Decoder #4 : The French Assembly MPs modify the access conditions for “assistance in dying”

Decoder #4 : The French Assembly MPs modify the access conditions for “assistance in dying”

by | June 7, 2024 | End of life, Euthanasia and Suicide

THE EVENT

In an animated debate where the different conceptions of freedom and “fraternity were vented, the MPs completed the examination of the first section of the end of life bill which concerns palliative care, “accompaniment care” and the rights of patients, and began to examine the second section which introduces the possibility of “assistance in dying”, i.e. resorting to assisted suicide or euthanasia.

THE FIGURES

On Monday 3rd June, Catherine Vautrin, the minister, estimated at “between 3,000 and 4,000 the number of people each year who experience the situation described by the bill“, i.e. who meet the various eligibility criteria mentioned in article 6. Nevertheless, she gave no indication concerning the data used as a basis for such claim which therefore appears quite unreliable. In its conclusions issued in March 2023, the mission to evaluate the Claeys-Leonetti law had recorded a crying lack of quantitative data on the end of life.

SUMMARY OF THE DEBATES UP TO 6th JUNE

Examination of the first section of the bill on palliative care, “accompaniment care” and the rights of patients took up the entire first week of the time allocated for the examination session. After validating the principle of an “enforceable right” and introducing in the text a multiple-year programming law (refer to decoder #3), the MPs voted for a  doubling of the budgets allocated in the ten-year strategy for accompaniment care, against the advice of the government.

According to the presentation of the amendment submitted by the communist MPs, “the effort” announced by the government in the ten-year strategy would “in fact equate to remaining at a constant level for the coming ten years and beyond”. Currently, the French Audit Office estimates that 50% of French people who need palliative care are unable to have it. This is the reason why this amendment doubles the budget allocated by the ten-year strategy.

Article 2 concerning the creation of “accompaniment establishments“ was adopted despite opposition by the LR and RN MPs, who denounced them as “Death homes“. Indeed, the minister Catherine Vautrin had specified during examination by the special commission that “assistance in dying” could be practiced there. The LR MP Marc Le Fur mentioned the number of ETP (equivalent full-time) doctors quoted in the impact statement, at a mere 0.2, i.e. one day per week, thus denouncing the absence of medical presence in such establishments.

Nevertheless, an amendment by the socialist MP Jérôme Guedj was adopted against the will of the government and of the reporter to rename these establishments as “palliative and accompaniment care homes”. Additionally, the MPs confirmed that the creation and management of such homes would be restricted to the non lucrative sector through the rejection of an amendment by the reporter Didier Martin.

At article 4, the MPs adopted an amendment by the government to back down on the possibility of recording a choice for “assistance in dying” in advance directives, in the event of an irreversible loss of conscience. This measure had been added by the special commission, whereas among the criteria adopted at article 6 for resorting to “assistance in dying” is the ability “to express one’s free and enlightened will”. 

The minister Catherine Vautrin recalled the government’s will that the patient should be able to express his/her will “in a free and enlightened manner” “not only at the moment of requesting assistance in dying, but also throughout the procedure, up to the moment when, as the case may be, he/she resorts to it.”

On Monday 3rd June, the MPs started to examine the second section on “assistance in dying” (title II). The debates were quite animated. The opponents to the text tried to introduce the terms “euthanasia” and “assisted suicide” in the text, instead of “assistance in dying”.

Renaissance MP Astrid Panosyan-Bouvet heckled the minister and the reporters who opposed the use of such terms in the text : “What are you afraid of ? Why do you not want to admit the truth?

Look on the internet at the titles of the laws adopted in Holland, in Australia – you will find the English translation –, or even in Switzerland. They refer to assisted suicide and euthanasia : in Australia, they speak of “physician-assisted suicide” and “voluntary euthanasia”. Why the need to invent Gallicised terms to qualify the end of life ? ». 

Nevertheless, all the amendments to change the terms were rejected. An amendment by a communist MP, suggesting to change Title II to “Right for assistance in dying” was also rejected.

The MPs debated at length on article 5 which defines “assistance in dying“, through till Thursday 6th June. They upheld the principle that the patient self-administers the lethal substance (assisted suicide). Only in the event of physical incapacity may the lethal substance be administered by a third party.

On Thursday 6th June, by 43 votes “for” and 42 “against”, the MPs deleted the possibility for a close relative to administer the lethal substance, against the advice of the government. The MPs defended several identical amendments mentioning the emotional trauma and psychological burden that such a task could represent for a relative or family member.

The examination of article 6 on the conditions of access for “assistance in dying” started on Thursday 6th June.

As expected, the government attempted by amendment, to reintroduce in the text the condition of “life expectancy threatened in the short or medium term“, which had been replaced by the special commission by the wording “in an advanced or terminal phase”. To that end, the minister Catherine Vautrin quoted the advice by the National Council of the Order of Physicians  and the National Medicine Academy.

In a statement dated 3rd June, the National Medicine Academy had denounced the “unsuitable and dangerous” nature of the term “advanced phase”, considering that once “threatened life expectancy” is removed, there is a risk of including those suffering from diseases which, although incurable, it is nevertheless possible to survive them for a long time”.

Nevertheless, the MPs from all sides, including from the Renaissance group, as well as the Chief Reporter Olivier Falorni expressed their strong opposition to any reintroduction of the notion of “medium term“, which is considered as indefinable. Finally, the amendment by Géraldine Bannier (Modem) was adopted, which describes the criterion as “a serious and incurable condition, threatening life expectancy, in an advanced or terminal phase“.

During the special commission, the text had been modified such that psychological suffering alone could not provide access to “assistance in dying“. It had to be associated with “physical suffering”. During the session, the MPs reintroduced the initial version of the text, which calls for “physical OR psychological suffering” associated with the condition for eligibility for access to “assistance in dying“.

