In June 2005, Italy held a referendum on repealing the law on medically assisted fertilization , which limits access to artificial reproduction to infertile couples, and prohibits the donation of gametes, the cryopreservation of embryos, preimplantation genetic diagnosis , and research on human embryos. The referendum was invalidated, and the law remained unchanged. The Italian political e bioethical debate on assisted reproduction was manipulated by the Catholic Church, which distorted scientific data and issues at stake with the help of (...) Catholic politicians and bioethicists. What happened in Italy shows that some perverse socio-cultural e political mechanisms are spreading the absurd and anti-historical view that scientific and technological advancements are threatening democracy and personal freedom. Scientists should not only contrast the political attempts at limiting freedom of scientific research, but also tell politicians, humanists and citizens that the invention of Western science with its view of scientific community as an “open society”, contributed and still contributes, through scientific education, to the construction and maintaining of the moral and political values underlying Western democracies. (shrink)

A Second level Master in “Clinical Bioethics Consultation” has been organized in Italy to offer an opportunity to offer an adequate training to carry out an ethics consultation in different health fields. The master has been promoted and realized by different institutions: Catholic University of Sacred Hearth in Rome, Insubria University in Varese, “Federico II” University in Naples, Lanza Foundation in Padua and the Local Health and Social Care Unit n.7 in Veneto Region. The aim of the master is (...) train ethics consultants to offer help regarding a correct decision, which will take by others. The choice must be as much as possible shared between patient, family and health care team. Ethics consultation can be primarily request by the physicians, nurses and health care staff such as support about a choice that wants to be the most appropriate and to clarify a dilemma between different options. Secondly an ethics consultation can be demand by the patient and the family members to find a clarification about their dilemmas and future choices. Also the administrative staff could ask the consultation, when it need to better explain ad example about a specific clinical case or a question concerned the health policy. (shrink)

La cosiddetta “morte cerebrale totale”, o più correttamente “morte encefalica” (whole brain death), è un criterio fisiologico riferito alla cessazione irreversibile e permanente di tutte le funzioni dell’encefalo (emisferi e tronco encefalico), ed è correlato alla cessazione del funzionamento integrato dell’organismo. L’applicazione del criterio neurologico, e degli esami che lo accompagnano, è finalizzato ad una diagnosi clinica e strumentale per individuare una condizione causata da lesioni neurologiche diffuse e responsabili di coma, assenza di coscienza, di respirazione spontanea, di risposte agli (...) stimoli esterni, e di attività elettrica cerebrale in pazienti collegati alle macchine per la rianimazione. La diagnosi consente la dichiarazione legale di morte. L’assunto scientifico alla base dell’impiego del criterio neurologico è la teoria dell’integratore centrale, secondo la quale l’encefalo è responsabile del funzionamento integrato e coordinato dell’organismo. Questo contributo ricostruisce a grandi linee il dibattito bioetico italiano sui criteri per l’accertamento della morte, prestando attenzione anche ai recenti sviluppi della discussione sui mass media. (shrink)

Stem cell research regulations are highly variable across nations, notwithstanding shared and common ethical concerns. Dominant in political debates has been the so-called embryo question. However, the permissibility of human embryonic stem cell research varies among national regulatory frameworks. Scholars have explained differences by resorting to notions of political culture, traditions of ethical reasoning, discursive strategies and political manoeuvring of involved actors. Explanations based on the role of religion or other cultural structural variables are also employed. This paper analyses the (...) emerging of the Italian regulatory framework on stem cell research using an analytical framework that considers the interplay between cultural structural features, political culture, traditions of ethical reasoning, institutional settings and the discursive and political agency of the actors involved. It aims also to explain the role of Roman Catholic Church in shaping the Italian stem cell research regulation not by treating religion as an autonomous causal factor, but through the analysis of the agency of Catholic and allied actors in the Italian political culture and institutional setting. (shrink)

