The project deals with the ethical, legal and economic implications of predictive medicine for the right to health, addressing the more specific and current topic of the inclusion of next generation prenatal genetic tests in the essential levels of healthcare services (LEA) ensured by the National Health Service (SSN).

Scientific and technological progress in medicine always represents a critical factor for the health policies of a country. The intensity and complexity of its impact, however, vary greatly depending on the configuration of the protection of the right to health in each legal system.

In Italy, the protection of health guaranteed by Constitution has been fully implemented with the establishment of a universal, comprehensive, equitable and tax-financed healthcare system. Later, the introduction of the institute of LEA has provided the system with a key tool for determining the substantial content of the social right to health, confirming the model of comprehensive universalism, but without ignoring the problem of the financial sustainability. The update of LEA, while obviously not being the only way for innovative treatments to enter clinical practice, represents a decisive moment for measuring the capability of the system to deal with scientific development and for studying its impact on the NHS.

The project set out to examine the ethical, legal, and economic implications of predictive medicine for the right to health, addressing the more specific and topical issue of the inclusion of next-generation prenatal genetic tests in the Essential Levels of Care guaranteed by the National Health Service.

With the aim of advancing knowledge regarding the present and future scenario of equitable access to prenatal genetic testing, the research progressed alongside the process of updating the LEA, which—following the agreement reached at the State–Regions Conference in October 2025—has now entered its final stage.

In light of these developments, the project was structured around the following lines of investigation.

• A first line of inquiry concerned the institution of the Essential Levels of Care within the framework of the National Health Service and Italian regionalism.

• A second line of inquiry, connected to the first but conducted from an economic perspective, examined the phenomenon of healthcare mobility as a significant indicator for evaluating the equity of access to healthcare services across the national territory.

• A third line of inquiry focused on the legal regulation of NIPT (Non-Invasive Prenatal Testing) under three key aspects: the provision of NIPT as an additional level of care in some Italian regions; the observation of how the test is regulated in other European legal systems; and the reconstruction of the legislative and jurisprudential framework governing informed consent in relation to prenatal testing, as well as the related rules of civil and criminal liability applicable to the healthcare professionals involved.

• Finally, a fourth line of inquiry broadened the perspective to include the background issues associated with the incorporation of innovative healthcare services into the health system, particularly those concerning the technical and scientific assessment underpinning public decision-making.