Piergiorgio Welby
Encyclopedia
Piergiorgio Welby was an Italian
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...

 poet
Poet
A poet is a person who writes poetry. A poet's work can be literal, meaning that his work is derived from a specific event, or metaphorical, meaning that his work can take on many meanings and forms. Poets have existed since antiquity, in nearly all languages, and have produced works that vary...

, painter
Painting
Painting is the practice of applying paint, pigment, color or other medium to a surface . The application of the medium is commonly applied to the base with a brush but other objects can be used. In art, the term painting describes both the act and the result of the action. However, painting is...

 and activist
Activism
Activism consists of intentional efforts to bring about social, political, economic, or environmental change. Activism can take a wide range of forms from writing letters to newspapers or politicians, political campaigning, economic activism such as boycotts or preferentially patronizing...

 whose three-month-long battle to establish his right to die
Right to die
The right to die is the ethical or institutional entitlement of the individual to commit suicide or to undergo voluntary euthanasia. Possession of this right is often understood to mean that a person with a terminal illness should be allowed to commit suicide or assisted suicide or to decline...

 led to a debate about euthanasia
Euthanasia
Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering....

 in his country.

Welby was diagnosed with muscular dystrophy as a teenager in the early 1960s. The disease progressed, and in 1997 he became unable to breathe on his own. He became politically active in the right-to-die movement, and in 2006 he publicly declared his wish to refuse the medical treatment that kept him alive. The case was controversial, with liberal politicians supporting him and conservatives and the Vatican speaking out against his cause. After three months, he was allowed to die, though he was denied a church burial.

Life and career

Born in Rome
Rome
Rome is the capital of Italy and the country's largest and most populated city and comune, with over 2.7 million residents in . The city is located in the central-western portion of the Italian Peninsula, on the Tiber River within the Lazio region of Italy.Rome's history spans two and a half...

, the son of Alfredo Welby
Alfredo Welby
Alfredo Welby was an Italian professional footballer who played for AS Roma, Reggina, Cosenza and MATER.He was the father of right-to-die activist Piergiorgio Welby....

, a Scottish
Scottish people
The Scottish people , or Scots, are a nation and ethnic group native to Scotland. Historically they emerged from an amalgamation of the Picts and Gaels, incorporating neighbouring Britons to the south as well as invading Germanic peoples such as the Anglo-Saxons and the Norse.In modern use,...

 footballer
Football (soccer)
Association football, more commonly known as football or soccer, is a sport played between two teams of eleven players with a spherical ball...

 playing for A.S. Roma
A.S. Roma
Associazione Sportiva Roma, commonly referred to as simply Roma, is a professional Italian football club based in Rome. Founded by a merger in 1927, Roma have participated in the top-tier of Italian football for all of their existence but one season in the early 50s...

, Welby was diagnosed with muscular dystrophy
Muscular dystrophy
Muscular dystrophy is a group of muscle diseases that weaken the musculoskeletal system and hamper locomotion. Muscular dystrophies are characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue.In the 1860s, descriptions of boys who...

 at the age of 17.

During the Sixties
1960s
The 1960s was the decade that started on January 1, 1960, and ended on December 31, 1969. It was the seventh decade of the 20th century.The 1960s term also refers to an era more often called The Sixties, denoting the complex of inter-related cultural and political trends across the globe...

 he became influenced by the hippie movement
Hippie
The hippie subculture was originally a youth movement that arose in the United States during the mid-1960s and spread to other countries around the world. The etymology of the term 'hippie' is from hipster, and was initially used to describe beatniks who had moved into San Francisco's...

, extensively travelling throughout Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...

 from 1969 to 1971 and using drug
Drug
A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulations, medicine, and colloquial usage.In pharmacology, a...

s to help forget his disease; back in Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...

,
he devoted his life to poetry and painting, supporting himself by giving private lessons.