Background On December 2017 the Italian Parliament approved law n. 219/2017 “Provisions for informed consent and advance directives” regarding challenging legal and bioethical issues related to healthcare decisions and end-of-life choices. The law does not contain an explicit reference to Ethics Committees (ECs), but they could still play a role in implementing the law. Methods A questionnaire-based survey was performed among the ECs of the Italian Institute for Research and Care belonging to the Network of neuroscience and neurorehabilitation, (...) with the aim of (1) knowing whether the ECs participated and, if so, how in the process of implementation of law n. 219/2017 in the referring institutes; (2) investigating the point of view of the ECs regarding their possible involvement in the process; (3) exploring the contribution ECs can provide to give effective implementation to the law principles and provisions. Results Seventeen ECs out of thirty took part in the survey; the characteristics of the responding and non-responding committees are similar, so the responding ECs can be regarded as representative of all ECs in the Network. Nine ECs did not discuss the law in anyway: the main reason for this is that the referring institutions (6) and the health care professionals (3) did not ask for an EC intervention. Nevertheless, the large majority of the ECs believe that their involvement in the implementation of the law as a whole is appropriate (8) or absolutely appropriate (6), while 3 of them are neutral. No EC believes that the involvement is inappropriate. The aspect of the law on which the 14 ECs converge in considering the EC involvement appropriate/absolutely appropriate is the one related to the health facilities obligation to guarantee the full and proper implementation of the principles of the law. Conclusions Our survey confirms that ECs believe they can play a role in the implementation of law n. 219/2017, although this does not entirely correspond to what the committees have actually done in reality. This role could be better exercised by ECs specifically established for clinical practice, which would have a composition, functioning and a mandate better suited to the purpose. This supports the call for a national regulation of ECs for clinical practice. (shrink)

The article examines reasons and features of the Italian bioethics movement in itself and in relationship to that in the U.S.A. Research, consultation, teaching are the most requested professional activities. Ethics committees are now established in several places and at different level: national (National Italian Committee for Bioethics), regional (Italy has about twenty regions with some political power), and institutional (research centers, university, main hospitals).

Cimatti and Salzani have put together a rich collection of essays on animal studies that provides an exhaustive overview of how Italian contemporary philosophers are engaging with animal ethics, antispeciesism, posthumanism, ecofeminism, and biopolitics. This edited volume represents an important development in the “animal turn” in the humanities, particularly because it is published in English, allowing for a more efficient dialogue between “Italian theory” and philosophers around the world. This is, in fact, the first collection that will give (...) an international audience access to the rich and varied contribution of Italian contemporary philosophy in the burgeoning field of animal studies. It is also important to point out that all the authors—who are either well-established erudite thinkers or bright and innovative new voices in the panorama of Italian philosophy—effectively engage with recent and prominent scholarship in the fields of animal studies, posthumanism, and biopolitics, such as the work of Zizek, Esposito, Hardt, Calarco, Braidotti, and Wolfe.The volume is clearly intended for an academic audience: professors, scholars, and graduate students studying not only philosophy, Italian studies, environmental humanities, and animal ethics, but also political science, ethology, comparative literature, art history, and religious studies. In addition, the book could also find an audience in animal rights and environmental activists who are interested in the philosophical aspects and ethical and political implications of their actions.The division of the book into three sections (“Animality in the Italian Tradition,” “Animality in Perspective,” and “Fragments of a Contemporary Debate”) provides the reader a clear trajectory from the Italian philosophical tradition to the current debate on “animality.” In the first section, in fact, the authors engage with the rich and complex tradition of both Italian animal philosophy and advocacy. In the three essays that make up this section, the authors provide a compelling historical perspective of the anti-Cartesian and antidualistic aspects of Italian thought, tracing its pre-Cartesian origin and post-Cartesian developments through the work of Francis of Assisi, Dante Alighieri, Giordano Bruno, Giambattista Vico, and Giacomo Leopardi, among others. This section also includes essays outlining the development of animal bioethics in Italy, which emerged from the work of animal advocacy pioneer Aldo Capitini and continued to have an important impact on Italian culture thanks to the antispeciesist movement and debate, of which the third essay of this section provides an exhaustive intellectual history.The second section of the volume, comprised of six essays, provides an overall view of the ongoing philosophical debate on animality that traverses Italian posthumanism, feminism, theology, biopolitics, environmental ethics, and Marxist thought. Here the authors engage with some of the prominent voices in the contemporary Italian philosophical landscape, such as Giorgio Agamben, Roberto Esposito, Roberto Marchesini, Antonio Negri, Maria Turchetto, Adriana Caravero, Luisa Muraro, and Paolo De Benedetti. As pointed out by the editors in their introduction, this section does not intend to offer a complete account of the extensive and heterogenous exchanges occurring inside the Italian biological turn, but instead aims at investigating its most compelling approaches and effectively links them to the ongoing transnational debate.The rich historiography and analysis of the first two sections is complemented, in the third section of the volume, by the speculative approach that strongly characterizes all five final essays. Here we can find some of the most exciting and original developments in Italian scholarship on animal philosophy. This section is, therefore, the most effective in presenting the distinctive approach of contemporary Italian philosophers in rethinking animality and the human-animal interplay, in particular inside the historical and epistemological frame of the Anthropocene. For instance, Massimo Filippi explores how slaughterhouses have become exemplary spaces to investigate the calculation that adds, subtracts, multiplies, and divides humans and animals, which removes animality and excises the other, which forcefully bans any imagining of the monstrously other, of the other-than-human, and that produces, among others and besides It-Self, the Woman, the Homosexual, the Abnormal, the Migrant, the Criminal, and the Animal. (p. 225)Structuring his argument on the real and metaphorical “mathematics of sacrifice” at work in the slaughterhouse (p. 226), Filippi engages with the processes that enable human ontological privilege, with intraspecific and interspecific mechanisms of discrimination, and with philosophical, political, and ethical implications of meat production.For a second and final example, ethologist Roberto Marchesini—one of the most original and prominent voices in animal studies—focuses on redefining the paradigm of “animality.” In his essay, Marchesini questions behaviorism and the automatism of learning, key aspects that have been prominent in defining animality in many fields, from biology to philosophy. Building from his groundbreaking and extensive work in ethology and zooanthropology, he argues for an “elaborative model” of animality (animal as subject) against the fallacy of the “automatism-based model” (animal as mechanism): Subjectivity is the implicit condition of the animal being, an expressive dimension that may also be unconscious but that precedes from (i) a constructivist conception of behavior, which we could explain by considering it a work in progress, always open and never predetermined, but equally never imposed and nonetheless always co-factorial to external contributions, and (ii) a propositional view of the individual, or rather from being supported by verbal structures such as to delight, to fear, to want, which join themselves to modal predicates declined according to context, but which likewise render the individual the protagonist. (p. 247)Animal studies has established itself as one of the most exciting areas of research inside the biological turn of the humanities worldwide and, by collecting such a large number of compelling and provocative theories from Italian contemporary philosophy, the impact of Cimatti and Salzani's volume will be twofold: It will enrich and expand a developing discussion in the environmental humanities and in animal studies while establishing the centrality of Italian thought in such an important and, in the Anthropocene era, necessary debate. (shrink)

