Macron defends strict conditions of ‘French-style’ model for assisted dying

A ‘French-style’ bill on assisted dying will be presented to France’s Council of Ministers in April, President Emmanuel Macron confirmed in an interview on Sunday (10 March), underlining that it will function differently to similar laws in other EU countries.

Macron is putting forward a “French-style” model, with strict and precise conditions for access, the Elysée told reporters on Monday (11 March).

The bill will make it possible “to request assistance in dying under certain strict conditions”, said Macron in an interview with French newspapers Libération and La Croix, adding he does not wish to use the terms assisted suicide or euthanasia.

First of all, the patient would have to be of legal age and “capable of full discernment”. This criterion excludes patients suffering from Alzheimer’s or mental disorders, unlike the Belgian model.

The patient must also be suffering from “an incurable disease with a short- or medium-term life-threatening prognosis” and be facing “intractable suffering”. “All these criteria must be met,” the Élysée states.

Next, patients wishing to benefit from active assistance in dying must submit their decision to the opinion of the doctors. If the doctor agrees, the patient may inject the lethal dose himself.

If they are unable to do so, which would be the case for people suffering from Charcot’s disease in particular, then they can appoint a third party to carry out the procedure.

The bill will also contain a section on supportive care, including palliative care. “We are going to put palliative care back at the heart of support,” the French President promised, “even before the law is enacted”.

The bill on the end of life was long-awaited in France, particularly after the work carried out by the Citizens’ Convention on the End of Life, made up of 150 citizens, in December 2022.

In its conclusions, published in April 2023, the members of the Convention said they were in favour of changing French law, but this did not lead to any legislative project.

At present, the law only authorises “prolonged and continuous sedation” for patients with a short-term life-threatening condition.

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Too permissive and yet not permissive enough

In a press release, the Association for the Right to Die with Dignity (ADMD) welcomed “the President’s departure from the hesitation zone in which he seemed to have been trapped since the Citizens’ Convention”.

“The announcement of a fairly precise timetable reassures us that the President is determined that a text should finally be submitted to the national assembly in the coming weeks,” ADMD added.

However, ADMD also criticised Macron’s bill, which “is not the one that will best meet the legitimate demands of people at the end of their lives”.

In particular, the group lamented the President’s choice to rule out the consideration of advance requests, for requiring that the prognosis be vital in the short or medium term – patients suffering from Charcot’s disease, for example, will have to wait until the final stages of the disease – and for omitting euthanasia.

Fifteen carers’ organisations also expressed their “anger” and “dismay” at the President’s bill, which they considered to be “far removed from patients and the day-to-day realities of carers” though this was on the basis that it was too permissive.

“No country envisages the administration of a lethal substance to a loved one,” reads the press release.

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Neither Belgium, Switzerland nor the Netherlands

Elsewhere in Europe, other countries have legislated on the end of life, based on two definitions: either assisted suicide, i.e. the taking of one’s own life with the help of a person who provides the means to do so, or euthanasia, i.e. when a doctor intentionally shortens a person’s suffering.

In Austria, Germany and Italy, assisted suicide is legal. The Netherlands, Belgium, Spain and Luxembourg authorise euthanasia, whereas in France it is treated as a homicide.

According to the Institute for European Social Protection (IPSE), several hundred French people leave France every year to be euthanised elsewhere in Europe.

“The French model is not the Belgian, Dutch or Swiss model,” the Elysée told Euractiv.

Prime Minister Gabriel Attal told AFP on Monday that once the bill has been examined by the Council of Ministers at the beginning of April, it will be presented to the National Assembly on 27 May.

Even though Macron has announced a tight timetable, “on a text with such high stakes, we are not asking for an emergency, there will be no fast-track procedure”, he said, suggesting that the parliamentary debates could last several months.

[Edited by Nathalie Weatherald]

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