ROME – Euthanasia took center stage this month in Italian politics after a polarizing case of a blind and quadriplegic man who fled to neighboring Switzerland in order to receive assisted suicide, which is illegal in Italy.

“Ending a life is always a defeat,” said Archbishop Vincenzo Paglia, president of the Pontifical Academy for life. “All of this must make us all sad, and also make us ask some questions.”

Paglia’s remarks were discordant in an ocean of sympathy that swept over Italian politics and society concerning the decision by Fabiano Antoniani, 39, to end his life after almost three years of being confined to his bed.

The Case

Fabiano Antoniani (Fabo) made a video on January 19 of last year begging the president of Italy, Sergio Mattarella, to help him in finding a way to die. The video made by the Luca Coscioni Association for the freedom of scientific research and voiced by Fabo’s girlfriend Valeria quickly became viral and spurred conversations over every Italian dinner table.

The video describes two Fabo’s. The first part shows a young and dynamic man who loves to travel, does motocross and livened the Italian night scene as a DJ. The second shows Fabo after his car accident on July 13, 2014, which broke his C3 and C4 vertebrae and left him blind and quadriplegic.

The video received no response from political representatives though it reawakened the debate surrounding the issue in the country.

According to Fabo, he did not give up immediately and after pursuing possible solutions at the hospital he even ventured to India in search of alternate medicines. None were successful and Fabo returned home desperate and incapable of imagining happiness in his life.

It was the blindness that got to him, he said in an interview on the Italian TV program Le Iene. He could not stand to live his life in the dark, a gasping Fabo told the reporter, as he lay surrounded by pictures of his old self, which he could no longer see.

Physician Angelo Mainini, heath director at the lay “Maddalena Grassi” foundation, was in charge of preparing the rehabilitation plan for Fabo. “We visited his home five day a week. He actively collaborated, he had a great desire to make it,” Mainini told Italian Catholic newspaper Avvenire.

“Then something changed.”

Fabo made up his mind that he was going to end his life by going to Switzerland where it is possible to receive assisted suicide. Physician-assisted suicide has been legal in Switzerland since 1942, although doctors can only prescribe drugs for the purpose – they can’t actively administer the drugs.

Over the years, “suicide tourism” has increased to the country,  and Swiss organizations with names like Dignitas and Exit actively publicize their activities across Europe. Over a thousand people were killed through euthanasia in Switzerland in 2016, over twice the number from just five years before.

A 2014 study of legal assisted suicide in Switzerland published in the International Journal of Epidemiology found that “assisted suicide was more likely in women than in men” and “those living alone compared with those living in households with others, the divorced compared with the married.”

According to Italian law whomever helps a person visit a country for the purpose of euthanasia is guilty as “an assistant to suicide,” hence the video by Fabo to the Italian President asking for his intervention.

“I value life based on quality, not quantity. I can’t bare to live in pain anymore,” Fabo told reporters after being asked if he was certain of his decision. “I will go with a smile, I will go free.”

The Debate

On February 27, 2017, Marco Cappato, treasurer of the Luca Coscioni Association, wrote a tweet: “Fabo died at 11:40. He chose to go following the laws of a country that is not his own.”

Cappato had accompanied Fabo to Switzerland and been with him at the end when the quadriplegic used his mouth to press the button and inject the lethal drug. When Cappato returned he committed himself to the police and now risks spending between 5 and 12 years in prison.

But the District attorney’s office in Milan has asked to archive the suit against Cappato.

The Italian government is not particularly happy that its citizens bypass the law to perform illegal practices in neighboring countries. Cappato claims that as of 2015 up to 225 people have asked his association for advice on the matter of euthanasia. Of those, 117 went to Switzerland, though Cappato underlines that some decided to think more on the issue and returned to Italy.

The Church has been vocally opposed to this practice and has expressed preoccupation for its consequences. “According to Italian law, it is obligatory to assist the dying. Palliative remedies exist precisely for this reason,” said Cardinal Elio Sgreccia, President emeritus of the Pontifical Academy for Life in an interview with Italian newspaper La Repubblica.

“They are based on the principle of healing, being assisted, and living with dignity.”

The Milan DA office is taking the position, in a lengthy and overtly technical document, that Cappato only helped bring Fabo to Switzerland in order for him to exercise his right to die. The document cited the Englaro and Welby cases, which are the equivalent to the Terry Schiavo case in the United States.

Terri Schiavo was a Florida woman who suffered severe brain damage after suffering a heart attack in 1990. A long legal battle between her husband and the rest of her family was fought on whether or not her feeding tube could be removed. After the husband won in court, Schiavo’s feeding tube was removed, and she died in 2005.

Worried by the implications of the DA’s position, Sgreccia insisted that though the law remains “unclear and undefined, it does not open the door to practices that are essentially euthanasia.”

The fact that it was allegedly Fabo himself who pressed the button for his lethal injection seemingly created a precedent allowing the Association and its members to ship desperate patients to Switzerland and return untouchable by the Italian law.

“It is essentially euthanasia if one takes a drug in order to kill himself just as much as if one does not take a drug that may save him,” Sgreccia insisted. “There is an obligation to assist the dying. If this doesn’t happen then the law is being bent.”

The Catholic Church keeps its eye on the big picture and though tragedies such as the accident and death of Fabo occur, it believes the consequences of legalizing euthanasia or using loopholes such as in this case can be damaging to the weaker members of society.

“As our society ages, there is a pull to save and not spend the necessary money for cures. All of this is unacceptable. If everything is based on saving money then we are little more than merchandise to be thrown away,” Sgreccia said echoing Pope Francis.

“In any case the request by the DA’s office is an imposition that inserts itself in a controversy that has no reason to exist since it is not provided by the Italian law.”

The Italian Parliament in recent months has been postponing the decision on whether to implement a “biological will” which would allow people to write down their intentions and wishes if they were to be in the same situation as Fabo.

But Mainini disagrees with this proposal which he thinks would bring more damages than benefits. “In the beginning many think that they want to die, but with time the opinion of 99 percent of them changes, as time goes on priorities change and, with the right support, they are able to appreciate what their new life can offer,” Manini said.

“If they are surrounded by people that they love and have events that they look forward to with joy, such as the birth of a nephew or the graduation of a child, even just being able to smile or move the head fulfills them entirely.”