What does the bill on “end of life” and “assisted dying” contain, which the government sent to the Council of State?

The executive has kicked off a process that promises to be long to establish strictly supervised “assisted dying” in France.

The end-of-life bill was sent by the government to the Council of State, after months of procrastination within the executive. Consulted by AFP on Monday March 18, this highly anticipated text notably opens the possibility of assisted suicide under strict conditions.

It must be debated in Parliament from the end of May. “The holding of the debate will be as important as the outcome of the debate”also warns a Renaissance MP to franceinfo, according to whom “we must have doubts even after having voted”. Here are the main provisions of this extremely sensitive bill before its presentation to the Council of Ministers in April.

Assisted suicide, under strict conditions

This is the great novelty of this text. For the first time in France, certain patients will be able to ask a doctor to be helped to commit suicide. Even if the text only mentions one “assisted dying”it is indeed a question of assisting the person to kill themselves, or even of carrying out the fatal gesture for them if they are incapable of doing so. “Assistance in dying consists of the administration of a lethal substance, carried out by the person themselves or, when the person is not physically able to do so, by a doctor, nurse or voluntary person that it designates”summarizes the text to which AFP had access.

However, this assistance in suicide can only be granted under multiple conditions. The patient must have an incurable pathology that threatens his life. “short or medium term”. This formulation is the subject of criticism from end-of-life specialists, because it is considered too vague. The interpretation is sent back to the caregivers, without excluding parliamentarians from specifying the criteria.

Then, the patient must be perfectly able to express his wishes. This therefore excludes patients with Alzheimer’s or other dementias, even if they made their choice before their mental capacities deteriorated.

The suffering must be “refractory and unbearable”. Here, the text is less restrictive than a version that had leaked in recent months, because it now includes suffering “psychological” and not only “physical”. Finally, the patient must be of legal age and French, or at least have lived in the country for a long time.

A staged procedure, with the decision of a single doctor

The patient who wishes to die must seek medical attention. First of all, this will necessarily offer palliative care. If the person maintains their choice, the doctor will be obliged to seek the opinion of two people: a specialist in the pathology concerned, who does not know the patient, and a non-doctor caregiver, who will preferably have accompanied the patient.

The first doctor, who may request other opinions, will have 15 days to give his opinion. And it will be up to him alone to decide, a less collegial procedure than what Emmanuel Macron recently announced in an interview with Release And The cross.

If the doctor’s opinion is positive, the patient will have to wait two more days to confirm their choice, then will have three months to carry out their procedure. One point differs from Emmanuel Macron’s prior announcements. In the event of refusal, only the patient will be able to challenge the decision before the administrative courts. The head of state had raised the possibility for other members of the family.

No caregiver can be forcibly involved

A doctor or nurse will inevitably have to accompany the patient to carry out his last gesture. It is this caregiver who will collect the fatal substance from the pharmacy, then prepare it when the time comes.

However, if the patient can act alone, the caregiver will not have to be in the same room. Furthermore, no caregiver can be forcibly involved. But in the event of refusal, he must provide the contact details of colleagues likely to accept.

The creation of “supportive care”

Assisted dying constitutes one of the two parts of the text. The other part concerns the development of palliative care and patients’ rights. On palliative care, the text creates the broader concept of “supportive care” which are not just about pain management. It provides for the creation of dedicated establishments, “support houses”.

However, it does not mention a vast program of development of palliative care, a “ten-year strategy” long promised by the government and which must be announced separately in the coming weeks. “The ten-year strategy is less a question of laws than a question of means. We don’t need a law”decides a parliamentarian from the majority.

Finally, on the rights of patients, the text specifies the status of the “trusted person” who must bear witness to the choices of their loved one if they are no longer able to do so.