"The Gesture of Libera": a 55-year-old woman suffering from multiple sclerosis took her own life using a device from the CNR activated by her eyes.

The room is silent, the light filtered by the blinds. On the reclining wheelchair, her gaze fixed on a pointer: a click of the iris and the infusion pump starts. It is the last act of self-determination of a 55-year-old woman from Tuscany, suffering from a very severe form of multiple sclerosis, who had waited over two years to exercise a right recognized by the judges. She was called “Libera.” The drug was self-administered thanks to a device developed by the National Research Council and configured to be activated with an ocular command, in order to meet the requirement of “autonomous act” required by Italian constitutional jurisprudence. The news of her death is from today. “I hope no one has to wait more than two years for their right,” she had said a few days ago, when the machine was finally delivered to her.

A code name and a long wait

“Libera” is a pseudonym that protected the identity of the woman and her family during a process that, involving medical assessments, ethical opinions, and administrative delays, has lasted from 2024 until today. The Florence Court had long established the requirements set by the Constitutional Court in 2019 (the so-called “Cappato/Dj Fabo case”): full capacity to understand and will, irreversible pathology causing intolerable suffering, dependence on life-sustaining treatments. It was this last criterion that was the subject, in 2024, of further clarifications by the Constitutional Court, which helped define the conditions for access even in the absence of artificial ventilation or nutrition, as long as there are supports that, in fact, keep the person alive.

The woman, paralyzed from the neck down, was not physically able to press a button or start an infusion without assistance. Here arose the most concrete obstacle: how to ensure that the act of administering the drug was truly performed by her and not by others? In 2025, the Florentine judge, acknowledging the difficulties in finding suitable technology on the market, ordered the Tuscan health authority to identify, through Estar (the purchasing center of the regional health service), a solution that allowed activation via “command sensor or ocular pointer.” Then, with another order, he instructed the Cnr to design a device capable of receiving input from the gaze and safely activating the infusion pump. The specified deadline was 90 days.

The deadlines have been postponed several times. On February 17, 2026, just before the last deadline, there was a new delay in the delivery of the technology, while the woman reiterated her desire to choose "when and how" to die, according to what had already been authorized by the judges. A few days later, the device arrived. Today, the conclusion.

The eye-controlled device: how it works and why it is crucial

The core of the solution is a human-machine interface that translates the movement of the eyeball into a secure and unique digital input: an "active consent" that the person can express without the use of limbs. The system, validated for clinical use in this procedure, consists of:  an eye tracker calibrated to the patient's gaze; and a logic module that requires an intentional sequence (for example, fixing on an icon for a predetermined time) to avoid involuntary activations; and an interface with the infusion pump, set to "start" only following the signal from the eye interface.

The choice of eye control is not a technical detail: it is the element that allows compliance with the "self-administration" criterion established by the Consultation in 2019 and reiterated by the measures of the Florence Court in 2025. Without that intentional and autonomous gesture, one would slip into the criminally prohibited area of "murder of the consenting person," which the Constitutional Court itself has confirmed cannot be circumvented by legal shortcuts.

Although the engineering details of the prototype have not been extensively disclosed, the essential steps of the process have been confirmed by institutional and press sources: from the judge's request to the provision of the device, including the direct involvement of the Cnr and the support of Estar and Asl Toscana Nord Ovest in making available the medications and supplies. The same Luca Coscioni Association has followed the case with its lawyers, documenting the stages and the compliance of the proposed solution with legal requirements.