Background: The rapid pace of progress in medical research, the consequent need for the timely transfer of new knowledge into practice, and the increasing need for ethics support, is making the work of Ethics Committees (ECs) ever more complex and demanding. As a response, ECs in many countries exhibit large variation in number, mandate, organization and member competences. This cross-sectional study aims to give an overview of the different types of activities of Italian ECs and favour discussion at a (...) European level.Methods: A questionnaire was emailed to all Italian Ethics Committees contained in the national Registry of the Ministry of Health, enquiring whether the EC was conducting, or planning to conduct, 4 specific activities. A telephone interview was conducted to determine reasons for failure to respond.Results: Response rate was 53% (101 respondents out of 191). 20% of ECs restrict their responsibilities to research protocol review, 25% also offer ethical consultation to institutions, support on individual health care decisions and promotes educational initiatives, while the remaining 50% conduct a few of the examined activities to varying degrees. Large variation was observed across different types of hosting institutions and geographical locations.Conclusions: A common European model should be developed, defining EC functions, member selection modalities, necessary member competences, decision-making criteria and measures for work verification. In the absence of sound empirical evidence, it would be interesting to study the effectiveness and efficiency of the different existing models. (shrink)

This volume brings together a set of critical essays on the thought of Professor Doctor H. Tristram Engelhardt Jr., Co-Founding Editor of the Philosophy and Medicine book series. Amongst the founders of bioethics, Professor Engelhardt, looms large. Many of his books and articles have appeared in multiple languages, including Italian, Romanian, Portuguese, Spanish, and Chinese. The essays in this book focus critically on a wide swath of his work, in the process elucidating, critiquing, and/or commending the rigor and (...) reach of his thought. This volume compasses analyses of many different aspects of Engelhardt's work, including social and political philosophy, biopolitics, the philosophy of medicine, and bioethics. It brings together internationally known scholars to assess key elements of Engelhardt's work. (shrink)

