updated 12/21/2006 9:20:06 AM ET 2006-12-21T14:20:06

A paralyzed man at the center of a right-to-die debate in this overwhelmingly Roman Catholic nation died after he was taken off his respirator, days after an Italian court issued a contentious ruling in the case.

Piergiorgio Welby, 60, died late Wednesday of cardiorespiratory arrest, said Mario Riccio, the doctor who removed the respirator. Riccio said Thursday that Welby had a constitutionally guaranteed right to refuse treatment.

“This must not be mistaken for euthanasia. It is a suspension of therapies,” said Riccio. “Refusing treatment is a right.”

Riccio said he was “very serene” and did not fear legal consequences.

According to Italian law, assisted suicide can carry a sentence of up to 15 years in prison.

Welby had been diagnosed with muscular dystrophy as a teenager. He was confined to a bed, attached to a respirator and communicated through a voice synthesizer. He was receiving nourishment through a feeding tube.

On Saturday, a Rome judge recognized Welby’s right to refuse treatment but ruled that doctors were not obligated to take measures that would result in the patient’s death — even at the patient’s request. The ruling urged legislators to address the issue, saying that for the moment the decision to pull the plug “is left to the complete discretion of any doctor to whom the request is made.”

Issue divided a nation
The case divided doctors and politicians and gripped the public’s attention in a country where the Catholic church still wields influence.

Euthanasia is illegal in Italy, and the Vatican forbids the practice, insisting that life must be safeguarded from its beginning to its “natural” end.

In the past few months, Welby had made a plea to Italy’s president, and appealed to Italian courts to have his respirator taken away.

“My dream ... my desire, my request — which I want to put to any authority, from political to judicial ones — is today in my mind more clear and precise than ever: being able to obtain euthanasia,” Welby said in his appeal this fall to President Giorgio Napolitano.

In another setback for Welby, a panel of Italian medical experts, the Higher Health Council, said Wednesday that a respirator does not constitute “extraordinary means” of keeping a gravely or terminally ill person alive and so need not be removed. The panel, whose opinion is not binding, also decided that precise guidelines for doctors were needed urgently to spell out what the law allows and what it does not.

U.S. law generally permits patients to ask that medical treatment be withheld or withdrawn, even if it raises their risk of dying. Voters in Oregon went further and approved the first physician-assisted suicide law in the U.S. in 1994, but it is now under legal challenge.

In 2001, the Netherlands became the first country to legalize voluntary euthanasia — where patients are killed at their request to ease suffering, even in cases where they might survive without treatment. Belgium legalized it under strict conditions in 2002.

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