During the Eighties
1980s
File:1980s decade montage.png|thumb|400px|From left, clockwise: The first Space Shuttle, Columbia, lifted off in 1981; American President Ronald Reagan and Soviet leader Mikhail Gorbachev eased tensions between the two superpowers, leading to the end of the Cold War; The Fall of the Berlin Wall in...

 he cured his drug dependency with the help of a methadone
Methadone
Methadone is a synthetic opioid, used medically as an analgesic and a maintenance anti-addictive for use in patients with opioid dependency. It was developed in Germany in 1937...

-based therapy which, while successfully detoxifying him, accelerated the progression of the disease, irreversibly paralyzing him from his waist down. At this time, he met his future wife Mina while she was traveling to Rome with her parish
Parish
A parish is a territorial unit historically under the pastoral care and clerical jurisdiction of one parish priest, who might be assisted in his pastoral duties by a curate or curates - also priests but not the parish priest - from a more or less central parish church with its associated organization...

.

On July 14, 1997, Welby suffered a respiratory insufficiency
Respiratory failure
The term respiratory failure, in medicine, is used to describe inadequate gas exchange by the respiratory system, with the result that arterial oxygen and/or carbon dioxide levels cannot be maintained within their normal ranges. A drop in blood oxygenation is known as hypoxemia; a rise in arterial...

 that left him completely unable to breathe naturally. He depended on mechanical ventilation
Mechanical ventilation
In medicine, mechanical ventilation is a method to mechanically assist or replace spontaneous breathing. This may involve a machine called a ventilator or the breathing may be assisted by a physician, respiratory therapist or other suitable person compressing a bag or set of bellows...

 and artificial feeding
Feeding tube
A feeding tube is a medical device used to provide nutrition to patients who cannot obtain nutrition by swallowing. The state of being fed by a feeding tube is called gavage, enteral feeding or tube feeding...

 and communicated through a speech-synthesizer
Speech synthesis
Speech synthesis is the artificial production of human speech. A computer system used for this purpose is called a speech synthesizer, and can be implemented in software or hardware...

.

Activism

The last years of his life were marked by activism
Activism
Activism consists of intentional efforts to bring about social, political, economic, or environmental change. Activism can take a wide range of forms from writing letters to newspapers or politicians, political campaigning, economic activism such as boycotts or preferentially patronizing...

. He joined the Italian Radical Party and later the Associazione Luca Coscioni
Associazione Luca Coscioni
The Luca Coscioni Association for the freedom of scientific research was founded on September 20, 2002 by Luca Coscioni, a victim of amyotrophic lateral sclerosis and a member of the Italian Radical Party who promoted the campaign for the freedom of scientific research on embryonic stem cells.In...

, which named him co-president in 2006, a group with close ties to the Radical Party, that advocates euthanasia, free access to assistive technology
Assistive technology
Assistive technology or adaptive technology is an umbrella term that includes assistive, adaptive, and rehabilitative devices for people with disabilities and also includes the process used in selecting, locating, and using them...

 and freedom of scientific research
Scientific method
Scientific method refers to a body of techniques for investigating phenomena, acquiring new knowledge, or correcting and integrating previous knowledge. To be termed scientific, a method of inquiry must be based on gathering empirical and measurable evidence subject to specific principles of...

. Welby used the Internet
Internet
The Internet is a global system of interconnected computer networks that use the standard Internet protocol suite to serve billions of users worldwide...

 as his primary mean of communication by posting on web forums
Internet forum
An Internet forum, or message board, is an online discussion site where people can hold conversations in the form of posted messages. They differ from chat rooms in that messages are at least temporarily archived...

 and, since 2003, on his own blog
Blog
A blog is a type of website or part of a website supposed to be updated with new content from time to time. Blogs are usually maintained by an individual with regular entries of commentary, descriptions of events, or other material such as graphics or video. Entries are commonly displayed in...

.

On May 1, 2002 he posted a message with the title Eutanasia (Italian
Italian language
Italian is a Romance language spoken mainly in Europe: Italy, Switzerland, San Marino, Vatican City, by minorities in Malta, Monaco, Croatia, Slovenia, France, Libya, Eritrea, and Somalia, and by immigrant communities in the Americas and Australia...

 for euthanasia) on Radical Party's on line forum, writing:


Everything still? Worse than the desert of the Tartars. ... while staring at the horizon. ... terminal patients like me. ... envy the Dutch people. ... WAKE UP


As of January 2007, the thread received over 20,000 replies.

