The Economic, Social and Environmental Council recommends, in an advisory opinion, to open access to euthanasia and assisted suicide, while further developing palliative care.
The debate on the end of life continues with the adoption by a large majority, Tuesday, May 9, of an opinion of the Economic, Social and Environmental Council (Cese), which proposes “to open up possible access to active assistance in dying”. This position is detailed in a report by the temporary committee on the end of life that franceinfo was able to consult. The Cese formula 13 “recommendations”among which the legalization, in certain cases, of “assisted suicide and euthanasia”, and the development of palliative care. Simply advisory, this opinion was requested by the government with a view to a future bill on the subject.
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To write this report of about sixty pages, the Cese relied in particular on the work of the citizens’ convention on the end of life, set up at the request of the government. This assembly voted last March 19 in favor of active assistance in dying. The recommendations of the Cese must be used to fuel public debate and the work of the government and parliamentarians, before the presentation of a bill before the end of the summer, as Emmanuel Macron announced on April 3.
Authorize assisted suicide and euthanasia for certain patients
The very first recommendation of the Cese goes in the same direction as the citizens’ convention, since it is a question of“a modification of the law to affirm that at the end of life, the right to support is open until active assistance in dying”. To date, French law only authorizes access to palliative care for sick people whose condition requires it, such as deep and continuous sedation maintained until death.
However, it is necessary “guarantee, in the name of the principle of individual freedom”the right to assisted suicide or euthanasia, “for people suffering from serious and incurable illnesses, in a state of unbearable and unappeasable physical or psychological suffering”writes the Cese, while emphasizing the right for health personnel “to refuse to perform these acts themselves”.
Raising awareness of the advance directives system
Furthermore, the Cese advises the public authorities to raise awareness of the existing systems, by organizing “a national awareness and information campaign on the right to end-of-life support and the choices offered”.
Among them, the “advance directives” allow everyone to specify their wishes for their end of life, as explained on the Public Service website. The Council would like these directives to be recorded in a national public register, and that they include assisted suicide and euthanasia. The dialogue between the patient and his doctor on the subject of advance directives must also be recognized and valued by a specific package.
If a patient has not given his advance directives and if he cannot express his “individual will and [son] consent”the Cese proposes“establish a specific legal procedure” for the most difficult cases to decide.
Develop the use of palliative care
On the subject of palliative care, which makes it possible to relieve physical and psychological suffering, the Cese advocates their deployment for any patient suffering from a serious progressive disease, as soon as the diagnosis is announced, in addition to curative treatments. “This care is too often considered as end-of-life care, whereas it can be useful from the start of the disease, and sometimes very far from the end of life for certain pathologies such as diabetes”, can we read in the report. They must be better developed, including at home and in nursing homes.
In addition, the Council warns of “the territorial and social inequalities that persist in access to palliative care” And “the lack of human and financial resources to really develop access” to this care. One in five departments remained without a palliative care unit at the end of 2021.
The institution also wants to better recognize the role of caregivers in the context of the end of life. It particularly recommends revaluing, “both on the amount of compensation and on their duration”caregiver and family solidarity leave.