The legitimacy of conscientious objection to abortion continues to fuel heated debate in Italy. In two recent decisions, the European Committee for Social Rights underlined that conscientious objection places safe, legal, and accessible care and services out of reach for most Italian women and that the measures that Italy has adopted to guarantee free access to abortion services are inadequate. Nevertheless, the Ministry of Health states that current Italian legislation, if appropriately applied, accommodates both the right to conscientious (...) objection and the right to voluntary abortion. One empirical argument used to demonstrate that conscientious objection does not create barriers to abortion is the “no correlation” argument, which the Italian Committee for Bioethics employed to demonstrate that no association exists between conscientious objection and waiting times for voluntary abortion in Italy and to support the weak form of conventional comprise adopted by the Italian legislation to balance the conflict between women’ autonomy and healthcare professionals’ moral integrity. Conversely, we showed how the “no correlation” argument fails to demonstrate the absence of a relationship between the number of conscientious objectors and waiting times for voluntary abortion, and that the limitations of the “no correlation” argument itself demonstrate how it is still difficult to describe the real effect of conscientious objection on the access to abortion services and to evaluate the suitability of conventional compromise to effectively balance conflicting moral principles. Further studies are needed to better describe the relationship between conscientious objection and waiting times for voluntary abortion. If new evidence would show that the increasing proportion of objectors does undermine the efficacy of the Italian law and the right of a woman to freely obtain a voluntary abortion, new ways will need to be found to address the conflict between moral principles and restrict the protection accorded to the principle of moral integrity. This would inevitably imply the need to constrain and to redefine the terms and conditions for claiming conscientious objection. (shrink)

Background The legitimacy of conscientious objection to abortion continues to fuel heated debate in Italy. In two recent decisions, the European Committee for Social Rights underlined that conscientious objection places safe, legal, and accessible care and services out of reach for most Italian women and that the measures that Italy has adopted to guarantee free access to abortion services are inadequate. Nevertheless, the Ministry of Health states that current Italian legislation, if appropriately applied, accommodates both the right to (...) conscientious objection and the right to voluntary abortion. Main body One empirical argument used to demonstrate that conscientious objection does not create barriers to abortion is the “no correlation” argument, which the Italian Committee for Bioethics employed to demonstrate that no association exists between conscientious objection and waiting times for voluntary abortion in Italy and to support the weak form of conventional comprise adopted by the Italian legislation to balance the conflict between women’ autonomy and healthcare professionals’ moral integrity. Conversely, we showed how the “no correlation” argument fails to demonstrate the absence of a relationship between the number of conscientious objectors and waiting times for voluntary abortion, and that the limitations of the “no correlation” argument itself demonstrate how it is still difficult to describe the real effect of conscientious objection on the access to abortion services and to evaluate the suitability of conventional compromise to effectively balance conflicting moral principles. Conclusion Further studies are needed to better describe the relationship between conscientious objection and waiting times for voluntary abortion. If new evidence would show that the increasing proportion of objectors does undermine the efficacy of the Italian law and the right of a woman to freely obtain a voluntary abortion, new ways will need to be found to address the conflict between moral principles and restrict the protection accorded to the principle of moral integrity. This would inevitably imply the need to constrain and to redefine the terms and conditions for claiming conscientious objection. (shrink)

In 2017, Italy passed a law that provides for a systematic discipline on informed consent, advance directives, and advance care planning. It ranges from decisions contextual to clinical necessity through the tool of consent/refusal to decisions anticipating future events through the tools of shared care planning and advance directives. Nothing is said in the law regarding the issue of physician assisted suicide. Following the DJ Fabo case, the Italian Constitutional Court declared the constitutional illegitimacy of article 580 of the (...) criminal code in the part in which it does not exclude the punishment of those who facilitate the suicide when the decision has been freely and autonomously made by a person kept alive by life-support treatments and suffering from an irreversible pathology, the source of physical or psychological suffering that he/she considers intolerable, but fully capable of making free and conscious decisions. Such conditions and methods of execution must be verified by a public structure of the national health service, after consulting the territorially competent ethics committee. This statement admits, within strict and regulated bounds, physician assisted suicide, so widening the range of end-of-life decisions for Italian patients. Future application and critical topics will be called into question by the Italian legislator. (shrink)

Is it necessary to contrast the spreading process of genetic engineering in the agri-food stuff sector? Can EU rules really consider the impact of this brand new technologies on biology and, consequently, on public health? Despite the general trend, a firm opposition is what is happening in some Regions of Italy, where GMOs production and placing on the market are foibidden.