In April 2003 he opened a blog, expressing his views on different topics, commenting on current political events and publishing small poems. Since his death, the blog has been maintained by his widow.

In May 2005, on the occasion of a referendum
Referendum
A referendum is a direct vote in which an entire electorate is asked to either accept or reject a particular proposal. This may result in the adoption of a new constitution, a constitutional amendment, a law, the recall of an elected official or simply a specific government policy. It is a form of...

 dealing, among other topics, with the use of human embryo
Embryo
An embryo is a multicellular diploid eukaryote in its earliest stage of development, from the time of first cell division until birth, hatching, or germination...

s for stem cell
Stem cell
This article is about the cell type. For the medical therapy, see Stem Cell TreatmentsStem cells are biological cells found in all multicellular organisms, that can divide and differentiate into diverse specialized cell types and can self-renew to produce more stem cells...

 research, he specifically asked his fellow Radical Party members to take him to his local polling station
Polling station
A polling place or polling station is where voters cast their ballots in elections.Since elections generally take place over a one- or two-day span on a periodic basis, often annual or longer, polling places are often located in facilities used for other purposes, such as schools, churches, sports...

, after his request to let disabled people who depend on life-support machinery to vote in their homes was denied.

In April 2006, a worsening of his muscular dystrophy paralyzed the finger which let him use the mouse
Mouse (computing)
In computing, a mouse is a pointing device that functions by detecting two-dimensional motion relative to its supporting surface. Physically, a mouse consists of an object held under one of the user's hands, with one or more buttons...

, making him unable to use his computer
Computer
A computer is a programmable machine designed to sequentially and automatically carry out a sequence of arithmetic or logical operations. The particular sequence of operations can be changed readily, allowing the computer to solve more than one kind of problem...

 and heavily limiting his communication. He decided to publicize his request to die, hoping to start a nation-wide debate on euthanasia.

Battle for euthanasia

On September 22, 2006, Welby sent an open video-letter to Italian President Giorgio Napolitano
Giorgio Napolitano
Giorgio Napolitano is an Italian politician who has been the 11th President of Italy since 2006. A long-time member of the Italian Communist Party and later the Democrats of the Left, he served as President of the Chamber of Deputies from 1992 to 1994 and as Minister of the Interior from 1996 to...

. It was shown on national television
Television
Television is a telecommunication medium for transmitting and receiving moving images that can be monochrome or colored, with accompanying sound...

 and made available for downloading
Uploading and downloading
In computer networks, to download means to receive data to a local system from a remote system, or to initiate such a data transfer. Examples of a remote system from which a download might be performed include a webserver, FTP server, email server, or other similar systems...

 on the Internet (see links), describing his condition and explaining his desire to die. Napolitano answered he felt deeply touched by Welby's situation, inviting Italian politicians to a parliamentary debate
Parliamentary Debate
Parliamentary Debate is an academic debate event. Many university level institutions in English speaking nations sponsor parliamentary debate teams, but the format is currently spreading to the high school level as well...

 on this and similar complex ethical
Ethics
Ethics, also known as moral philosophy, is a branch of philosophy that addresses questions about morality—that is, concepts such as good and evil, right and wrong, virtue and vice, justice and crime, etc.Major branches of ethics include:...

 issues.

Welby's case aroused a heated debate, involving political, ethical, religious and medical aspects. Radical Party members supported Welby's decision by organizing hunger-strikes
Hunger strike
A hunger strike is a method of non-violent resistance or pressure in which participants fast as an act of political protest, or to provoke feelings of guilt in others, usually with the objective to achieve a specific goal, such as a policy change. Most hunger strikers will take liquids but not...

 and demonstrations
Demonstration (people)
A demonstration or street protest is action by a mass group or collection of groups of people in favor of a political or other cause; it normally consists of walking in a mass march formation and either beginning with or meeting at a designated endpoint, or rally, to hear speakers.Actions such as...

