Deontologia medica e diritto tra convergenze e antinomie: modelli comparati e nuove sfide nelle scelte di fine vita

Partendo dal dibattito sull’assistenza medica al suicidio alla luce dell’ordinanza n. 207/2019 della Corte costituzionale e del possibile conflitto con il divieto previsto dal codice di deontologia medica (CDM), il contributo analizza alcuni rapporti tra diritto e deontologia, con particolare riferimento alle reciproche interazioni, convergenze e antinomie nell’ambito delle scelte di fine vita. Tali profili vengono analizzati attraverso il metodo della comparazione giuridica. Considerate le peculiarità del CDM come fonte posta all’intersezione tra etica medica e diritto, quindi tra dimensione professionale e dimensione statale, il contributo esamina alcune delle principali problematiche relative sia alla posizione del CDM nel sistema delle fonti del diritto sia alle relazioni tra dimensione giuridica e dimensione deontologica sul piano dei contenuti normativi. La comparazione con le scelte delle categorie professionali di altri ordinamenti europei in rapporto alle legislazioni sull’aiuto medico a morire permetterà di sottolineare alcune caratteristiche del ruolo che il CDM può svolgere nell’ambito analizzato. Verranno inoltre individuati alcuni profili critici del modello italiano di deontologia medica sui quali è necessario avviare una riflessione congiunta per valorizzare le potenzialità e la portata pratica del CDM nel dialogo con il diritto e nel rispetto dei principi costituzionali.

MEDICAL ETHICS AND LAW BETWEEN CONVERGENCES AND ANTINOMIES. COMPARATIVE PATTERNS AND NEW CHALLENGES IN END-OF-LIFE DECISIONS. Starting from the Italian debate on medical assisted suicide raised by Order no. 207/2019 of the Italian Constitutional Court and on the conflicts that may arise with the prohibition provided for by the Code of Medical Ethics (CME), the paper analyses the rela-tionships between law and medical ethics, with particular reference to their mutual interactions, con-vergences and antinomies in the field of end-of-life decisions. These issues are analysed from a com-parative legal perspective. Due to the transformation of principles of medical ethics in rules embedded in the CME, which are binding for professionals, the CME is, by its very nature, at the intersection be-tween medical ethics and law, and therefore between state and professional regulation. Accordingly, the paper examines some of the main issues related to the position of the CME in the hierarchy of norms, as well as its relationships with other sources of law in terms of normative contents. The com-parative analysis shows that the CME can integrate and complement the law or even anticipate statuto-ry rules, but is also likely to lead to tensions between law and medical ethics as to the related regulato-ry models. As a matter of fact, rules of medical ethics are gaining growing attention due to their ability to regulate important aspects of professional conduct, also beyond those related to the “internal” di-mension of the professional community, thus directly affecting fundamental rights. This becomes even more remarkable in end-of-life decisions due to the huge variety of sensitive and controversial rights and issues concerned. The legal comparison of the choices made by other European medical associa-tions confronted with the decriminalisation of euthanasia and/or assisted suicide helps in highlighting some general principles as to the role the CME can perform in this field. On the one hand, the regula-tory power of the professional community should not prevail on the democratic principle in governing issues having an impact on fundamental rights. On the other hand, the role of the CME in opposing a statutory act if a higher protection of rights is needed should also be granted, thus avoiding an uncriti-cal adaptation to laws. Nevertheless, the scope of the CME’s role must be grounded and is limited by the respect of constitutional principles and by the level of pluralism CME’s rules are able to properly consider, protect and promote. The paper also highlights some crucial features of the Italian model of medical ethics on which to reflect to foster the dialogue between law and medical ethics, as well as to enhance the role of the CME in complementing the legal framework in accordance with constitutional principles.