Editing Advance healthcare directive (section)

===European Union===
''Country reports on advance directives''<ref>{{cite web|url=http://www.ethik.uzh.ch/dam/jcr:00000000-14d5-886d-ffff-fffff1488f30/Country_Reports_AD.pdf |title=Country reports on advance directives, 100 pages |publisher=University of Zurich |access-date=2017-02-11}}</ref> is a 2008 paper summarizing advance health care legislation on each country in the European Union with a shorter summary for the U.S.; a 2009 paper also provides a European overview.<ref>{{cite journal|url=https://www.academia.edu/457880 |title= Advance Health Care Directives: Towards a Coordinated European Policy?|journal=European Journal of Health Law|last1= Andorno|first1= Roberto|year= 2009|volume= 16|issue= 3|pages= 207–27|doi= 10.1163/157180909x453053|pmid= 19788001}}</ref>



====Germany====
On 18 June 2009 the [[Bundestag]] passed a law on advance directives, applicable since 1 September 2009. Such law, based on the principle of the right of self-determination, provides for the assistance of a [[fiduciary]] and of the physician.

====Italy====
On 14 December 2017, [[Senate of the Republic (Italy)|Italian Senate]] officially approved a law on advance healthcare directive that came into force on 31 January 2018.<ref>{{cite web|url=http://www.normattiva.it/uri-res/N2Ls?urn:nir:stato:legge:2017-12-22;219|title=*** NORMATTIVA ***|website=www.normattiva.it}}</ref><ref>{{Cite web|url=http://proversi.it/discussioni/pro-contro/176-biotestamento| title=Biotestamento. Favorevole o contrario?|website=ProVersi.it|date=19 February 2018}}</ref>

Controversy over end-of-life care emerged in Italy in 2006, when a terminally ill patient suffering from muscular dystrophy, Piergiorgio Welby, petitioned the courts for removal of his respirator. Debated in Parliament, no decision was reached. A doctor eventually honored Welby's wishes by removing the respirator under sedation.<ref>{{cite news|last1=Fisher|first1=Ian|title=Euthanasia Advocate in Italy Dies|url=https://www.nytimes.com/2006/12/21/world/europe/22italycnd.html|access-date=23 November 2017|newspaper=New York Times|date=21 December 2006}}</ref> The physician was initially charged for violating Italy's laws against euthanasia, but was later cleared. Further debate ensued after the father of a 38-year-old woman, Eluana Englaro, petitioned the courts for permission to withdraw feeding tubes to allow her to die. Englaro had been in a coma for 17 years, following a car accident. After petitioning the courts for 10 years, authorization was granted and Englaro died in February 2009.<ref>{{cite news|last1=Owen|first1=Richard|title='Right to die' coma woman Eluana Englaro dies|url=https://www.thetimes.com/uk/healthcare/article/right-to-die-coma-woman-eluana-englaro-dies-mlm26hzjgq5|access-date=23 November 2017|newspaper=The Times|date=10 February 2009}}</ref> In May 2008, apparently as a result of the recent Court of Cassation's holding in the case of Englaro, a guardianship judge in Modena, Italy used relatively new legislation<ref>Law No. 6 of January 9, 2004</ref> to work around the lack of the advance directive legislation. The new law permitted a judicially appointed guardian ("amministratore di sostegno") to make decisions for an individual. Faced with a 70-year-old woman with end-stage Lou Gehrig's Disease who was petitioning the court (with the support of her family) to prevent any later use of a respirator, the judge appointed her husband as guardian with the specific duty to refuse any tracheotomy and/or respirator use if/when the patient became unable to refuse such treatment herself.<ref>Decree of Dr. Guido Stanziani, Guardianship Judge of the Tribunal of Modena, 13 May 2008.</ref>