🇮🇹 Italy →

Brazil requested the extradition of a former federal parliamentarian for the enforcement of a sentence concerning unlawful carrying of a firearm and unlawful coercion committed with a firearm. The appellant challenged surrender on political-offence and persecution grounds, alleged unfairness before the Brazilian Supreme Federal Court, disputed double criminality, and relied on prison conditions and serious health concerns. The Court rejected the objections concerning the political character of the offences, fair trial, double criminality, and the general conditions at the designated women’s prison, finding the information and assurances on those matters sufficiently specific. It nevertheless quashed the judgment and remitted the case because the lower court had not obtained precise, individualised information showing that the requested person would receive continuous specialist monitoring, appropriate medication, and adequate treatment for her documented medical conditions.

The case concerned a person held in custody in Italy pending extradition proceedings before the Court of Appeal of Bologna. The defence sought revocation or substitution of the custodial measure, arguing that the requested person’s health conditions were incompatible with prison detention. The Court of Appeal rejected the application, relying on the continuing risk of flight and on a prison medical report which considered detention compatible with the person’s health, without ordering an independent expert assessment. The Italian Supreme Court annulled that decision. It held that, where an application for revocation or replacement of custody is based on alleged incompatibility between the person’s health conditions and prison detention, the court must order medical assessments in expert form unless the alleged incompatibility is unsupported by adequate justification or the situation is clearly compatible with detention. That was not the case here. The prison medical report did not provide a stable and conclusive clinical picture, referred to the need for constant monitoring, and did not clarify whether the necessary diagnostic and therapeutic measures could be adequately and promptly provided within the prison system or in a prison medical facility. Only after such assessment could the court properly evaluate the continuing need for custody, the concreteness of the risk of flight, and the possible adequacy of less restrictive alternative measures. The order was therefore annulled with remand for a fresh assessment.

The case concerned Ecuador’s request for the extradition of the requested person for prosecution for sexual violence. The Court of Appeal of Rome had found that the conditions for extradition were met. The requested person challenged that decision, arguing that his serious diabetes and alleged depressive condition with suicidal thoughts made detention and transfer incompatible with his health, that the assurances provided by Ecuador concerning detention conditions were generic and misunderstood by the Court of Appeal, and that extradition would disproportionately affect his family life and social roots in Italy. The Italian Supreme Court rejected the appeal. As to health, it held that the expert assessment had found the diabetes, which did not present complications, compatible with ordinary detention and with transfer to Ecuador, and that the Ecuadorian authorities had confirmed the availability of healthcare, medicines and assistance in the intended detention facility. The Court also found that the medical material concerning alleged suicidal ideation was generic and did not disclose a structured suicide risk capable of barring extradition. As to detention conditions, the Court held that the Court of Appeal had correctly understood the information supplied by Ecuador, including the reported 82% overcrowding rate, and had assessed it together with the other specific assurances on detention and healthcare. The risk of inhuman or degrading treatment could not be inferred from overcrowding alone where the requesting State had provided concrete assurances and no precise contrary evidence had been submitted. Finally, the Court held that family ties and social integration in Italy do not constitute a judicial ground for refusing extradition, since such considerations fall within the exclusive competence of the Minister of Justice and cannot be treated as equivalent to the refusal ground applicable in European Arrest Warrant proceedings. The appeal was therefore dismissed.

The Court of Appeal may rely on the guarantees provided by the issuing State, which clarified that the requested person: (a) will receive medical assistance within the penitentiary facility; (b) may, if necessary, be permanently admitted to the prison infirmary; (c) will be provided with pharmacological treatment and psychological support; and (d) may, if necessary, be placed in a cell under video surveillance. The Court also drew the requesting State’s attention to the need to put in place effective safeguards and monitoring measures to protect the requested person’s health, including by considering the possibility of alternatives to custodial detention.

In matters of extradition to a foreign State, for the purposes of assessing the ground for refusal related to the person’s health conditions under Article 705(2)(c-bis) of the Italian Code of Criminal Procedure, the Court of Appeal may not confine itself to verifying whether the healthcare facilities in the requesting State are adequate to meet the extraditee’s therapeutic needs. It must also take into account the concrete adverse impact that the surrender procedure itself may have, including pathological complications associated with transfer abroad, as well as the need to ensure continuity of ongoing treatment (case concerning the failure to consider the health condition of a person suffering from HIV and in need of life-saving medication not available in Albanian prisons).

Health conditions and extradition. The Russian Federation requested the extradition of an elderly Russian business executive for prosecution in connection with alleged fraud, embezzlement and corruption offences. The Court held that the requested person’s severe cardiac condition, diabetes and hypertension, requiring uninterrupted treatment and continuous medical monitoring, made surrender and the ensuing detention abroad incompatible with his health and exposed him to a concrete risk of significant pathological consequences. The Court regarded those health conditions as the decisive ground for refusal under Article 705(2)(c-bis) of the Italian Code of Criminal Procedure. It also considered Russia’s expulsion from the Council of Europe and the impending cessation of ECHR protection as an additional factor undermining the expectation of humane detention, and therefore rejected the extradition request.

The Court of Appeal must refuse extradition “where reasons of health or age entail a risk of consequences of exceptional gravity for the requested person.” Such a ground for refusal may apply not only where adequate medical treatment cannot be ensured in the requesting State, but also where the extradition procedure itself is liable to prejudice the person’s health. In particular, such prejudice does not arise from any negative impact on the individual’s health, but only where extradition may result in consequences of exceptional gravity, namely serious and objectively verifiable pathological effects. Accordingly, the Court cannot confine its assessment to verifying whether the healthcare facilities in the requesting State are adequate to meet the person’s therapeutic needs, but must also take into account the concrete impact—and thus the potential adverse effects—of the surrender procedure on the requested person’s health. This includes, for example, the difficulties and possible complications arising from the transfer abroad or the need to avoid interruption of ongoing medical treatment.