Drunk Driving: Therapeutic Blood Draw and the Right to Defense in Ruling 20376/2025

Drunk driving is one of the most serious violations of the Highway Code, with significant criminal consequences for those caught driving under the influence of alcohol. Often, alcohol level checks occur in delicate contexts, such as following road accidents that require hospitalization. In these situations, a crucial question arises: when can a blood sample, taken for medical reasons, be used as evidence in criminal proceedings for drunk driving, and what defense guarantees are afforded to the driver? The Court of Cassation, with Ruling No. 20376 of 2025, filed on June 3, 2025, provides clarity on this matter of great legal and practical importance.

The Regulatory Framework and the Issue of Testing

Article 186 of the Highway Code penalizes drunk driving, providing for different offenses depending on the blood alcohol level detected. The regulation also governs the methods of testing, stipulating that, in the event of an accident, judicial police officers or agents may escort the driver to healthcare facilities for the collection of biological samples, with the prior authorization of the Justice of the Peace. However, practice shows that blood samples are often taken in hospitals for purely therapeutic reasons, following the admission of a driver involved in an accident. This is precisely where the complexity lies.

According to Articles 356 of the Code of Criminal Procedure and 114 of the Implementing Provisions, the defendant or the person under investigation has the right to be assisted by their chosen defense counsel during investigative acts to which they are entitled to participate. The central issue is therefore to determine whether this guarantee must also extend to blood samples taken in a hospital setting for clinical purposes, but which are subsequently used to ascertain the state of intoxication.

The Distinction Between Therapeutic and Investigative Blood Draws: The Core of the Ruling

The Supreme Court, with Ruling No. 20376 of 2025, rapporteur M. B. and president E. D. S., rejected the appeal filed by the defendant S. N., upholding the decision of the Court of Appeal of Perugia of 20/05/2024. The ruling focuses on the clear distinction between a blood sample specifically requested by the judicial police for investigative purposes and a sample taken on the initiative of medical personnel for therapeutic purposes.

In matters of drunk driving, there is no obligation to provide prior notice to the driver involved in a road accident to be assisted by a defense counsel pursuant to Articles 356 of the Code of Criminal Procedure and 114 of the Implementing Provisions of the Code of Criminal Procedure, when the blood sample is taken on the initiative of medical personnel, as part of a protocol activated for therapeutic purposes during admission to a healthcare facility, and is not independently requested by the judicial police pursuant to Article 186, paragraph 5, of the Highway Code.

This maxim crystallizes a principle already established in the case law of legitimacy (see, among others, the consistent rulings No. 3340 of 2017 and No. 34886 of 2015, as well as the United Sections No. 5396 of 2015). The reason for this orientation lies in the nature of the act: a blood sample for patient care is not an investigative act in the strict sense. It falls within normal healthcare procedures and, therefore, does not trigger the defense guarantees typical of acts performed by judicial police or the Public Prosecutor.

In other words, the obligation to inform the driver of the right to be assisted by a defense counsel arises only when the blood sample is actively and independently requested by the judicial police, pursuant to Article 186, paragraph 5, of the Highway Code. If, however, the blood draw is a direct and necessary consequence of the therapeutic course established by medical personnel for the patient's health, without any specific investigative solicitation, then the alcohol level results can be acquired and used in criminal proceedings even in the absence of defense counsel.

Practical Implications and Citizen Protection

What does all this mean for a citizen involved in a road accident? It is crucial to understand that:

• If the blood sample is taken for therapeutic purposes (e.g., to assess general health status, for urgent surgery), medical personnel are not obligated to inform the driver of their right to have legal representation. The alcohol level analyses can be used against them.
• If, however, the judicial police explicitly request the blood sample to ascertain the state of intoxication, then the driver must be informed of the right to be assisted by legal counsel. Failure to provide such notice could invalidate the evidence.
• The difference lies in the initiative: medical for health vs. investigative for evidence.

This distinction is crucial for the validity of evidence and the correct application of defense guarantees. Although the principle may appear restrictive to the right of defense, its logic lies in the non-coercive and non-investigative nature of therapeutic blood draws. The driver is still protected by the fact that the blood draw must be performed in compliance with health regulations and that the results must be properly entered into the record.

Conclusions

Ruling No. 20376 of 2025 by the Court of Cassation reiterates a firm principle in Italian jurisprudence: the validity of ascertaining the state of intoxication through blood samples is not subject to the notification of the right to defense when the act is performed by healthcare personnel for therapeutic purposes. This ruling offers clear guidance for both law enforcement and citizens, emphasizing the importance of distinguishing between acts for health purposes and acts for investigative purposes. For those involved in complex situations like these, the assistance of a lawyer specializing in criminal law and road traffic law is essential to navigate the nuances of the law and best protect their rights.