Italy’s political and constitutional debate over medically assisted suicide has intensified after the national government decided to challenge an end-of-life law adopted by the Emilia-Romagna regional government.

The Council of Ministers decided to bring the regional legislation before Italy’s Constitutional Court, arguing that parts of the law raise constitutional questions concerning the division of powers between the national government and regional authorities.

The Emilia-Romagna law, approved in July, establishes organisational procedures for implementing Constitutional Court rulings concerning medically assisted suicide. It sets out how requests should be handled by the regional health system and how medical and administrative procedures should be organised.

The national government has argued that some provisions go beyond the region’s authority. According to the government’s explanation, the legislation delegates the definition of certain requirements to regional guidelines, potentially entering areas that fall under the exclusive jurisdiction of the state.

The government also raised concerns about palliative care. Palazzo Chigi said the regional framework does not provide sufficiently clear guarantees that patients would first receive an appropriate personalised palliative-care pathway and other forms of support.

The government has linked that argument to its wider healthcare policy. It said national funding for palliative care had been increased by €40 million, bringing the overall allocation to €140 million, while arguing that several regions have not yet fully met implementation targets for those resources.

The Emilia-Romagna regional administration disputes the government’s interpretation of the legislation. Regional President Michele de Pascale has defended the law and said the region had been willing to discuss specific technical changes. He has also argued that the national government should address the issue through national legislation rather than leaving individual regions to develop different regulatory frameworks.

The dispute is taking place against a complicated legal background.

Italy’s Constitutional Court ruled in 2019 that assisted suicide could be lawful in narrowly defined circumstances. A subsequent 2024 ruling further addressed the legal framework surrounding medically assisted suicide. However, Italy’s Parliament has not enacted a comprehensive national law establishing a single legislative framework for the issue.

That legal situation has left regions facing questions about how healthcare authorities should implement existing constitutional principles. Emilia-Romagna is not the only Italian region to have introduced legislation or procedures concerning end-of-life issues. Veneto, Tuscany and Sardinia have also taken steps in this area.

The government’s decision therefore has implications beyond Emilia-Romagna. A Constitutional Court ruling could help clarify the respective responsibilities of the national government and regional authorities and determine how regional legislation can operate within the existing constitutional framework.

Importantly, the government’s decision to challenge the legislation does not automatically suspend the regional law. As of the latest reports, the Emilia-Romagna legislation remains operational while the legal challenge proceeds. The government must formally file its case with the Constitutional Court, after which the court will consider the constitutional questions raised.

The regional health authorities have already received requests connected with the procedure since the law was approved. According to regional reporting, at least two requests had reached local health authorities before the government’s challenge.

The controversy also reflects a broader political disagreement between Italy’s national government and some regional administrations over how sensitive social and healthcare issues should be regulated.

For supporters of a national framework, the dispute highlights the need for Parliament to establish uniform rules. Regional authorities, meanwhile, have argued that existing constitutional jurisprudence requires healthcare systems to provide practical procedures for eligible patients.

The Constitutional Court will ultimately determine whether the disputed provisions comply with Italy’s constitutional division of powers and other relevant constitutional principles.

Until that judicial process produces a ruling, the Emilia-Romagna law remains in effect. The case could therefore become an important test of Italy’s legal framework for medically assisted suicide and the balance between national and regional authority.