The great social reform of Emmanuel Macron's second five-year term is underway. The French government presented this Wednesday a bill that opens the way to the legalization of assisted suicide and, in some cases, euthanasia, under very strict conditions. The legislative proposal, a promise of the current president, pays particular attention to the chosen words and prefers the term “aid in dying.” The objective is to send a message of conciliation before its parliamentary process begins in May. A journey that promises to be arduous, after years of debates in France about the right to die with dignity.
The bill, whose final version has not yet been released, is “particularly balanced”, the Minister of Health, Catherine Vautrin, insisted, before its presentation in the Minister council. The message that the Government is trying to send is that it has listened to everyone, both those who want to go further and those who will do everything possible to stop the reform as much as possible. As a result, the text contains two main parts. On the one hand, it presents the conditions and procedure for aid in dying under strict medical supervision. On the other hand, it emphasizes the reinforcement of palliative care, a key aspect for detractors of the norm.
In France, neither assisted suicide nor euthanasia is legal, but since 2016, the country has a rule that allows terminally ill patients to stop taking medication and receive only palliative care. The Claeys-Léonetti law on the end of life allows deep sedation of terminal patients, but only for those who suffer “a serious and incurable disease and whose vital prognosis is compromised in the short term.”
The minister cited five conditions to request “help in dying.” The person requesting it must be of legal age, have French nationality or reside in the territory, suffer from a serious and incurable illness with a fatal prognosis in the short or medium term, suffer unbearable pain that cannot be treated, and express their request. freely and clearly. One of the pillars of the text, Vautrin stressed after the Council of Ministers, is the “capacity for discernment evaluated by a doctor”, which excludes, for example, psychiatric diseases or Alzheimer's.
Once the patient requests help, a doctor must make a decision within a period of 15 days after examining the case with another doctor and a nurse. If the opinion is favorable, a lethal drug may be prescribed for the patient to take alone or, if his physical condition does not allow it, with the help of a member of the medical staff or a volunteer designated by him. The project, which has already been examined by the Council of State to verify its conformity with the Constitution, will be debated in Parliament starting on May 27, just before the European elections.
Macron does not have an absolute majority in the National Assembly (the lower house) so he is forced to negotiate each law he wants to advance. Obtaining enough support will not be an easy task, especially in the conservative wing. Olivier Marleix, president of the Republicans in the Assembly group, the twin party of the PP in France, assured this Wednesday that the main challenge continues to be palliative care. “I believe that in a society we do not have the right to help another person die if we have not first offered to help them live,” he said on the Franceinfo radio station.
Palliative care
The issue of palliative care appears in the bill, but the Government wanted to anticipate it. During the weekend, the Executive announced a 10-year strategy to strengthen them, with a budget of 1.1 billion euros. Macron had highlighted his importance in an interview given in March to the newspapers La Croix and Liberation, with very different editorial lines and audiences, in which he outlined the main lines of his proposal. The leader he pointed out at that time that the law did not amount to “assisted suicide” or “euthanasia.”
To defend its project, the Government took into account the conclusions of a citizen convention created in December 2022 to study the need or not to reform current legislation. A 76% of the 184 participants, named at random, was in favor of promoting a form of assisted death. The debate is not new and is revived from time to time. In December, the French singer Françoise Hardy, 80 years old and terminally ill with cancer, sent a letter to Macron in which he asked him to restart the debates on a dignified death.
The country also has two emblematic cases. That of Vincent Lambert, a nurse who remained quadriplegic and in a vegetative state for more than a decade until, after a long court battle, the justice system authorized his deep sedation and disconnection from the machines that kept him alive. And that of Alain Cocq, who suffered from an incurable and painful illness, and finally died in Switzerland, where he resorted to legal assisted suicide.
In a statement, the French Association for the Right to Die with Dignity, has celebrated the “first step towards a new right”, despite having been “postponed several times”. According to a 2023 survey70% of French people are in favor of a law that legalizes assisted dying or euthanasia.
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