; party founder Marco Pannella
Marco Pannella
Giacinto Pannella, better known as Marco Pannella is an Italian politician.He is the historic leader of the Italian Radicals...

 declared his readiness to turn the machines off himself as an "act of civil disobedience
Civil disobedience
Civil disobedience is the active, professed refusal to obey certain laws, demands, and commands of a government, or of an occupying international power. Civil disobedience is commonly, though not always, defined as being nonviolent resistance. It is one form of civil resistance...

".

Most Catholic
Catholic
The word catholic comes from the Greek phrase , meaning "on the whole," "according to the whole" or "in general", and is a combination of the Greek words meaning "about" and meaning "whole"...

 politicians adhered to the official position of the Roman Catholic Church
Roman Catholic Church
The Catholic Church, also known as the Roman Catholic Church, is the world's largest Christian church, with over a billion members. Led by the Pope, it defines its mission as spreading the gospel of Jesus Christ, administering the sacraments and exercising charity...

, opposing both euthanasia and aggressive medical treatment. On a televised debate, Cardinal Javier Lozano Barragán declared that stopping mechanical ventilation would only be
acceptable if it were judged futile or disproportionate by his doctors.
Health Minister Livia Turco
Livia Turco
Livia Turco is an Italian politician, member of the Democratic Party .She came from a working class background in Morozzo, Cuneo and studied in Cuneo and Torino. In Torino she began her political career by becoming onvolved with the communist party, becoming a deputy in 1987...

 said that a parliamentary debate should focus more on improving palliative care rather than on euthanasia.

The head-physician and president of the "Italian Association of Sclerosis Patients", Mario Melazzini, had Amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis , also referred to as Lou Gehrig's disease, is a form of motor neuron disease caused by the degeneration of upper and lower neurons, located in the ventral horn of the spinal cord and the cortical neurons that provide their efferent input...

, a similar sickness to Welby's. Melazzini decided to speak in Rome
Rome
Rome is the capital of Italy and the country's largest and most populated city and comune, with over 2.7 million residents in . The city is located in the central-western portion of the Italian Peninsula, on the Tiber River within the Lazio region of Italy.Rome's history spans two and a half...

 with other ALS patients, asking the help of the State for the right of such people to life. He declared to the weekly newspaper Oggi that "Only those who want death are listened to". That appeal gained the support of many Italians, including the writer Claudio Magris
Claudio Magris
Claudio Magris is an Italian scholar, translator and writer.Magris graduated from the University of Turin, where he studied German studies, and has been a professor of modern German literature at the University of Trieste since 1978.He is an essayist and columnist for the Italian newspaper...

 and the singer Ron
Ron
Ron is a panchayat town in Gadag district, North Karnataka in the Indian state of Karnataka.Of historical importance, called Dronapur in ancient times...

. Subsequently, after Melazzini's statement, hundreds of patients (among them notable cases in medical ethics such as Nello Guerra Crescenzi, Enrico Canova, and Salvatore Crisafulli — who was famous for having come out of a 2 year coma) wrote letters to Welby asking him to "fight for his life".

Oncologist
Oncology
Oncology is a branch of medicine that deals with cancer...

 and long-time euthanasia supporter Umberto Veronesi
Umberto Veronesi
Umberto Veronesi Knight Grand Cross OMRI is an Italian surgeon and oncologist, internationally known for his contributions on prevention and treatment of breast cancer throughout a career spanning over fifty years. He heads Italy's Nuclear Safety Agency.-Scientific career:Veronesi was born in Milan...

 and surgeon
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 Ignazio Marino
Ignazio Marino
Ignazio Marino is an Italian surgeon, specialising in liver transplantation, and politician in the Democratic Party. He is a member of the Italian Senate, being first elected in 2006.-Early life:...

 said Welby's right to refuse medical treatment was granted by Italian constitution
Constitution of Italy
The Constitution of the Italian Republic was enacted by the Constituent Assembly on 22 December 1947, with 453 votes in favour and 62 against. The text, which has since been amended 13 times, was promulgated in the extraordinary edition of Gazzetta Ufficiale No. 298 on 27 December 1947...

 and by the code of conduct
Code of Conduct
A code of conduct is a set of rules outlining the responsibilities of or proper practices for an individual, party or organization. Related concepts include ethical codes and honor codes....

 of the Italian medical association
Medical association
A health association is a professional organization for health professionals. They are often based on specialty and are usually national, often with subnational or regional affiliates. Health associations usually offer conferences and continuing education...

