time, and this does not lead to any intervention from magistrates or to problems of conscience." He was briefly questioned by the police, but his lawyers said that he was not accused of anything. The medical board is also evaluating the case.

Mr Welby's wife and sister, both practising Roman Catholics like him, asked for a religious funeral in their parish in the Cinecittà quarter of Rome, but Vatican authorities, who have always opposed euthanasia and insist that any life must be safeguarded until its "natural" end, said that his funeral could not be celebrated in a Catholic church.

"The debate will continue," said the prime minister, Romano Prodi, a Catholic who heads a centre left coalition, "and it is clear that a country, a government, cannot help taking into account the great value of human life and therefore must reflect deeply on this case."

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