Advance directives are written or oral statements that are intended to govern healthcare decision-making for their authors, for both positive and negative decisions, should they lose decisional capacity in the future. In a Europe which is facing an ageing population, advance directives play an increasing role to (help) formulate the wishes from elderly patient once they start losing the capacity to decide independently. Advance directives should not only be used as a formulation of the patients’ previously made decision, but can also be used as guidelines to better understand the previous expressed wishes of the patient. If the advance directive is formulated in too vague form, the healthcare proxy and/or the healthcare trustee can help the physician interpret the directive. This broader approach towards advance directives is reflected in the case-law of the European Court of Human Rights, as well as on the European legislative level.
The outbreak of the Covid-19 pandemic has forced States to take restrictive measures to contain the growing number of infections. Among these measures, after the approval of vaccines by the EMA, the possibility of introducing a compulsory vaccination has become a plausible and attractive prospect. In Italy, Covid-19 compulsory vaccination is implemented by a succession of Decrees concerning specific categories of workers and, only recently, a section of the population with the recent Decree of 7 January, 2022, no. 1. However, if we look back at the most critical restrictions implemented in the country, we realise that a de facto obligation was already in place before establishing a de jure obligation. The following article traces the most important profiles of the vaccination obligation implemented de jure and de facto by the Italian government.