A decade after Quebec and twenty years after Belgium, France is preparing to open the debate on active euthanasia. What is known in Quebec as “medical assistance in dying” had not previously been the subject of any law in France, unlike the Netherlands, Switzerland, Belgium or Spain. . On Monday, President Emmanuel Macron broke what had hitherto been the subject of consensus for the first time by announcing that an “end of life” law would be presented to the National Assembly by the end of summer.
The debate has been raging for several months now. Many personalities have even entered the battle. In The Obs, the writers Annie Ernaux and Laure Adler, the member of the radical left (LFI) Clémentine Autain and the former socialist minister Najat Vallaud-Belkacem have taken a public position in favor of euthanasia. Conversely, in an article in the Harper’s Magazinetranslated by Le Figarothe writer Michel Houellebecq compared this practice to Harry Harrison’s science fiction novel which inspired Richard Fleischer’s film entitled Green Sun. “To shorten the agony unduly is both impious (for those concerned) and immoral (for everyone): this is what all civilizations, religions, cultures that have preceded us have thought; this is what a so-called progressivism is about to destroy,” he writes.
Citizen’s agreement
On Monday, Emmanuel Macron received at the Élysée the members of the citizens’ convention that he himself had created last September in order to reflect on the question and present proposals to the government. Highly criticized by opponents of active euthanasia, this convention brought together 184 members, the majority of whom were drawn by lot, in order to answer this general question: “Is the end-of-life support framework adapted to the different situations encountered or should any changes be introduced? »
We made laws for people who are going to die. Now we try to make laws for people who want to die.
It was the research and polling company Harris Interactive that selected 150 of the 184 members of the convention supposed to represent French society according to age, sex, region and socio-professional categories. After meeting for nine three-day weekends, 75% of members voted in favor of “medical assistance in dying” which could range from assisted suicide (which consists, as is done in Switzerland, of providing a lethal cocktail to the candidate who administers it himself) to a lethal injection administered by a doctor. One member out of four of the committee did not wish to modify the current laws, preferring rather their full and complete application by the generalization of palliative care.
Evoking “a new French model”, Emmanuel Macron emphasized the dikes necessary for such a modification of the law such as the expression of a “free and enlightened will”, “incurability” and the existence of “refractory mental and physical suffering”. According to him, active assistance in dying can never “be carried out for a social reason, to respond to the isolation which, sometimes, can make a patient feel guilty who knows he is condemned to term and would like, in haste, to plan the outcome in order to not to be a burden for his family and for society”. The president excludes the opening of such a possibility to minors and wishes to guarantee a conscience clause to doctors. Nothing indicates for the moment whether the law that will be tabled in Parliament will make it possible to formulate advance requests in the event of “serious and incurable illness leading to incapacity”, such as the one currently being discussed in the National Assembly of Quebec. .
The Leonetti Law
It is not yesterday that Emmanuel Macron has expressed his intention to legalize euthanasia. On September 2, he publicly declared his support for actress Line Renaud, who has been campaigning for this for a long time, saying that “it was going to change”. In December, the government even entrusted a commission chaired by the academician Erik Orsenna with the drafting of a small glossary on the words of the end of life in order to find synonyms for “euthanasia”. An order described as Orwellian by some members of the opposition.
If France has taken all this time to follow Belgium and the Netherlands, it is because a strong consensus has reigned since the unanimous adoption, in 2005, by the National Assembly of the the so-called Leonetti law “relating to the rights of patients and the end of life”. Adopted at a time when the debate was raging in Belgium, the French law refused to cross the red line consisting in killing a patient. Amended in 2016 to clarify its objectives, it “sets itself an ambitious objective: to eliminate suffering even if this action can lead to death”, its author, Jean Léonetti, told us at the time. In practice, the law recognizes the patient’s right to refuse any treatment and gives the caregiver the obligation to eliminate the suffering even if it means, by “prolonged and continuous sedation”, plunging the patient into a deep coma which would lead to death.
“We made laws for people who are going to die. Now we are trying to make laws for people who want to die,” Jean Léonetti recently declared on French-language Christian Radio. In announcing the filing of a new law, the president also announced “a ten-year national plan for palliative care and pain management”. The convention report proposes 67 measures to be implemented without delay. While 26 departments still do not have palliative care units, Emmanuel Macron says he wants to ensure “effective access to end-of-life support care”, as unanimously requested by the members of the convention.
For many, the change of position was played out in 2016 when, at the very end of his mandate, François Hollande appointed the immunologist François Delfraissy, a recognized supporter of euthanasia, as president of the National Advisory Committee on Ethics which was, until then, opposed to it. Delfraissy also played a significant role in the citizens’ convention.
Parliament divided
Even if no one yet knows what the bill will actually contain, the debate promises to be explosive. In February, 13 associations bringing together more than 800,000 caregivers said in a forum that “such legalization [de l’aide active à mourir] would inevitably lead the legislator to subvert the very notion of care as it is commonly accepted today”. According to the signatories, “death is not a treatment”. Ten days earlier, in The world500 health professionals had published an op-ed to the contrary affirming that “medical assistance in dying is care when we are faced with a serious and incurable disease, causing intolerable physical or psychological pain”.
Several have accused Emmanuel Macron of brandishing the debate on euthanasia in order to divert attention from that against the pension reform which continues despite the adoption of the law. The president may call for a “transpartisan” attitude and a “work of co-construction”, without a real presidential majority, the adoption of a law on such a sensitive subject could be complicated. And this, even if for once, according to an IFOP poll, 78% of French people say they agree with the president.
If the door seems open on the side of the radical left (LFI), this is not the case on the right with Les Républicains and on the far right with the National Rally. “On ethical issues, there is no choice. You have to know how to work together, ”said LFI MP Caroline Fiat, who salutes the work of the convention. On the right, MP Bruno Retailleau (LR), on the contrary, castigated a “citizen convention whose conclusions were known in advance”. Personally opposed to such a law, the president of the National Rally, Marine Le Pen, said she would favor a referendum on the subject. “If indeed decisions have to be made [à ce sujet]it’s up to the French people to take them,” she said.