The bill on the end of life, which opens for the first time in France assistance in dying for certain patients, cleared, during the night from Friday to Saturday, a first obstacle in the National Assembly without great difficulty, even if the majority has split spectacularly on a key point. The text was approved by show of hands in a special committee shortly after midnight, at the end of an intense week of debates led by former Minister of Health Agnès Firmin-Le Bodo (Horizons). The general rapporteur of the text Olivier Falorni welcomed the vote for a “great, beautiful republican law”.
The main change made by the deputies to the government text concerns one of the conditions required to have access to this aid: the criterion according to which patients must have their “vital prognosis engaged in the short or medium term” has been replaced by the concept of “advanced or terminal” condition. When addressing this question on Thursday, Olivier Falorni (member of the MoDem group and therefore of the majority) mentioned “the most problematic point and which caused the most debate”. He himself gave his support to the proposed rewriting, pointing out the “great difficulty of establishing what the middle term was”.
“The patient may wish, as soon as he is struck by a serious and incurable illness, not to experience the horrors of the disease, even if his vital prognosis is not directly involved,” several have emphasized. Socialist deputies in the explanatory statement of the reasons for their amendment. The president of the commission, Agnès Firmin-Le Bodo, who participated in the birth of the text as a minister, took a position against this modification, as did the rapporteur Caroline Fiat (LFI).
“Removing the short and medium term, very clearly, we are no longer in the same law at all. We are in a law which can allow people whose vital prognosis would be compromised in the long term, who may have physical suffering refractory, to ask to die This is not the balance of the law that was desired and that was presented,” she indicated.
The Minister of Health Catherine Vautrin also spoke out against this rewriting, arguing that it would have the consequence, contrary to the intentions of its supporters, of restricting the field of eligible people to patients “at the extreme end of life”. LR MP Annie Genevard, hostile to the bill, expressed her “stunnedness” after the removal of this “essential barrier”.
“Collegiality Canada Dry”
The text plans to establish the possibility for certain patients to ask a doctor to be helped to commit suicide, via a lethal substance that they would administer themselves or that a third party could administer to them if they cannot not do it. In addition to being affected by a “serious and incurable illness in an advanced or terminal phase”, to be eligible, patients must be of legal age, capable of expressing their wishes in a free and informed manner, and present suffering that is refractory to treatment or intolerable. The deputies ruled out the opening of the right to die for minors, as well as the possibility for patients who could not express their wish to be euthanized on the basis of their advance directives.
Another hotly debated point is that of the collegiality of the decision. An amendment proposed by rapporteur Laurence Cristol (Renaissance) specified that the doctor who will make the decision to authorize assisted dying will do so “as part of a multi-professional collegial procedure”. The right denounced a “lure”, a “Canada Dry collegiality”.
The bill also includes a section on palliative care. The deputies managed to have an amendment adopted against the government’s advice in favor of an “enforceable right” to benefit from this care, while one in two people does not have access to it today. The text will arrive in the hemicycle on May 27, continuing a legislative journey that could last at least until the summer of 2025.