The aim of the paper is that of investigating the concept of “person” in the context of Italian law on informed consent and advance healthcare directives. The following paper will first consider the importance of the concept of “person” within bioethics; secondly it will exhibit how there are different levels of bioethics, and that on the discussion level of laws and regulations, concepts worthy of metaphysical and value references cannot be used, because they must be shared by (...) everyone in a pluralistic society. I’ll then move on to discuss the law on informed consent and advance healthcare directives; first I’ll discuss the references to the Italian Constitution, showing that the implied concept of “person” is closely linked to the concepts of “equality” and “autonomy”, and finally I’ll discuss the particular case of minors and the protection that the law provides them. (shrink)

The concept of personhood has been recently strongly criticized by some bioethicists. The present article aims at refuting these criticisms. In order to show how the notion of personhood operates in bioethics, two understandings of it proposed by an Italian bioethicist Maurizio Mori are sketched: a person as a part of the cosmological order and a person as an autonomous-like entity. It is argued that none of the proposed understandings is adequate. The cosmological concept perceives the person as (...) a derivative of the empirical processes. The autonomous-like, in turn, conceives the person as a freely acting subject. This paper endeavours to prove that both conceptions are one-sided. In order to do that, the thought of German philosopher Robert Spaemann is deployed. He convincingly points out that the person must be considered from a so-called “modus existendi” stance. It means that to be a person is to possess a unique way of being. That being encompasses the material content not as a casual factor but as an indispensable mean of expressing itself. The final thesis is that the person's being is man's life. Drawing upon such a conclusion, it is taken up a critical discussion with the views rejecting the usefulness of the concept. (shrink)

The concept of personhood has been recently strongly criticized by some bioethicists. The present article aims at refuting these criticisms. In order to show how the notion of personhood operates in bioethics, two understandings of it proposed by an Italian bioethicist Maurizio Mori are sketched: a person as a part of the cosmological order and a person as an autonomous-like entity. It is argued that none of the proposed understandings is adequate. The cosmological concept perceives the person as (...) a derivative of the empirical processes. The autonomous-like, in turn, conceives the person as a freely acting subject. This paper endeavours to prove that both conceptions are one-sided. In order to do that, the thought of German philosopher Robert Spaemann is deployed. He convincingly points out that the person must be considered from a so-called “modus existendi” stance. It means that to be a person is to possess a unique way of being. That being encompasses the material content not as a casual factor but as an indispensable mean of expressing itself. The final thesis is that the person's being is man's life. Drawing upon such a conclusion, it is taken up a critical discussion with the views rejecting the usefulness of the concept. (shrink)

PurposeThe aim of this paper is to assess the complex issue of responsibility in clinical practice. The paper focuses mainly on the relationship between personal- and medical-professional responsibility of practitioners and clinical guidelines.MethodsAfter a theoretical review of the different definitions of responsibility in selected bioethical and biojuridical literature, two recent juridical proceedings concerning medical responsibility from Italian Courts are discussed. Subsequently, a theoretical analysis of the definition of clinical practice guidelines is proposed in order to show their feasibility to (...) assess personal- and medical-professional responsibility.ResultsThe definitions of responsibility and the two Italian cases show the theoretical and practical difficulties of shared assessments of both personal-professional and medical-professional responsibility in clinical practice. Clinical practice guidelines cannot be assumed as an objective code of action stating exactly a rule of conduct in all situations, but as a tool suggesting how to decide what to do in different conditions.ConclusionsResponsibility in clinical practice is such a complex issue to deserve a special ethical assessment. The clinician’s personal-professional responsibility cannot be replaced or reduced by clinical practice guidelines, because medicine is as such a relationship focused on the expertize of practitioners. Nonetheless, a shared approach to different clinical conditions is needed in order to avoid a relativist outcome and protect patients’ and even clinicians’ rights. Formal guidelines (that describe not exactly what to do but how to decide what to do) are proposed as potential useful tool to achieve this aim. (shrink)

Different definitions of bioethics in American and Italian literature are reported. It is argued that they refer to three different conceptions of the epistemological status of bioethics: the first conceives of it as an application of moral principles to biomedical problems, the second as a methodology for the working out of clinical judgement, the third as a broader and interdisciplinary public inquiry. It is suggested that each approach grasps a part of the truth, for each singles out (...) one level of the bioethical work. Bioethics is in fact a complex, three-level form of knowledge. The misunderstanding of this complexity has led to some confusion and to conflicts of attribution among those who are concerned with it. Keywords: applied ethics, bioethics, medical ethics, interdisciplinarrity CiteULike Connotea Del.icio.us What's this? (shrink)

The creation of biobanks depends upon people’s willingness to donate their samples for research purposes and to agree to sample storage. Moreover, biobanks are a public good that requires active participation by all interested stakeholders at every stage of development. Therefore, knowing public’s attitudes towards participation in a biobank and biobank management is important and deserves investigation.

