Marco Bellocchio originally imagined the character of Rossa to be in her early twenties but during the first auditions he felt that the dialogue didn't ring true for such a young character. Eventually he decided to change the character's age and cast Maya Sansa in the role.
Several scenes of the film were shot outside the real nursing home in Udine where Eluana Englaro was moved and her feeding discontinued. Some of the extras playing the protesters were the same people who protested in 2009 when Eluana Englaro was moved in Udine.
From the very beginning, the movie's production caused an anguished debate in Friuli Venezia Giulia (the Italian region where the movie was almost entirely shot). The Region board tried to prevent the production company from receiving the allocated funds from the local Film Commission. The debate was so strong that it culminated with the Board's drastic, much-criticized decision to suppress the whole Friuli Venezia Giulia Film Commission.
The movie was shot over ten weeks: seven in Friuli Venezia Giulia and three in Rome.
Michele Riondino filmed his last scene on his birthday (March 14, 2012). The cast & crew celebrated with a small party on the highway-cafeteria the scene was set in.