The Ethics Committee delivers an expected opinion on the end of life on Tuesday, September 13, at a time when Emmanuel Macron is preparing to draw the outlines of a citizens’ convention on this subject of society before a possible law. But where exactly is France today?
“Deep and continuous sedation”
To take stock, it is necessary to start with what is prohibited. The 2016 law, known as the Claeys-Leonetti law, named after its authors, prohibits euthanasia and assisted suicide. On the other hand, it allows what is called the “continuous deep sedation“until death for the terminally ill and in very great suffering when their vital prognosis is engaged in the short term. Concretely, the patient is put to sleep, the treatments stopped, and painkillers administered as well as palliative care.
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The law also provides for the cessation of treatment to avoid therapeutic relentlessness, which is also called “unreasonable stubbornness“. The patient can, in fact, ask that everything be stopped. If he cannot express himself, the decision must then be taken by several doctors. Finally, the law reinforces “advance directives”, these instructions that each person can leave in case they find themselves at the end of their life without being able to express themselves.Theoretically, according to the law, these directives are binding on doctors.In 2018, the Council of State and then the CCNE ruled that this law should not be changed, but both stressed the need to ensure better access to palliative care.
Still, France is out of step with some of its European neighbours, Belgium in the lead. While several countries have modified their legislation over the past ten years and the French Parliament has debated it, the National Consultative Ethics Committee (CCNE) set up a working group in June 2021 to reflect again end-of-life ethical issues. The publication of the new opinion of the Ethics Committee will formally launch a sequence which could lead to a text of law.
Moreover, Emmanuel Macron intends to set up a citizens’ convention for next October, as franceinfo announced in early September. One way to deal with a potentially abrasive subject: if the head of state himself does not want to give his personal position – “It matters little”, sweeps Emmanuel Macron – this debate on the end of life is divisive even in the parties policies. And yet, “we must move,” said the president, arguing that we must respond to a request from part of society, and, in passing, fulfill one of his campaign promises.
Citizens and professionals will have six months to determine how to go further than the Claeys-Leonetti law on the model of the Climate Convention, while avoiding the failures of two years ago. This time, only one subject: no more question either of promising that the proposals will be taken up without filter. The text resulting from the convention will only be a basis, which may be amended by Parliament or transformed into a bill submitted to the French. The Head of State can also call a referendum: he confides that he does not exclude it to change the law by the end of 2023.