• Suicide, Assisted (Physician-assisted suicide); Euthanasia; Terminal Care (End-of-life care); Personal Autonomy (Right to self-determination); Bioethics; Legislation, Medical (Italian legislation). The absence of national legislation on access to physician-assisted suicide (PAS) has led to significant behavioral uncertainty. To fill this legal gap, in February 2025, the Tuscany region passed a regional law, translating into legislative action the guidance provided by two rulings of the Constitutional Court. We analysed other European countries’ legislations, as much as Italian Constitutional Court rulings No. 242/2019, No. 135/2024, and No. 204/2025, in combination with the previous regional adaptation attempts (Emilia-Romagna’s resolution, Veneto’s draft law), finally focusing on Tuscany and Sardinia laws. Our analysis highlights the heterogeneity of PAS regulations across Europe. Some countries—such as Belgium, Luxembourg, Switzerland, Spain, and Austria—have legalized forms of euthanasia or PAS through structured legal frameworks. Others—such as France, the UK and the Czech Republic—have severely restricted these practices. Ireland and Germany are currently undergoing legislative transitions. In Italy, the only existing regulation is Tuscany’s law. The Constitutional Court deemed Article 580 of the Penal Code unconstitutional in the section where is not excluded punishment for assisted suicide under certain conditions. With no national legislative action, regions like Tuscany have acted. Tuscany’s citizen-driven law differentiates PAS from euthanasia, defines the care process, involved professionals, traceability, ethical oversight and consent validation. The service is free with extra regional funds. Ethically, it raises issues of self-determination and the line between dying with dignity and therapeutic obstinacy.
Bonilla et al. (Sun,) studied this question.