Image: Wikimedia Commons – Perugia, capital city of Umbria, Italy
The Italian region of Umbria has approved legislation regulating access to assisted suicide, becoming the fifth region in the country to introduce rules governing the practice despite continuing opposition over the risks to vulnerable people and the absence of a national legal framework.
The regional assembly in Perugia approved the citizens’ initiative bill on Thursday 22nd October by eleven votes to six, with three abstentions. Regional president Stefania Proietti did not take part in the vote. The legislation sets out procedures and timescales for requests for medically assisted suicide, following years of uncertainty after Italy’s Constitutional Court ruled that assisted suicide could be lawful in certain circumstances.
The bill was developed by the Luca Coscioni Association, which campaigns for assisted suicide, and was supported by 4,801 signatures. It was dedicated to Laura Santi, a journalist from Perugia who had multiple sclerosis and died by assisted suicide at home in July 2025, following a three-year legal battle. Her husband, Stefano Massoli, attended the parliamentary debate.
Under a landmark Constitutional Court ruling in 2019, assisted suicide can be permitted in Italy under specific conditions. These include an irreversible medical condition causing intolerable suffering, dependence on life-sustaining treatment, and the ability to make a free and informed decision. The court called on the national parliament to establish a comprehensive legal framework, but no national legislation has been enacted.
In the absence of national rules, several regions have moved to regulate the procedures through their healthcare systems. Umbria joins Tuscany, Sardinia, Emilia-Romagna, and Veneto, which approved its legislation last month under a centre-right administration.
The Umbrian law requires local health authorities to establish permanent multidisciplinary commissions to assess whether applicants meet the legal criteria. These will include specialists in palliative care, psychiatry, anaesthesia, psychology, forensic medicine, and nursing.
Supporters argue that formal procedures will reduce delays and provide greater clarity for people seeking assisted suicide. Regional vice-president Tommaso Bori described the vote as “a conquest of civilisation, freedom and dignity”.
However, the legislation has faced opposition from politicians who argue that healthcare services should focus on caring for patients rather than facilitating their deaths. Proietti, who did not participate in the vote, has argued that the issue should be addressed by the national parliament to ensure consistent rules across Italy. She has also emphasised the need to expand access to palliative care.
The national government, led by Prime Minister Giorgia Meloni, maintains that assisted suicide legislation falls within the authority of the state rather than regional administrations. It has challenged similar laws passed by Tuscany and Sardinia before the Constitutional Court, and has indicated that it will challenge other regional measures. The court partially upheld the challenge to Tuscany’s legislation in 2025, while confirming that regions could regulate certain organisational aspects of healthcare delivery.
The vote in Umbria adds to pressure on Italy’s national parliament to resolve the legal uncertainty surrounding assisted suicide. It also deepens a debate over whether the response to suffering should involve helping people to end their lives or ensuring that they receive the care and support they need to live with dignity.
Peter Kearney, SPUC’s Communications Manager, said: “The decision in Umbria is a worrying development for the protection of vulnerable people. Healthcare should be about caring for people, relieving suffering, and supporting them through the most difficult moments of their lives, not establishing procedures to help them end those lives.
“People living with serious illness or disability deserve the assurance that society values them and will provide the care they need. Expanding access to assisted suicide risks sending the opposite message, particularly where people may already feel isolated or burdensome. Governments should prioritise high-quality palliative care and practical support so that no one feels that death is their best or only option.”
