The bioethics committee on Cóspito is divided

From Il Dubbio [The Doubt]. Translation by ALB Noticias [Spanish]. English machine translation

Alfredo Cóspito was transferred yesterday again to the Opera prison, in the Comprehensive Care Service. The Undersecretary of Justice, Ostellari, guaranteed maximum attention to his state of health.

The anarchist, who has been on hunger strike for more than four months in protest of 41 bis, had been admitted to the San Paolo hospital in Milan for several days due to the worsening of his condition. The man, after the last verdict of the Court of Cassation last Friday that rejected the appeal of his lawyer, has tightened his diet again, deciding to stop taking supplements.

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Alfredo Cóspito was transferred yesterday again to the Opera jail, to the Integrated Care Service.

The Undersecretary of Justice, Ostellari, guaranteed maximum attention to his state of health. The anarchist, who has been on a hunger strike for four months in protest of 41 bis, had been admitted to the San Paolo hospital in Milan for several days due to his deteriorating condition.

The man, after the verdict of the Supreme Court last Friday rejecting his lawyer's appeal, has once again hardened his fast by stopping taking supplements. The trusted doctor, adviser to the lawyer Flavio Rossi Albertini, after an examination last Saturday had clarified that a picture of "severe malnutrition" with "generalized muscular atrophy" "persists".

He had spoken of a still stable state with vital parameters that remain, "superimposable" to those of the last few days, but that could "get worse from one day to the next."

In the meantime, the opinion of the National Bioethics Committee is still awaiting, which also announced last Friday that it wanted to 'continue the analysis to obtain the greatest possible convergence regarding the delicate and complex substantive issues, respecting all the positions that have arisen up to now'.

The new date on which they will meet again has not yet been set.

The postponement, as has been known, was also decided to await the decision of Piazza Cavour, which arrived late on Friday afternoon.

One of the feelings harbored within the CNB is that of impatience with this request from the Government.

According to some, the answer to Cóspito's question must be purely legal and not ethical.

Any doubt that arises via Arenula could already be resolved by reading the Constitution -article 32 prohibits medical treatment without consent, except by provision of the law-; article 5 of Law 219/2017 on biotests (In the relationship between patient and doctor referred to in article 1, section 2, regarding the development of the sequelae of a chronic and disabling pathology or characterized by an unstoppable evolution with prognosis unluckily, shared care planning can be carried out between the patient and the doctor, to which the doctor and the health team are obliged to adhere if the patient is unable to express their consent or in a situation of incapacity) and the Code of Medical Ethics, in particular two articles: "Art.

The doctor, when prescribing and applying mandatory medical treatment, will always act respecting the dignity of the person and within the limits provided by law.

In the case of Cóspito, explains Professor Casonato, a former member of the CNB, "you cannot think of applying a Tso because the man is capable and aware and has no mental health problems."

The other article prescribes: 'Art. 53 Conscious refusal to eat The doctor will inform the capable person of the consequences that a prolonged refusal to eat entails for their health, document their will and continue care, without taking coercive initiatives or collaborating in coercive procedures for artificial feeding or nutrition '.

So, some CNB sources wonder, "what use is our opinion, if everything is already codified? We could only express an ethical assessment, but the Cospito matter must be resolved legally."

From what has transpired, however, the committee is divided between pro-life and pro-abortion: with a majority that would like to impose artificial feeding on Cospito and a minority, on the other hand, that would like their right to self-determination, crystallized in the Dates that he wrote and delivered to his lawyer.

Therefore, it is very likely that two opinions will be formulated, obviously not binding on the Ministry of Justice, which has been addressed to the Cnb.

Internal sources say that the prevailing opinion is that the hunger strike that Cospito is undergoing is transforming him from a healthy person to a sick one. In fact, in the range of options would also be the attempt to impose, through mandatory Health Treatment, a psychiatric examination on the detainee in hard jail to verify his ability to understand and will.

And from there open the way to force feeding.

If the path were really to pass off Cóspito as 'crazy' in order to impose medical treatment on him that he has said several times that he wants to refuse, and if the State accepted this perspective, it would mean violating the only space of freedom that Cóspito has left, it is say, his habeas corpus. It would be true state violence.

