cvcPhysician-assisted suicide in Europe: Comparative legal perspectives and the emerging role of Italian regional legislation

Leg Med (Tokyo). 2026 Feb 23;82:102821. doi: 10.1016/j.legalmed.2026.102821. Online ahead of print.

ABSTRACT

INTRODUCTION: The absence of national legislation regulating access to physician-assisted suicide (PAS) in Italy has generated significant legal uncertainty. In response to this regulatory gap, the Tuscany region adopted a regional law in February 2025, translating into procedural rules the criteria established by Constitutional Court judgments.

MATERIALS AND METHODS: We conducted a qualitative comparative legal analysis of European regulatory frameworks on euthanasia and PAS, examining national legislation and relevant constitutional or judicial rulings. With specific reference to Italy, we analysed Constitutional Court judgments No. 242/2019, No. 135/2024, and No. 204/2025, as well as regional legislative initiatives, focusing on Tuscany and Sardinia.

RESULTS: The analysis confirms the heterogeneity of European approaches to PAS, which can be broadly classified into permissive, transitional, and prohibitive models. While several countries have introduced comprehensive statutory frameworks, others rely on judicial developments or maintain criminal prohibitions. In Italy, PAS currently operates within a judicially defined space in the absence of national legislation, with regional interventions representing interim regulatory responses.

DISCUSSION: Constitutional Court rulings have partially decriminalized assistance to suicide under specific conditions, while repeatedly urging parliamentary intervention. In the absence of national legislation, regional laws-particularly in Tuscany and Sardinia-have sought to regulate procedural access to PAS within the limits of regional competence. Judgment No. 204/2025 clarified the constitutional boundaries of such intervention, confirming the legitimacy of regional regulation limited to healthcare organization, while excluding encroachment into criminal law.

PMID:41795486 | DOI:10.1016/j.legalmed.2026.102821