“The State must in no way give itself the authorization to kill someone”, according to Philippe Juvin

Emmanuel Macron promised, in an interview on Sunday with “Libération” and “La Croix”, a bill for “assisted dying” under “strict conditions”, which will be presented in April.

“The State must in no way give itself the authorization to kill someone”said Monday March 11 on franceinfo Philippe Juvin, Les Républicains deputy for Hauts-de-Seine, head of emergency at the Georges Pompidou hospital in Paris, the day after the announcements on the future bill for “assisted dying”.

franceinfo: Do ​​you approve of the end-of-life bill proposed by Emmanuel Macron?

Philippe Juvin: Every day as a doctor, I help people die. We help people die by accompanying them, by relieving them. But we don’t inject drugs to kill them. Emmanuel Macron wants to say that from now on, we will be able to ask a doctor to inject a drug that will make people die, which was obviously not the case. It was done at one time, illegally, before palliative care was created.

When I started medicine, thirty years ago, there were practices where we administered medications to end-of-life patients with the aim of hastening their death, because we had no choice. Today, what exists is deep sedation: when you are in a very terminal phase and you are in pain, you can ask to be put to sleep, this is the Leonetti law. I did that, and I do it, but we don’t do it to cause death, but to relieve people.

Why talk about active assistance in dying and not euthanasia or assisted suicide?

Emmanuel Macron does not want to offend and therefore he does not use the right words: what is being proposed to us is euthanasia, as exists in a certain number of countries. Where I am concerned is that in the countries where it has been legalized, we set limits at the beginning, when the law was passed, by saying that it will be aimed at such and such a category of patients and not at such and such. other, and over time we saw a deviation with a deviance, with categories for which it was prohibited at the beginning, and for which it became authorized. In Belgium for example, since 2014, euthanasia has been authorized for minors and children.

The State must in no way give itself the authorization to kill someone. Robert Badinter spoke about euthanasia, saying that the State can never take someone’s life. From the moment it is a principle, you cannot put exceptions to it, because if you invent one, you will invent a second and then a third…

“What we lack in France is palliative care. At the end of the day today, 500 people in France died without having had access to palliative care even though they should have had access to it. The real subject, It’s how we help people die with palliative care.”

Philippe Juvin, deputy Les Républicains

at franceinfo

The generalization of palliative care in France is the other leg of this upcoming bill. What is the reality ?

It’s always the same, we’re in communication: the announcement from the President of the Republic is a few billion euros. What will be on the table to develop palliative care represents 1.50 euros per French person per year. So we are not there at all: we are missing palliative care units, we are missing mobile units. The National Advisory Council on Ethics said a very simple thing: do not legalize euthanasia, which is what the government wants to do, until you have upgraded palliative care.

For what ? The risk is that people request euthanasia due to lack of access to palliative care. The second risk is social pressure: you are of no use, you are a burden for the family, for others, and therefore you decide to go towards euthanasia. I have been a doctor for several years, I have had several requests for euthanasia in my career: all requests for euthanasia have disappeared the moment you provide a response to psychological suffering, physical suffering or isolation. The question is not to propose euthanasia but to propose solutions to the reasons for this euthanasia.

The question was asked in particular in the context of high-profile cases of patients who continue to be in palliative care, some in a state of brain death, who are kept alive for too long. How to respond to this?

There have been a few publicized cases, I do not deny that. We cannot give euthanasia to someone who cannot oppose it. The cases that are put on the table, which are these people in a coma, cannot say no. Some people in France are asking that we be able to give euthanasia based on advance directives: people become demented, can no longer express themselves, but from the moment they would have said five or ten years before that they would like in In this case being euthanized, they will not be able to defend themselves. I hope that won’t be the case.

We doctors are here to defend the most vulnerable. When I walk into a patient’s room in a white coat, I don’t want them to have to wonder why I’m there. He shouldn’t have any doubts. As a doctor, I am here to relieve and help, to accompany people towards death, but not to cause death. I will be against this bill because in all the countries where it has been legalized, there has been an extension of the field of application: in Luxembourg, Belgium, Holland, Spain, euthanasia is open to mentally ill people. Every day in the emergency room and in intensive care, we see people who have attempted suicide. What should we do tomorrow? Do we continue to resuscitate them or do we not resuscitate them, since we will have legalized assisted suicide? We enter a world where all points of reference are lost.

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