Towards a New Italian Secular and European Bioethics: Criteria, Models, and an Operational Proposal

Italian bioethics emerged as an extension of academic moral philosophy rather than as a clinical practice. The delegation of ethical governance to moral philosophers, combined with the importation of American principlism and the persistence of Catholic anthropology, produced an abstract and ideologically polarized model that is poorly aligned with the realities of clinical practice. In contrast, European bioethics developed as a prudential and contextual practice rooted in clinical work, palliative medicine, therapeutic proportionality, and relational responsibility. Germany, France, Switzerland, Austria, and Scandinavia offer mature models of clinical bioethics grounded in Aristotelian phronesis, shared responsibility, and a cultural understanding of human limits. This article proposes the criteria for a new Italian secular and European bioethics capable of restoring ethical governance to clinicians, integrating palliative care as an autonomous discipline, and grounding clinical decision-making in measure, prudence, and relationality. An operational roadmap for the next decade is outlined, aimed at building an Italian bioethics finally rooted in clinical practice and in the European culture of limits.