The Italian Government has been plunged into a constitutional crisis over the fate of a 38-year-old woman who has been in a coma for the past 17 years.
Eluana Englaro was left in a vegetative state after a car crash in 1992.
After a decade-long court battle, doctors reduced her nutrition yesterday in preparation for removing her feeding tubes, which her father claims would be in accordance with her wishes.
But in an extraordinary turn of events, the country's Prime Minister, Silvio Berlusconi, after consultation with the Vatican, has issued an emergency decree stating that food and water cannot be suspended for any patient depending upon them, reversing the earlier court ruling.
On issuing the emergency decree, Berlusconi declared: "This is murder. I would be failing to rescue her. I'm not a Pontius Pilate."
Justifying his campaign to save Englaro's life, the Prime Minister added that, physically at least, she was "in the condition to have babies", a remark described by La Stampa newspaper as "shocking".
Giorgio Napolitano, Italy's President, has refused to sign the decree, but if it is ratified by the Italian Parliament doctors may be obliged to resume the feeding of Eluana early this week.
But, in a moving interview, Eluana's father Beppino said last week that the doctors were carrying out his daughter's wishes by allowing her to die.
"If she couldn't be what she was [before the accident in 1992] then she would not have wanted to live".
The case has deeply divided Italian society and raised concerns over the influence of the Vatican.
Pope Benedict indirectly referred to Englaro in a message delivered to mark the World Day of the Sick, stating that society had a duty to defend "the absolute and supreme dignity of every human being" even when "weak and shrouded in the mystery of suffering".
But even some of Berlusconi's political allies, including the president of the Lower House of Parliament, Gianfranco Fini, have stated the Supreme Court ruling should be obeyed and Englaro should be allowed to die.
Opposition leader Walter Veltroni, of the centre-left Democratic Party, said the Government should leave the Englaro family in peace and warned Berlusconi's intervention "could cause a very dangerous constitutional crisis". Demonstrations in support of Eluana's right to die and the Supreme Court ruling were taking place across Italy.
An analyst said Berlusconi, who won a landslide election last year, was using the highly emotional case to concentrate power in his hands by weakening the head of state and the courts.
"He is trying to reduce the power of the courts and the residual powers of the president, and he already has control of both houses of parliament," said James Walston, professor of Italian politics at the American University of Rome.
"If he succeeds, it's a form of coup. He is basically changing the Italian constitution. And he is doing this with the support of the Vatican, which is a strong ally."
Meanwhile, doctors are following the original Supreme Court ruling. Yesterday they began reducing the amount of food in Eluana Englaro's feeding tube, according to a precise medical protocol that will see nutrition gradually replaced with sedative and anti-convulsant medication.
Experts say that within four to five days her condition may have deteriorated to an irreversible extent, though it might be two weeks or more before her heart stops.
The process means the Englaro family and their doctors are now in a race against time as they try to end Eluana's life before the Berlusconi Government and its backers in the Vatican halt the process.
Beppino, 67, was in the family home in Lecco, north of Milan, caring for his wife and Eluana's mother, Saturna, who is gravely ill with cancer. After a long, agonising fight to allow his daughter to die, he described the Government's last-ditch attempts as "a grotesque attack on my family".
Prior to issuing the decree, Berlusconi was involved in frantic telephone exchanges with the Vatican head of state, Cardinal Tarcisio Bertone, who implored the Prime Minister to prevent Eluana's death. The cardinal reportedly told Berlusconi: "We have to stop this crime against humanity."
Doctors have confirmed that, after 17 years and with such catastrophic brain damage, Eluana will never regain consciousness or awareness. The anaesthetist caring for her, Professor Antonio de Monte, said: "Eluana died 17 years ago."
* Global dilemma
During the 1989 Hillsborough football stadium disaster in the UK, Bland suffered two punctured lungs which blocked oxygen flow to his brain. He was left in a persistent vegetative state. The House of Lords ruled in 1993 that withdrawing treatment, as advised by a doctor and approved by Bland's parents, was lawful.
Diagnosed with amyotrophic lateral sclerosis in 1991, Rodriguez campaigned against Canada's law forbidding medically assisted suicides. The Canadian Supreme Court ruled against her. Rodriguez found a physician willing to assist in her death in 1994.
Respiratory and cardiac arrest in 1990 caused Schiavo massive brain damage leading to PVS. After eight years, her husband Michael Schiavo petitioned the Florida courts to have her life support removed. Terri's family appealed, leading to a seven-year legal battle. Her feeding tube was finally removed in 2005.
Ewert's assisted death caused headlines when he allowed it to be filmed for a Sky television documentary, Right to Die, screened in December 2008. The former university professor, from the town of Harrogate in northern England, was suffering from motor neuron disease.
- OBSERVER, AP