Palliative Care and Quality of Life in the New Italian Code of Medical Ethics

A brief analysis of the most significant provisions of the new Italian Code of medical ethics reveals the centrality of the ethical principles of beneficence, respect of autonomy, proportionality of care in the doctor – patient relationship. In general, the application of these principles results in particular attention to promote the wellbeing and the quality of life of the patient, taken as a whole in his/ her global dimension as a ‘person’. This is explicitly stated in Section 3 of the Code according to which duties of the physician are the protection of life and psycho-physical health, the treatment of pain, and the relief of suffering, respecting the freedom and the dignity of the person. The Authors therefore intend to analyse the new provisions of the Code, concerning the assistance to terminal patients and designed to establish specific rules of behavior, e.g. the avoidance of diagnostic procedures and therapeutic interventions not proportionate to the effective condition of the patient (Section 16), the prohibition of acts intended to cause thepatient’s death (Section 17), the use of palliative care, pain sedation, and relief of suffering (Section 39). These provisions reflect a concept of protection of health which includes including all measures directed to achieve the best mental and physical balance in terminally ill patients, respectful of the dignity and therefore of the wishes freely expressed by the individual regarding his/ her treatments (Section 38). In assessing the moral significance of the very complex concept of quality of life, the Authors also intend to probe its direct bearings on the ethics of the healing practices and the medical profession.