Eluana's 17-year sleep caught up in legal row over treatment

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The case of a woman who has been comatose for 17 years has divided opinion throughout Italy

ELUANA HAS been “sleeping” for the last 17 years, ever since a January 1992 car accident that left her in a “persistent vegetative state”. Not only did she suffer injuries to the spine that have almost certainly left her totally paralysed but, more tragically, she suffered brain damage that has left her in a comatose state.

For nearly all of the last 17 years Eluana has been cared for by the Misericordia sisters in a hospice in her native town of Lecco, northern Italy. She has been kept alive, thanks to a feeding tube. She gives no indication of hearing or seeing anyone or anything.

She has to be “turned” in her bed every two hours while sometimes she is moved into a chair where the nuns have to be careful to put her leaning back so that she does not fall forward.

For the last decade, presumably unknown to her, 38-year-old Eluana has been at the centre of a complex legal wrangle as her father, Beppino Englaro, has requested the right to disconnect her feeding tube, in accordance, he says, with her own wishes expressed before the accident.

Her plight, and that of her family, has prompted deep divisions in Italian society. She has become “Italy’s Terry Schiavo”, the brain-damaged Florida woman who died in 2005 after her feeding tube was removed, following a seven-year legal battle between her husband and parents.

On Monday Eluana’s case may have moved to a definitive “endgame” when a Milan court upheld a previous landmark “right-to-die” ruling, overruling a decision by Lombardy local government to refuse to make clinics or health workers available to the Englaro family so that she might be allowed to die.

When the case came before the Corte di Cassazione (High Court) in October of 2007, the court ruled that two conditions had to be met in order to allow the disconnection of her feeding tube.

Firstly, the court would have to satisfy itself that her condition was “irreversible” and that there was not the “slightest possibility of a regaining of consciousness”. Secondly, it must be proven that the patient, before the accident, had stated she would be opposed to such treatment for herself in the event of a serious accident.

On the first count, medical and “spiritual” opinion is obviously divided. After visiting Eluana some years ago, neurologist Carlo Defanti of Milan’s Niguarda hospital commented: “Even if she is not suffering directly in her present state, it should be clear to everyone that her condition lacks dignity. Of her, there remains a body incapable of experiencing any sensation, totally dependent on the people who look after her.

“Her condition is painful for those who look after her and who have long ago given up hope of her regaining consciousness and it is painful for her parents who have lost a daughter but who cannot fully mourn her.”

Yet, after that court had awarded Beppino Englaro the right to disconnect Eluana’s life support last November, Cardinal Ennio Antonelli, head of the Vatican’s Pontifical Council for the Family, objected, saying: “Eluana is in a vegetative state but she is not a vegetable. She is a person who is sleeping. The person, also when she is sleeping or disabled, retains all her dignity.”

Last July, L’Avvenire, the daily run by the Italian Bishops’ Conference, also rejected any idea of terminating Eluana’s “treatment”, writing: “To take care of the sick and in particular of those who are incurable, of the ‘repugnant’ ones and of those for whom there is no hope not only of a cure but even of a simple improvement has a profound meaning.” That argument will run and run.

As for the second condition established by that 2007 ruling, lawyers for the Englaro family have claimed that after visiting a friend in hospital not long before her own accident, a friend in a similar comatose condition, Eluana told her parents that if anything like that were to happen to her, she did not want to be kept alive. As her legal guardian, Beppino Englaro claims he is trying to ensure that her will (expressed verbally but not written) be done.

What will happen now? This week’s ruling calls on the Lombardy region to “indicate” a suitable health clinic where Eluana might be allowed to die. In the wake of last November’s ruling, a clinic in Udine had offered to accommodate Eluana. However, the clinic withdrew that offer after health minister Maurizio Sacconi issued an instruction prohibiting state health clinics and those linked to the national health system from suspending Eluana’s nutrition. (That instruction is the subject of an ongoing judicial inquiry).

Last week, the governor of Piedmont, Mercedes Bresso, said that her region was ready to help the Englaro family. In response, the Archbishop of Turin, Severino Poletto, claimed that to stop Eluana’s nutrition would be “an act of euthanasia” and “against the law of God”. To which Governor Bresso further replied that “we’re not living in a republic of ayatollahs” where religion overruled the law.

The debate continues hot and heavy. What some see as “passive euthanasia” is simply “state murder” for others. Meanwhile Eluana sleeps on.

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