The ethical dimension in palliative care. The experience of the Ethics Committee for the End-of-life [La dimensione etica nelle cure palliative. L'esperienza del Comitato per l'etica di fine vita]

After identification of indifference towards terminal patients as the key aspect of premodern as well as of modern technological medicine and clarification of the ethicalmethodological reasons for this attitude, the paper focuses on medical practice and ethics as reformulated by the introduction of palliative care in the health care system. Starting from the question whether this model exists in Italy and whether there are the cultural conditions for its implementation, the paper takes into account initiatives of private citizens in the 1980s, which forestalled institutional interventions, aiming at spreading an adequate assistance for terminal patients. In particular, the paper deals with the role played by the Committee for the End-of life. The paper describes its activities from 1991 till present. Particular attention has been payed to highlighting the constant commitment of the Committee to affirming the inseparable link between relief of suffering and respect for autonomy of terminal patients. The paper underlines the current and persistent relevance of this commitment, in particular as palliative care is being administered in increasingly early phases of illness in order to meet patients' needs in different pathological scenarios, not exclusively oncological.