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A new law has been passed in Italy giving severely ill people the right to refuse treatment that would prolong their lives.
The legislation passed in the Senate by 180 votes to 71, despite fierce opposition from conservative groups.
Adults will now have the right to sign what is called a 'living will', with preferences on how to be treated if the ability to communicate is lost.
Marco Cappato, a spokesman for the 'end-of-llfe' association Luca Coscioni told reporters: "This law is a good step forward because it recognises what judges had already established in other cases.
"Of course we are still missing legalisation on euthanasia, which we will submit to the next parliament with a draft bill."
Critics remain fiercely opposed to the so-called living will, 10 years after it was first proposed.
Francesca Poleggi, an activist for the 'pro-life' Provita group, said: "This law does not safeguard in any way a person's right to choose or individual freedom.
"A person who signs this declaration does so when he or she is feeling well, without any health problems, and this person can only guess how he or she will react in case of illness.''
The new law says that people can decide in their declarations to refuse not only medical treatment, but also food and water.