EUTHANASIA. Euthanasia is debated and discussions are relaunched at the top of the State. Prohibited in France, but authorized elsewhere, this medical act consists in voluntarily putting an end to the life of a patient at the latter’s request. Everything you need to know.
[Mis à jour le 3 avril 2023 à 17h36] Euthanasia is a red line in French law. If the term evokes a gentle death without agony, the act still amounts to causing the death of someone, with their consent. It is therefore impossible for the legislation to allow such a thing, yet a majority of French people seem ready to see the law evolve on the subject. On April 2, 2023, the citizens’ convention on the end of life spoke out in favor of legalizing euthanasia and/or assisted suicide in the context of “active assistance in dying”: 76% of the 184 members supported the idea. Two years ago it is a Ifop poll conducted in April 2021 which indicated that 93% of those questioned were in favor of the use of euthanasia for patients with unbearable or incurable diseases. The same study added that 69% of French people wanted the Claeys-Leonetti law of 2016 which legislates the right to end of life to be modified “because it does not make it possible to solve many cases linked to people with incurable diseases”. These voices could finally be heard since on Monday April 3, 2023, after a meeting with the citizens’ convention, Emmanuel Macron announced that he wanted to propose a bill to better govern the right to end of life, including a possible recourse to euthanasia by the end of summer 2023.
Euthanasia, whether one is for or against, leaves no one indifferent. The medical profession is the first to be torn on the issue between caregivers inclined to see active aids in dying authorized and others, like thedoctor’s orders, who strongly oppose the practice of euthanasia or assisted suicide. Both sides rely on the hippocratic oath to defend their position between the concern “to restore, preserve or promote health” and respect for “all people, their autonomy and their will, without any discrimination according to their condition or their convictions”.
It is therefore difficult to draw up a legal framework around euthanasia. Before the bill expected in 2023, previous measures have been taken to regulate the end of life and euthanasia, in particular the Leonetti law of 2005 and the Claeys-Leonetti law of 2016. It is still this text which governs the practices that surround the end of life in France.
From the ancient Greek “eu” (good) and “thanatos” (death), euthanasia describes having a sweet death. Today, the term refers to the act of causing the death of an individual suffering from an incurable disease and in a state of psychological and/or physical suffering that is difficult to bear. This act is often performed by a doctor or a third party. A distinction is commonly made between active euthanasia (administration of a lethal substance to cause death) and passive euthanasia (termination of treatment and/or care that keeps a person alive).
French law condemns and prohibits euthanasia on its territory. In the same way, assisted suicide, a nuanced form of euthanasia, is also prohibited. In 2005, the Leonetti Law however, establishes the idea of a right to “let die”. It is a question of allowing doctors, gathered in a collegial way, and with the consent of the relatives, to set up a painkiller treatment “which can have the side effect of shortening [la] life”. We are talking about the possibility of limiting therapeutic relentlessness.
In 2016, the legislation on the right to end of life was amended by the Claeys–Leonetti law. New clarifications are provided and the text introduces the refusal of unreasonable obstinacy, which allows patients to request the cessation of all treatment in favor of deep and continuous sedation. The 2016 law also provides for the designation of a person of trust or the recognition of advance directives which must enable patients to make their wishes heard, whether it is a matter of continuing or stopping treatment. Finally, the law establishes rights in terms of access to palliative care.
There Belgium is one of the few European countries to allow active euthanasia. On the other side of the Franco-Belgian border, “the act, practiced by a third party, which intentionally puts an end to the life of a person at the request of this one”, is framed by the law. Several conditions must be respected (awareness of the patient at the time of the request, medical situation of the patient described as “dead end”, etc.) so that the act carried out by a voluntary doctor is carried out in all legality.
Without explicitly authorizing euthanasia, the Swiss has for some years legislated on certain forms of assisted death. The country thus tolerates passive euthanasia and indirect active euthanasia (both are the subject of a precise definition) while continuing to condemn direct active euthanasia. In Switzerland, there are certain associations which offer aid or assistance to suicide within the framework of a “right to die with dignity”. Only the Dignitas association grants this right to foreigners coming to Switzerland. In 2011, assisted suicide provided by this association cost 10,500 Swiss francs, or 8,500 euros according to France info.
The Vincent Lambert affair is, in France and in Europe, an emblematic case of the debates around euthanasia:
- 2008: Vincent Lambert, 32, victim of a road accident, finds himself in a state called “pauci-relational” or “state of minimal consciousness plus”.
- 2008-2013: Vincent Lambert receives care in different establishments, none of which improves his condition.
- 2013: Vincent Lambert’s wife, Rachel, agrees to stop feeding her husband. The family, informed a few days later, opposes this approach. A long legal battle ensues.
- 2013-2017: The Vincent Lambert case navigates between the different courts, Council of State, European Court of Human Rights (ECHR), etc. Each decision that switches to one of the two parties is contested by the other party. In 2015, the ECHR confirms the cessation of food and hydration of Vincent Lambert. The doctors refuse to apply this decision. This is a new return of the Vincent Lambert case to justice.
- July 2017: The Council of State confirms a decision of the administrative court of appeal of Nancy and authorizes the doctor to resume the consultation procedure which could lead to the cessation of treatment.
The case of Vincent Lambert perfectly illustrates the fight between individuals who are for euthanasia and those who are against euthanasia. Each part displays its arguments.
The main arguments for euthanasia:
- respect the patient’s wishes;
- avoid unnecessary suffering.
The arguments against euthanasia:
- ban on killing;
- risks of skidding;
- advances in medicine can reduce the intensity of pain and suffering.