. One of Welby's doctors noted that after switching off the ventilator, the code of conduct would force him to take proper action to revive the patient once he reached a state of unconsciousness
Unconsciousness
Unconsciousness is the condition of being not conscious—in a mental state that involves complete or near-complete lack of responsiveness to people and other environmental stimuli. Being in a comatose state or coma is a type of unconsciousness. Fainting due to a drop in blood pressure and a...

.

The case was brought to a court which denied the request, finding no specific law governed it and urging Parliament to solve the problem.

In December 2006, anesthetist
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...

 Mario Riccio contacted Radical Party member Marco Cappato
Marco Cappato
Marco Cappato is an Italian politician. He was a Member of the European Parliament from Italy until 2009. He represented the Lista Emma Bonino within the Alliance of Liberals and Democrats for Europe parliamentary group. He was Member of the Foreign Affairs, the Civil Liberties and Human Rights...

, informing him that he would perform the operation, seeing no legal impediments. Doctor Riccio arrived in Rome and after ensuring Welby's request was voluntary and not dictated by external pressures, decided to grant his request.

Death and aftermath

After the doctor agreed to his request, Welby asked to listen to Antonio Vivaldi
Antonio Vivaldi
Antonio Lucio Vivaldi , nicknamed because of his red hair, was an Italian Baroque composer, priest, and virtuoso violinist, born in Venice. Vivaldi is recognized as one of the greatest Baroque composers, and his influence during his lifetime was widespread over Europe...

's The Four Seasons
The Four Seasons (Vivaldi)
The Four Seasons is a set of four violin concertos by Antonio Vivaldi. Composed in 1723, The Four Seasons is Vivaldi's best-known work, and is among the most popular pieces of Baroque music. The texture of each concerto is varied, each resembling its respective season...

; as it was not available, he then chose Bob Dylan
Bob Dylan
Bob Dylan is an American singer-songwriter, musician, poet, film director and painter. He has been a major and profoundly influential figure in popular music and culture for five decades. Much of his most celebrated work dates from the 1960s when he was an informal chronicler and a seemingly...

. The procedure started with sedation
Sedation
Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure...

 at 11:00 p.m. on December 20 and ended at 11:40 p.m., when Welby was officially declared dead.

His death was announced the following morning by Marco Pannella on radio; further details were given at a press conference
News conference
A news conference or press conference is a media event in which newsmakers invite journalists to hear them speak and, most often, ask questions. A joint press conference instead is held between two or more talking sides.-Practice:...

 held some hours later.
Italian politicians were divided after his death. Members of the Radical Party and of left wing expressed sorrow for Welby's death, together with relief for ending his long suffering. On the other hand, members of the Italian conservative parties criticized the doctor and the political use of Welby's case. Luca Volonté, of the Christian Democrats, requested the immediate arrest of "Welby's murderers." Despite strong pressure from public opinion, both the Ethical Committee of local Medical Association and the criminal court judged Doctor Riccio’s conduct to be legitimate.

In a controversial move, Roman Catholic Church refused to allow a religious funeral
Funeral
A funeral is a ceremony for celebrating, sanctifying, or remembering the life of a person who has died. Funerary customs comprise the complex of beliefs and practices used by a culture to remember the dead, from interment itself, to various monuments, prayers, and rituals undertaken in their honor...

, officially declaring that

Welby had repeatedly and publicly affirmed his desire to end his own life, which is against Catholic doctrine

A civil funeral was celebrated in a public square in Rome.

External links

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