La Teoria costituzionale dopo lo "Stato di partiti"

La costituzione è fonte di norme. Da che è iniziata l’epoca delle costituzioni scritte questa affermazione ha un che di scontato. Poco importa che una costituzione sia posta da un’assemblea elettiva o concessa da un monarca su pressione delle rappresentanze popolari: l’intenzione di redigerne una si accompagna sempre alla volontà di farla valere come precetto di diritto. E tuttavia, che la costituzione sia fonte di norme non significa che sia pure fonte di norme prevalenti rispetto a qualsiasi altra norma dell’ordinamento. La normatività di un testo costituzionale presuppone una differenza di grado tra la “forza di legge” e la “forza di costituzione” solo quando questa normatività intende manifestarsi come superiore. Da dove deriva e quali effetti produce la superiorità delle norme costituzionali? Le condizioni della validità e prescrittività delle costituzioni democratico-pluraliste possono riassumersi in tre parole-chiave: connessione, incorporazione e irradiamento. L’espressione connessione evoca la Verbindungsthese di Robert Alexy, cioè l’idea di un legame necessario tra diritto e morale. Nella costituzione si situa il punto di contatto tra l’ordinamento giuridico-positivo e le assunzioni etiche condivise socialmente. Il testo costituzionale è valido non già perché voluto e “portato” da un sovrano ma perché riposa su una “consuetudine di riconoscimento”; e le disposizioni costituzionali possono essere riconosciute consuetudinariamente come valide solo alla condizione di veicolare quelle esigenze di giustezza materiale che una società pluralista avverte come imprescindibili. In virtù di questa connessione essenziale la costituzione incorpora principi di giustizia irriducibili alla categoria delle norme-regole. Questa incorporazione – la seconda parola-chiave – orienta in modo particolare l’operatività concreta della costituzione; e mostra come l’argomentazione di “diritto costituzionale” confluisca fatalmente nell’argomentazione morale pratica. Per il tramite dei “principi”, e delle pratiche di bilanciamento che li riguardano, il discorso giuridico disvela la propria appartenenza al discorso morale pratico. La terza parola-chiave – l’irradiamento – segnala come l’applicazione dei principi costituzionali di giustizia, e il tipo particolare di ragionamento che li veicola, si irradino per tutto il sistema, ad ogni livello. Penetrano a fondo nell’ordinamento, caratterizzando tutte le pratiche giuridiche che ivi si svolgono. L’irradiamento sottrae dunque specificità all’interpretazione costituzionale rispetto all’interpretazione giuridica tout court: l’argomentazione per principi non è più una prerogativa del giudice costituzionale, ma diventa un modo di delineare il fatto interpretativo che ormai accomuna tutti i giudici

L’Autonomia locale nelle regioni speciali: dalla clausola di adeguamento automatico alle prospettive di riforma

Sommario: 1. L’autonomia locale e la clausola di adeguamento automatico nella giurisprudenza costituzionale; 2. La clausola di maggior favore e i “principi di sistema”; 3. Uno schema operazionale per il concetto di autonomia, 4. L’autonomia come rivendicazione verso l’alto; 5. Segue: le conseguenze applicative; 6. La regula indotta dalla giurisprudenza costituzionale e il “doppio binario”; 7. L’insostenibilità del “doppio binario”; 8. Le prospettive di riforma

La Novità delle origini: recenti sviluppi del pensiero costituzionale originalista

Originalism is one of the solutions that american constitutional theory offers to solve the «counter-majoritarian difficulty», but it could apply to all the constitutional experiences. All the originalists insists that the meaning of the Constitution is fixed: the words and phrases of the constitutional text have the same meanings today as they did when the Constitution was enacted. But we can distinguish between an old and a new originalism. The first one argues that the interpreters must read the constitutional text trying to search the original intent of the Framers’. The second one repudiates any form of intentionalism and proposes a diffe-rent methodology, based on the original public meaning of the text, that is the meaning that the words and phrases had (or would have had) to or-dinary members of the public during the time of the enactment. The essay analyses the two forms of originalism, trying to discover which one is preferable and expounding a comparation with the rival method called the moral reading of the Constitution, which was proposed by Ronald Dworkin

Il Nesso tra libertà e volontà generale nel <i>contratto sociale</i> di Jean-Jacques Rousseau

The essay concerns the relationship between two concepts that are fundamental in the thought of Rousseau: liberty and general will. The purpose of the analysis is to demonstrate that general will means, essentially, principle of reciprocity: this principle is strongly related with the concept of “public reason”, which is of central importance in the political liberalism of John Rawls. Peraphs we need to re-think the ancient idea that suggests a democratic but not a liberal interpretation of Rousseau’s thought; and it could be the case that his theoric work finds a place even in the contemporary liberal thought

Specialità e asimmetria nel sistema regionale italiano

In the contemporary constitutional experiences there are two general models of federal system: the first is cooperative, inclusive and symmetrical, whereas the second is a-symmetrical and competitive. Moving from the perspective opened by this big dichotomy, what can we say about the experience of regional “specialty” that characterizes the Italian constitutional order? Is it totally true that it belongs to the second one or, perhaps, a different answer is nearer the truth? In this essay I will offer a general theoretical explanation of regional specialty in Italy and I will show which features of Italian special regions are related to competitive and asymmetrical federal systems and which features, on the contrary, are connected to a different institutional logic

Il Ruolo presidenziale e la distinzione tra funzioni di garanzia e funzioni d’indirizzo politico

Sommario: 1. Un modello interpretativo ricorrente; 2. Atti composti e atti complessi; 3. La concezione garantistica di Serio Galeotti; 4. La separatezza tra «indirizzo politico presidenziale» e «indirizzo politico governativo» nel pensiero di Giuseppe Guarino; 5. Il Capo dello Stato come organo di «indirizzo politico costituzionale» nel pensiero di Paolo Barile; 6. La distinzione tra indirizzo e garanzia come nuovo fondamento della concezione polifunzionale; 7. La dubbia distinzione tra «atti politici» e «atti di controllo»; 8. Scambi di ruolo e incoerenze del modello; 9. La dissociazione tra forma e sostanza nell’ordine costituzionale delle competenze presidenziali; 10. Capo dello Stato e sovranità popolare nel pensiero di Vezio Crisafulli; 11. Capo dello Stato e indirizzo politico alla luce degli articoli 87, 90 e 95 della Costituzione; 12. La “terza via” della Repubblica parlamentare italiana; 13. La sovra interpretazione del principio maggioritario; 14. L’essenza del costituzionalismo; 15. Il Capo dello Stato come rappresentate dell’unità nazionale; 16. L’evoluzione possibile del ruolo presidenziale e la centralità del Parlamento

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease