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Europe

Calls for Reform, Recriminations After Italian Coma Patient's Death

The controversy surrounding a woman's death after 17 years in a coma hasn't abated. Italy's prime minister and the Vatican have said she was murdered, while others say her case shows the need for living wills.

Eluana Englaro

Englaro's personal tragedy has become a very public issue

After the news that Englaro had suffered a fatal heart attack on Monday, February 9, organizations and politicians outside of Italy have called for legal reforms to prevent the political wrangling that marked the Italian woman's final days after 17 years spent in a coma.

The German Hospice Foundation -- a patients' rights group -- said that similar cases could happen in Germany and argued for clear right-to-die legislation.

"A politicization such as in Italy can only be permanently prevented by a living-will law that establishes clear rules for determining [a patient's] will," the foundation said it an official press statement.

Englaro -- who suffered terminal injuries in a car accident in 1992 and had been in a coma for 17 years -- made headlines throughout Europe after Italian Prime Minister Silvio Berlusconi tried to force through a law overturning a court order that had allowed life-support measures to be discontinued.

Englaro's father succeeded in convincing an Italian court that his daughter would not have wanted to be kept alive artificially for so long. Advocacy groups say the patient's own preferences should have primacy in such cases.

Italian pro-life activists and right-to-die activists yell at each other

Italian pro-life and right-to-die activists squared off over the woman's fate

"The patient's will, and the patient's will alone, should be decisive in the elemental distinction between the right to die and the prohibition against killing others," the German Hospice Foundation argued in its statement regarding Englaro's death.

That position has received considerable support from German politicians -- at present three laws regulating living wills are circulating the country's lower house of parliament, the Bundestag.

The author of one of those pieces of legislation told the Protestant news agency EPD that Englaro's cases showed the need to establish the legal validity of patient declarations in cases of incurable disease or injury.

Among the thorny issues to be decided are whether statements concerning medical wishes need to be notarized and whether a person to whom the patient has granted power of attorney should have to make the final decision between life and death.

Italy divided

Italian President Giorgio Napolitano talks at the San Carlo theater in Naples

Italian President Giorgio Napolitano refused to sign Berlusconi's bill into law

There have been calls for legal reforms to allow living wills in Italy as well, but others want to see the judiciary step in to keep patients like Englaro alive.

Most prominently, Prime Minister Berlusconi insinuated that Englaro's death had been hastened because of fears that legislation he had initiated would have required doctors to keep her alive.

"Eluana did not die a natural death," Berlusconi told the conservative newspaper Libero. "She was killed while they were discussing whether or not the government's bill was constitutional."

The Catholic Church struck a similar tone in its reactions, with one prominent cardinal, Javier Lozano Barragan, saying in a statement that he was praying for God to forgive "all those who brought (Englaro) to this point."

Prosecutors in the northeast Italian city of Udine, where Englaro died, are set to carry out a routine autopsy to determine the exact causes of her death.

Italy's constitution forbids euthanasia but does permit patients to refuse medical treatment, and right-to-die groups there say they hope legislation will be passed to establish the validity of living wills.

But many of those who wanted to keep Englaro alive are calling for laws to prohibit such statements of preference, so the debate surrounding the issue of whether individuals have a right to die will likely be significantly more heated in Italy than in Germany.

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