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I guess this is what I am concerned with when people proclaim that the Italian state is killing Alfredo. If they successfully force feed him, they might keep him alive while going a step further in violating his bodily autonomy. The proclamation takes away some of his own agency in the process. The state would certainly be complicit in his death, should the hunger strike kill him, but I guess this is just the minefield of slogan/proclamations. No disrespect to anyone trying to publicize his fight, especially those that act in solidarity with him.

The usual purpose of a hunger strike is to "wind the clock" on a reversible slow motion process of bringing about one's own death if demands are not met.

Force-feeding makes it plain the demands are being refused, removing all reasons to care about "slow and reversible." If someone this far into a hunger strike suddenly decides to commit suicide outright is is doubtful doctors can stop it.

If THAT happens, all hell will break loose, and Italy will face the vengeance of the entire global anarchist movement possibly backing up the entire weight of Italy's extra-parliamentary left social movemente. Ask any UK vivisector in business 20 years or more about Barry Horne...

I'm not sure force feeding after 130 days of a Turkish style Hunger Strike is going to end well. I will be surprised if it does not kill him itself, although maybe techniques are more advanced these days.
Does anyone have info on this?

The members of the National Bioethics Committee share the "refusal to adopt coercive measures against the person's current will" and "believe that there are no juridically and bioethically based reasons that allow the non-application of Law 219/2017 to the detained person , which, in general, can refuse medical treatments also through the Advance Treatment Provisions (Dat)". This was indicated by the Committee itself, which in its plenary meeting on 6 March "approved the document in response to the questions from the Ministry of Justice presented on 6 February".

The Committee, continues the note, "first of all questioned itself on the possibility of answering questions for which the connection to a clearly recognizable personal story is evident, even if not explicitly mentioned". The regulation of the Cnb excludes the possibility of giving answers to "questions referring to personal cases", but provides that this can happen "in exceptional cases in which there are reasons of general interest and in any case in compliance with the jurisdictional function due to the Judiciary". Consequently, the Committee "has no legal, political, moral and ethical legitimacy to formulate an opinion 'ad personam'. Consequently, the NBC's response has a general nature". During the session, "various shared reflections" emerged, which "are the premise of positions that differ in some conclusions". The majority of the members of the Committee (19) "considered that, in the event of imminent danger of life, when it is not possible to ascertain the current will of the prisoner, the doctor is not exempt from carrying out all those interventions aimed at saving his life" and points out that "the European Court of Human Rights (ECHR) itself has recently argued that: 'neither prison authorities nor doctors will be able to limit themselves to passively contemplating the death of a fasting prisoner'". It is also noted that "the Data are incongruous, and therefore inapplicable, where they are subordinated to the obtaining of goods or to the behavior of others, as used outside the rationale of Law 219/2017". Other members of the Cnb, believe that "there are no juridically and bioethically founded reasons which allow the non-application of Law 219/2017 to the person held on hunger strike, even in danger of life. Also in this case artificial nutrition and hydration can be refused, also through the Dat and the shared planning of care. The inviolable right to live all phases of one's existence without undergoing medical treatments against one's will - a logical derivation of the right to the inviolability of the bodily sphere of every human being - constitutes a fundamental constitutional principle of our legal system". Finally, 2 members of the Committee, " while favoring this second position as regards the interpretation of the current legislation and the applicability of the Data, they believe that a different balance of the principles at stake cannot be excluded, also looking at the experience of other countries. However, they consider - concludes the note - that an intervention by the legislator is the obligatory path, however narrow due to constitutional constraints and jurisprudence. They also underline the need to offer an explicit and clear regulatory reference to those who will find themselves making these decisions, starting with doctors". However, they consider - concludes the note - that an intervention by the legislator is the obligatory path, however narrow due to constitutional constraints and jurisprudence. They also underline the need to offer an explicit and clear regulatory reference to those who will find themselves making these decisions, starting with doctors". However, they consider - concludes the note - that an intervention by the legislator is the obligatory path, however narrow due to constitutional constraints and jurisprudence. They also underline the need to offer an explicit and clear regulatory reference to those who will find

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