“Assistance in dying”: euthanasia that does not mean its name

To avoid talking about “euthanasia ” or “assisted suicide”, Emmanuel Macron plays on semantics and the strong use of the words “fraternity” and “dignity”.

BY LUDOVIC GENIN for The Epoch Times, March 11, 2024
Source : https://www.epochtimes.fr/aide-a-mourir-une-euthanasie-qui-ne-veut-pas-dire-son-nom-2564037.html

The Head of State came in person to announce the future draft law on the end of life in an interview given to La Croix and Libération. After a presentation to the Council of Ministers in April, the subject will be debated in May in the Assembly, a few weeks before the European elections.

To avoid talking about “euthanasia ” or “assisted suicide”, Emmanuel Macron plays on semantics and the strong use of the words “fraternity” and “dignity”. Despite everything, it will be a question of asking doctors to take the life of a patient or to assist them in their suicide, which is contrary to the code of ethics of medicine.

With hindsight, the law on euthanasia promulgated in 2002 in Belgium caused deep divisions between generations and in society's care for the weakest people. The number of euthanasias continues to increase each year and assisted suicide of minors is now authorized.

Emmanuel Macron says he wants to “look death in the face”

First of all, in the interview with La Croix and Libération, Emmanuel Macron insists not to speak of euthanasia or assisted suicide but rather of a “law of fraternity”, because it is necessary, according to him, to “properly name reality without ambiguity. To find this path between words and evils, the president says he relied on the opinion of the National Consultative Ethics Committee (CCNE) and the work of the Citizens' Convention.

In a column in Le Figaro published in 2023, thirteen professional organizations and learned societies, representing 800,000 caregivers, declared that euthanasia is a practice “incompatible” with the profession of care and criticized the fact of not having been associated with the Citizens’ convention.

Regardless, the term that will be used in the law will be “ assisted dying ” because, according to the president, the term euthanasia “means the act of ending someone’s life.” However, if the bill wants to erase the term, it will not erase the act. It will be up to the doctor to kill a patient, which is contrary to his Hippocratic oath. Every doctor in France has taken the Hippocratic Oath, affirming to do everything to “relieve suffering, not unduly prolong agony and never deliberately cause death”.

For the president, it is not an assisted suicide either, even if in the end it will be the patient or a loved one who will administer the lethal substance. According to Emmanuel Macron, the future law will stipulate that “the administration of the lethal substance is carried out by the person himself […] either by a voluntary person whom he designates […] or by the doctor or nurse who 'accompanied. » But no assisted suicide or euthanasia, words at this stage no longer seem to have much importance.

According to the president, who declares that he wants to “look death in the face”, “assisted dying” will be reserved for adults “capable of full and complete discernment”. You will need to have an incurable illness and a life-threatening prognosis, but patients suffering from “psychiatric illnesses or neurodegenerative illnesses which impair discernment, such as Alzheimer’s”, will be “excluded”.

A law already regulates the end of life

According to Claude Grange , hospital practitioner in chronic pain and palliative care for 25 years, the public is not sufficiently informed about palliative care and the proportionality of the care and sedation protocols already existing in the Claeys-Leonetti law.

Today, the Claeys-Leonetti law, known as the “Leonetti law”, governs the end of life of incurable patients. Adopted unanimously (a rare occurrence) in 2005 and strengthened in 2016, it prohibits euthanasia and assisted suicide, but allows “deep and continuous sedation until death” for terminally ill patients in great suffering.

According to Claude Grange, patients need to better know the different existing therapeutic means to relieve pain, because sedation protocols already have a diversity of possible solutions, depending on the duration and depth of the sedation and the consent of the patient. the person.

With his prolonged experience in palliative care units, the practitioner says he is unfavorable to active assistance in dying: “Personally, I am not for changing the current law. Let’s start by applying the existing one.”

The question of access to palliative care

The main problem at the end of life is above all that of access to care and the means given to palliative care. According to the Court of Auditors , half of the patients who could have been entitled to palliative care in 2022 were unable to access it.

According to Claire Fourcade, president of the French Society of Palliative Care (SFAP), interviewed by Le Figaro , “today, 500 people per day do not have access to palliative care in France. Every 3 minutes, a person dies without this support.”

In his announcements, the president affirms the establishment of a palliative care unit in each department, while the current units are already struggling to survive. According to Claire Fourcade, “with this bill, it seems obvious that it will be easier to access euthanasia than palliative care for a large number of patients. » Euthanasia or assisted suicide will cost the State less than longer palliative care; the cynicism of this law will be clear.

According to the president of the SFAP, using the term “fraternity law” used by the president, fraternity would “first of all offer people access to the care they need. » This fraternity is currently being carried at arm's length and with few resources, by palliative care professionals and volunteers, doctors and nurses.

The Belgian euthanasia model

Belgium authorized euthanasia in 2002 and in 2014 became the first European country to allow children with incurable illnesses to choose euthanasia, sweeping away doubts about the child's discernment. Since then, the number of euthanasias carried out in Belgium has continued to increase. It was 2,699 in 2021, 2,966 in 2022 to reach 3,423 euthanasias in 2023, according to data from the Federal Commission for the Control and Evaluation of Euthanasia. A figure up 15% compared to the previous year.

In Marianne , the journalist Pierre Jova, who investigated the model of euthanasia in Belgium, notes that having put euthanasia and assisted suicide in the law had the consequence of applying it to the whole of society and of force every citizen to consider it.

With hindsight on the issue, it is important, according to him, to see the “dramas and human damage” that the Belgian law has caused: “Elderly people obtain euthanasia and do not notify their families […] without talk about euthanasia for mental suffering, which is rare and spectacular, but immoral. » How can a society offer euthanasia for cases of autism, depression or schizophrenia, he asks.

For him, the generalization of euthanasia in the law was a signal sent to the elderly and the most vulnerable who thought they were a burden for their family or for society. This goes against the moral fabric of society and the nature of our humanity to care for others and especially the oldest and weakest. “In reality, we never die alone, it is always a social event, a family event, a cultural event which has been codified by civilizations throughout the ages” concludes the journalist.