Background On December 2017 the Italian Parliament approved law n. 219/2017 “Provisions for informed consent and advance directives” regarding challenging legal and bioethical issues related to healthcare decisions and end-of life choices. The law promotes the person’s autonomy as a right and provides for the centrality of the individual in every scenario of health care by mean of three tools: informed consent, shared care planning and advance directives. Few years after the approval of the law, we conducted a survey (...) among physicians working in four health care facilities specific for the care of people suffering from psychiatric disorders, cognitive disorders and dementia located in the North of Italy aiming to investigate their perceived knowledge and training need, attitudes regarding law n. 219/2017 provisions, and practices of implementation of the law. Methods A semi-structured questionnaire was developed on an online platform. The invitation to participate in the survey was sent by email to the potential participants. Information was collected by means of the online platform (Google Forms) which allows to export data in a spreadsheet (Windows Excel) to perform basic statistical analysis (frequency distributions, bar chart representation). Results Twenty-five out of sixty physicians participated in the survey. None of the respondents value their knowledge of the law as very good, 10 good, 13 neither poor nor good, 1 poor and 1 very poor. All the respondents want to learn more about the law (21 yes and 4 absolutely yes). The majority of respondents agrees with the content of the law as a whole (3 absolutely agree, 13 agree), and on each provision. The question on the clarity of the concept of capacity in the law received mixed answers and this impacted on the physicians’ opinion regarding the legitimacy in principle for our groups of patients to realize shared care planning and write advance directives. Thirteen physicians neither introduced the theme of shared care planning nor arranged for shared care planning and the main reason for this was that no patient was in a clinical situation to require it. When shared care planning is realized, a variability in terms of type and number of meetings, mode of tracking and communication is registered. Conclusions Our survey results indicate a need for more clarity regarding the interpretation and implementation of the law in the patient groups under study. There are in particular two related areas that deserve further discussion: (1) the question of whether these patient groups are in principle legitimized by the law to realize shared care planning or write advance directives; (2) the notion of capacity required by the law and how this notion can be declined in real-life situations. (shrink)

The paper relates to the actual extent of the “margin of appreciation” of national law-making power in Europe when it takes ethical issues into consideration. This occurs when the use of technoscience may affect fundamental interests. The discretion of the legislature is limited, particularly by the transnational system arising from the European legal integration within both the European Union and the Council of Europe. The two schemes of integration, although there are differences between them, converge to put national legislation under (...) pressure, particularly when it considers ethical matters. As a matter of fact, ethical issues cannot be approached at the national level alone but must be addressed at least at the continental level. An important role in the work of shaping the ethical rules from a continental perspective is played not by the national legislatures, but by the dialogue between the different levels of the judiciary. This role is inescapable and cannot be replaced by legislation, even if it is approved in a transnational plan. The function of the case law in regulating phenomena with ethical implications is studied, taking into consideration the case of Italian Law no. 40 of 2004 concerning medically assisted reproduction. Over the last 15 years, this law, which is inconsistent with many fundamental ethical principles, but has not been amended by the legislature, has been in the process of being corrected by the dialogue between European and national case law. (shrink)

This chapter highlights how the encouragement of citizens' participation may in fact masquerade their rulers' attempt to create consensus for their ‘superior’ political project. It illustrates in ethnographic detail how rulers have symbolically used the public space, along with policies of urban regeneration, to win popular consensus and, thus, legitimise their position. The analysis addresses a central problem in the dynamics of democratic government, as it shows that lack of responsibility and superimposition of a political rhetoric on good governance eventually (...) leads to people's distrust of those in power. The case of Naples significantly points to the fact that, while people may be granted formal membership of society, rulers' pedagogic approaches and self-legitimisation do in fact deny fundamental citizenship rights, such as social and economic rights. (shrink)