Autodeterminazione e responsabilità medica: capovolgimento di un rapporto asimmetrico e i suoi rischi

The essay addresses the issue of balancing the patient’s right to self-determination with the legal and ethical duties of the physician, in light of the complex decisions faced by public authorities in the healthcare sector, also taking into account the sustainability of public healthcare expenditure. The author highlights how the evolving interpretation of the right to health, understood as encompassing existential well-being and personal self-fulfilment, has progressively challenged the traditional model of medical intervention, historically oriented exclusively toward the treatment of disease. From this perspective, both the refusal of life-saving treatments based on ethical or religious convictions—emblematically exemplified by the refusal of blood transfusions by Jehovah’s Witnesses— and the issues related to end-of-life decision-making and euthanasia practices assume paradigmatic significance. These situations call for a redefinition of the boundaries between the protection of life, respect for the patient’s will, and the physician’s professional responsibility.