VATICAN CITY — With the Italian parliament expected to vote soon on a proposed law on medically assisted suicide, a Jesuit physician and moral theologian has called on lawmakers to stop postponing action and to restrict the practice as much as possible by refining and passing an “imperfect law” that is on the table.

The current lacuna in Italian law must be filled with clearer and controlled norms and putting in place even an “imperfect” measure would avoid the effects of an even worse law or scenario on the horizon, Jesuit Father Carlo Casalone wrote in the Jesuit journal, La Civiltà Cattolica, which is reviewed before publication by the Vatican Secretariat of State. Casalone is a member of the Pontifical Academy for Life and a professor of moral theology at Rome’s Pontifical Gregorian University.

A similar approach was employed in 2004, when momentum was building in Italy to legalize artificial reproduction.

That initiative was led primarily by Catholic parliamentarians and supported by the Italian bishops’ conference, who called for greater rights for the human embryo, and by politicians who called for controls on a procedure that had no legal guidelines.

Led by Catholic legislators, Italy’s parliament passed a law that — even though not all the provisions were in line with church teaching — emphasized the rights of human embryos and imposed sweeping restrictions.

For example, the church teaches that all artificial fertilization outside the sexual act in marriage is wrong. The hotly debated law allowed for the practice, but it: forbade third-party donations, mandating the egg and sperm used belong to the couple wanting to conceive; required that no more than three embryos be produced at one time and all those produced be implanted at the same time; and banned production of embryos for scientific experimentation.

Imposing strict limits with a regulatory law was considered a victory for many Catholics who had feared the consequences of no regulation whatsoever.

This has been a frequent dilemma for Catholic lawmakers, and St. John Paul II directly addressed it in his 1995 encyclical “Evangelium Vitae,” on the value and inviolability of human life.

According to his letter, it is never permissible to vote for a law that permits an evil such as abortion or euthanasia. However, it can be licit to vote on a restrictive measure whose aim is not to permit something that is currently illegal, but to replace, prohibit or restrict a more permissive law that has already passed or was likely imminent.

St. John Paul wrote (EV 73): An elected official, “whose absolute personal opposition to procured abortion was well known, could licitly support proposals aimed at limiting the harm done by such a law and at lessening its negative consequences at the level of general opinion and public morality. This does not in fact represent an illicit cooperation with an unjust law, but rather a legitimate and proper attempt to limit its evil aspects.”

A theoretical example of that could involve an existing law or proposal to allow abortion up to 24 weeks. It would be licit for a Catholic lawmaker to vote for an alternative proposal that says abortion is lawful up to 16 weeks. It remains a proposal that permits abortion, but its aim is not to allow for an evil, but to try to limit or restrict it in some way.

Since then, much has been written by eminent theologians, including Pope Benedict XVI, about this dilemma and so-called “imperfect laws.” Then-Cardinal Joseph Ratzinger wrote to U.S. bishops in 1982: “According to the principles of Catholic morality, an action can be considered licit whose object and proximate effect consist in limiting an evil insofar as possible. Thus, when one intervenes in a situation judged evil in order to correct it for the better, and when the action is not evil in itself, such an action should be considered not as the voluntary acceptance of the lesser evil but rather as the effective improvement of the existing situation, even though one remains aware that not all evil present is able to be eliminated for the moment.”

The guidance Casalone offered in his La Civiltà Cattolica article is similar in the face of what he and others see as the threat of a growing acceptance of the right-to-die movement across Europe and intensifying in Italy.

Euthanasia and physician-assisted suicide are not legal in Italy. However, in 2019, the Constitutional Court ruled that an assisted suicide is not punishable when a patient is “suffering from an irreversible pathology” causing “physical and psychological suffering that he or she considers intolerable” and is being kept alive by life-support treatments.

The court, which ruled only on the punishability of assisting or convincing someone to commit suicide, urged parliament to take up the matter with democratic debate and clear legislation to fill the legal void so the judiciary would not be left to regulate.

That did not happen, and a regional ethics committee used the court ruling to approve in November 2021 the country’s first assisted suicide. Right-to-die activists also succeeded in gathering more than 1 million signatures for a referendum supporting the repeal of an article criminalizing active euthanasia. If the Constitutional Court allows the petition, the matter could be put for a popular vote this year.

Casalone’s article laid out the need to help the wider public understand: the sanctity and dignity of human life lived out to its natural end; the still untapped resources available in the field of palliative care and support; and the true meaning of human freedom and self-determination.

The current parliamentary proposal only guarantees a person’s right to make a request for a medically assisted death. The patient would have to meet specific conditions, and no one would be obligated to grant the request or perform a morally objectionable act.

So far, those conditions include: the patients must be in the terminal stage of an incurable disease or “irreversible clinical condition”; they must be guaranteed and offered ongoing palliative support and care protecting their dignity and quality of life; and their condition would have to be causing “absolutely intolerable” psychological and physical suffering. Casalone said further restrictions could include limiting the law to patients with a medical condition that was so severe that if the patient’s life support were withdrawn, it would lead to death in the short term.

Although still imperfect and problematic, the proposed measure before parliament “could constitute a dam” against the rising waters of broader and more permissive rules, Casalone wrote.