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ROME – With Italy poised to hold a referendum on the legalization of euthanasia, the Vatican’s top official on life matters and the head of an Italian government commission on care for the elderly has put forward a new charter stressing the need for better palliative care.

Italian Archbishop Vincenzo Paglia, president of the Pontifical Academy for Life, presented the charter, titled, “Charter of the Rights of the Elderly and the Duties of the Society,” to Italian Prime Minister Mario Draghi in a Sept. 1 audience that was also attended by Italy’s Health Minister, Roberto Speranza.

Drafted by the commission for elderly care after its establishment by the Italian Health Ministry last year, the Charter itself outlines fundamental principles and rights of the elderly, and offers both operational and organizational suggestions to institutions and other entities charged with caring for the elderly.

According to Italian newspaper Il Tempo, Draghi praised the Charter, saying, “the work developed by Monsignor Paglia and the Commission is extraordinary. This is an initiative of enormous social and ethical importance.”

“Italy must guarantee the rights of the elderly and respect for the dignity of the person, in all conditions. Social health care must be adequate and responsible. Therefore, the government will support the proposed intervention presented today,” he said.

In an interview with Vatican News following the meeting with Draghi, Paglia said the Ministry of Health accepted the Charter’s proposal for palliative care, including at home care, “so there will be a help network as we weaken, and problems arise.”

It is a “a cure, therefore, against pain and above all care for the elderly as they go on over the years,” Paglia said.

This news comes as the Italian government faces pressure to legalize euthanasia following a referendum proposal launched Aug. 18 by a host of different organizations, but which is led by the Luca Coscioni Association – founded in 2002 to defend “civil liberties and human rights.”

In Italy it is currently legal to request “medically assisted suicide,” meaning the indirect help from a doctor to die under specific conditions: That the patient asking for it is fully cognizant and aware of what the procedure involves, and that they are willing; that they have an irreversible pathology which causes severe mental or physical suffering; and that they are only able to survive with the help of life-sustaining treatments.

However, euthanasia itself – the direct killing of a patient by a doctor – is still considered a crime in Italian law.

The campaign for the referendum began in July with the goal of gathering the required 500,000 signatures by Sept. 20.

Those signatures have already been gathered and will now be presented to the Italian courts for consideration. If the courts deem the possibility of a referendum legitimate, the vote would be held in 2022.

In his interview with Vatican News, Paglia made no direct reference to the referendum, but when asked, said there was “no doubt” the Charter was a response to it.

“The questions of euthanasia are often not questions of death, but questions of help not to suffer, not to be alone, not to be abandoned. It is this sense that we must creatively and urgently equip with the response of accompaniment,” he said.

Paglia said asking to die is not normal, and that what the people who turn to this really want and need “is not to be abandoned and not to suffer.”

“In this sense, this plan responds to these problems, also because unfortunately the number of abandoned people and those who are left alone and who would like to live well is an enormous number. But nobody talks about them.”

“My experience says that where there is care, where there is therapy for pain, everyone prefers to continue living,” he said.

The Charter itself is divided into three sections, the first of which is dedicated to “Respect for the Dignity of the Person Even in Old Age.” This section lists the rights of the elderly, which, although not specifically mentioned in the Constitution, the commission argues are key to the reform of health and social care of the elderly.

The second section, titled, “For Responsible Care,” covers both the rights of the elderly and the duties that doctors, health professionals, and health institutions have in relation to care of the elderly and methods providing healthcare.

In the third section, titled, “For an Active Life of Relationship,” the problem of loneliness is addressed, stressing the rights the elderly have to a life of coexistence and access to both cultural and recreational services, and to express their thoughts on different matters, despite whatever psycho-physical limitations they might have.

It also underlines the duty institutions and society have in preventing the elderly from isolation and confinement and seeks to help elderly better understand their fundamental rights and duties as well as the duties of those who care for them or come into contact with them in any way.

Noting that there are 25 million people in Italy who are aged 65 and above, Paglia said that under the current system of care, most end up in an institution and are completely alone.

What the Charter aims to do, then, he said, is to raise awareness in Italian society of the duty, especially for the government, to care for the elderly, beginning with care in their own homes, and to continue the same quality of care as the years go by.

In one chapter, he said, there is a provision requiring people over-80 to be visited twice a year by a socio-health team so that a course of care can be identified and planned for them.

He also advocated for group housing for the elderly, so they don’t live alone, and for at least a thousand day centers to be opened throughout the country allowing elderly people with disabilities or specific problems to go out again, while continuing to live at home with the help, support, and care that they need.

This would lead to around 100,000 new employment opportunities for new social workers, who would be tasked with visiting the elderly at home, and taking them to the day centers, he said.

Paglia said there is also a proposal for long-term hospitalization facilities, which he said would have to be “re-thought” in the context of the overhaul of the elderly care system. Each of these facilities, he said, “must also have rehabilitation, co-housing, and home assistance centers.”

One other thing the Charter foresees, and which Pope Francis has long advocated for, is interaction between the elderly and younger generations, particularly at the day centers.

“For me an important horizon to underline is that the reorganization of healthcare shows the whole society, and therefore also the youngest, that aging is not a tragedy. That having 20 or 30 years of life donated by science, progress, development, does not mean being destined for loneliness and abandonment,” Paglia said.

“For the youngest, then, to see their own future – even decades long – worth living, will certainly be of existential and psychological help.”

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