End of life: first stones for the construction of the law

End of life first stones for the construction of the law

"By the end of the summer", the government must unveil its bill to create "active assistance in dying" in France, the first drafts of which are scrutinized by both defenders of legalization of assisted suicide, even euthanasia, and by opponents.

Groping government

At the beginning of April, when he received the French who worked as part of the citizens' convention, Emmanuel Macron announced that he wanted a new law on the end of life "by the end of the summer".

This text must take into account the conclusions of the convention, which decided at the beginning of the year for the legalization under conditions of "active assistance in dying", potentially grouping assisted suicide and/or euthanasia.

The President of the Republic also spoke of a "French model", with several safeguards.

The bill "will include three blocks: active assistance in dying, palliative care and patient rights", according to Agnès Firmin Le Bodo, Minister Delegate in charge of Territorial Organization and Health Professions, who is leading the file.

These three components, consensual for the last two, appear in a working document communicated in mid-June to parliamentarians.

On the most sensitive and divisive, "active assistance in dying", the executive is advancing on a crest line. "The definition should not include the terms + suicide + or + euthanasia +, but on the other hand use the term + die +", notes his document, without deciding on the final scenario.

Conditions for benefiting from this "active assistance in dying": being of legal age at the time of the request, "justified by a medical reason", suffering from "a serious and incurable condition which involves its vital prognosis in the medium term", " capable of discernment to exercise an autonomous choice".

The appreciation of the discernment and the "medium term" -estimated between 6 and 12 months in the text- appear in the delicate questions.

Politics on the lookout

The law will be "co-constructed with parliamentarians", insists the government, without necessarily convincing.

For the presidential majority, if Renaissance elected officials seem largely in favor of active assistance in dying, Horizons and MoDem are more difficult to identify.

The left, for a "dignified end of life" and freely chosen, mainly defends assisted suicide and euthanasia, under conditions, with positions close to the Association for the right to die with dignity (ADMD).

The right and the extreme right are hostile to it, sometimes worrying about a risk of "trivializing euthanasia", and calling for better application of the Claeys-Leonetti law and palliative care. This is the line of a report from the Senate Social Affairs Committee, predominantly LR, submitted on Wednesday.

Different sensitivities are expressed within the government itself.

Unlike Agnès Firmin Le Bodo, determined, François Braun was reserved on a law which "would profoundly change our society and our relationship to death". Beware of "an implicit message" dangerous for "vulnerable people", added Jean-Christophe Combe, Minister of Solidarity.

At the Elysée, trust seems to be in order. After "a journey undertaken with the Citizens' Convention, we will be able to find the ways and means which will make it possible to identify a majority of ideas on an important text", estimates a source close to the executive.

Caregivers under pressure

On the front line, caregivers working in palliative care insist that "to kill is not a treatment".

"The debate sometimes seems to be reduced to a choice between euthanasia and assisted suicide", regretted the president of the French Society of palliative care (Sfap), Claire Fourcade, during the recent congress of the organization.

Reluctance and concerns crystallize among many caregivers around their role, despite the promise of a "conscience clause".

After the frame unveiled to parliamentarians, 15 caregiver organizations have notified their red lines in writing to Agnès Firmin Le Bodo - who regularly brings them together in a working group.

In particular, they want active assistance in dying to appear "in the criminal code, not in that of public health, as an exception to the ban on killing", and result from "a collegial and a priori decision" by doctors. , explained Claire Fourcade to AFP.

The future law will have to open "a new right for the French", with "balance" and taking into account the "legitimate concerns" of caregivers, reaffirmed Agnès Firmin-Le Bodo on Wednesday, at the end of the ADMD meeting.

ADMD president Jonathan Denis, an euthanasia defender, has previously pleaded for a “humanity” law and “without obligation for anyone, including caregivers”.

The Editorial Board (with AFP)

Image credit: Shutterstock/ Akkalak Aiempradit

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