[Life-Sustaining Treatments: a requirement for accessing medically assisted suicide, or a trap for doctors and patients?].

The paper analyzes the concept of "Life-Sustaining Treatments" (LST) in the context of Medically Assisted Suicide (MAS) in Italy. The authors highlight how the requirement of LST, established by Constitutional Court Ruling n. 242/2019 along with three other criteria (irreversible pathology, intolerable suffering, decision-making capacity), has often been used to reject requests for access to MAS. Subsequent Constitutional Court rulings (135/2024 and 66/2025) have progressively expanded the definition of LST, including care procedures such as bowel evacuation, urinary catheterization, and mucus aspiration, and establishing that there can be no discrimination between those already undergoing treatments and those who legitimately refuse them. The authors argue that the traditional notion of LST, associated with advanced technologies such as ventilators or dialysis, is now outdated. In modern clinical practice, LST comprises the integrated set of devices, medical supplies, drugs, and care procedures that keep alive people with severe and progressive diseases, including oxygen therapy, chemotherapy, cardiovascular support medications, and nursing procedures. The document criticizes the restrictive use of the LST requirement as a "technical loophole" that prevents access to MAS, hoping that a future law will focus on essential aspects (irreversible disease, intolerable suffering, voluntariness) rather than on technological distinctions, following the example of other countries with clearer legislation on medically assisted death.