OUR ANALYSIS

Unquestionably, the MPs worked on overall improvement of the first section of the bill by reintroducing palliative care which corresponds to a practice which is well-defined and recognised internationally, as opposed to “accompaniment care” which does not refer to any scientific definition. The creation of an “enforceable right“, the inclusion of a ” programming law” and the doubling of the budget of the ten-year strategy are all measures which will commit the State to a real effort to provide the French people with access to palliative care.

One can also delight at the removal from the text of the possibility of expressing a choice for “assistance in dying” in advance directives, even if the debate is bound to return naturally during the examination of the second section on “assistance in dying“.

By a single vote, the MPs chose to protect close relatives by excluding them from administering the lethal dose, which will however be left to a doctor or nurse in the event of physical incapacity of the patient.

Examination by the MPs of the conditions for access to “assistance in dying” resulted in a considerably expanded device:

  • A condition of a threatened life expectancy but with no time factor
  • Physical OR psychological suffering.

The new version under elaboration no longer corresponds to the government’s intention, the latter being powerless to have its amendments adopted. These debates clearly show the impossibility of establishing a strict framework from the moment that assisted suicide or euthanasia are legalised.

OUR FAVORITE CONTRIBUTION

Two important columns appeared this week in Le Figaro to express the concern of the sick or those suffering from handicap and their relatives :

  • In a column published on 4th June, parents of mentally handicapped people call explicitly for the prohibition of euthanasia and assisted suicide for those suffering from intellectual deficiency.
  • On 7th June, Caroline Brandicourt (the spokeswoman for Soulager mais pas tuer) and Isabelle Mordant gave a warning about the risk that suffering patients will be condemned by the law on the end of life, due to the absence of palliative care accessible everywhere.

OUR ALERT CALL

The amendment by LR MP Annie Genevard, which proposed prohibiting organ donations by any person having benefited of “assistance in dying” in order to avoid such donations inciting a form of altruist administered death, was rejected, for the reason that it would create an inequality between citizens – whose organ donation is an assumed principle – and act as “an additional obstacle to assistance in dying”.

European elections: What are the bioethical stakes ?

European elections: What are the bioethical stakes ?

by | June 7, 2024 | Bioethics, News

At the approach of the European elections on 9th June, what are the bioethical stakes for the European Union ?

The national stakes are interfering with the European campaign to such an extent that it is not always easy to understand whether or not the proposals are within the scope of responsibility of the European Union. The EU has different levels of competence, which are defined in the treaties :

  • Some are exclusive (customs union, competition rules, common commercial policy, conservation of the biological resources of the sea) which the member States must comply with.
  • Others are shared between the EU and the States (agriculture, consumer protection, transport, trans-European networks, energy, freedom of movement, security and justice, common security stakes regarding public health, research, technological and space development, cooperation for development and humanitarian aid, in particular)
  • Or so-called support, coordination or supplemental, under the terms of which the EU may conduct actions in order to support, coordinate or supplement the action by member States.

Under the terms of Article 168 of the Treaty governing the Functioning of the EU, the Union holds, on the subject of public health, competence to support, coordinate or supplement the actions of member States.

It specifies that “The action of the EU is conducted in compliance with the responsibilities of the member States with respect to the definition of their health policy, as well as the organisation and supply of health services and medical care. The responsibilities of the member States include the management of health services and medical care, as well as the allocation of the resources assigned to them“.

Despite this precise legal framework, many lists of candidates issued by political groups wish to carry their militant ideas to the European level, whether or not they come under the competence of the EU ! A total of 38 lists have been submitted.

Under the current term, two regulation proposals pose particularly problematic ethical questions on which the European Parliament has been consulted.

  • Finally adopted by the European Council on 27th May, the new regulations governing substances of human origin (SOHO) presented by the European Commission are intended to revise the rules established over 20 years ago. The revision aims to ensure the safety and quality of the blood, tissues and cells used in health treatments and to facilitate cross-frontier exchanges within the EU. Contrary to the previous directive, an amendment added gametes and human embryos in the same way as exchanges of other human products. Human embryos are therefore considered as objects without any consideration of their belonging to the human community. According to that regulation, the products are checked for quality, thus opening the door to eugenics in the case of human embryos. Also, although the regulation specifies that the donations must not be paid for, it does allow compensation or refunds for the donor with a risk of facilitating a market for procreation.
  • The European parliament voted on 14th December 2023 in favour of the proposal initiated by the European Commission concerning the recognition of filiation documents between EU member States. Highly controversial, this regulation could seriously interfere with the national competence of member States for the establishment of filiation and children’s rights. Particularly since the proposal goes so far as to establish a European filiation certificate. Alliance VITA has issued an analytical notice denouncing the risk that France will be forced into accepting practices which it prohibits, in particular surrogate motherhood. The regulation is to be examined mid-June 2024 by the European Council, with a vote which must be unanimous. Several States have already expressed their opposition, including France.

What manifestoes ?

This analysis covers the main groups who have expressed themselves in their manifestoes on the stakes concerning bioethics.

I- Measures associated with European competence

Human trafficking and surrogate motherhood

The EU has just added surrogate motherhood to the list of human trafficking crimes during the revision of the directive on human trafficking established in 2011 .

The criminalisation of surrogate motherhood was obtained via an amendment submitted by MEP François-Xavier Bellamy, head of the “Les Républicains” group. The latter had made the fight against surrogate motherhood an item of its manifesto in 2019.

The amended text confirms the criminalisation of the exploitation of forced marriage, illegal adoption and surrogate motherhood. Several measures are also aimed at reinforcing the support for victims and the fight against human trafficking.

No group has submitted any proposals in favour of human trafficking. On the other hand, the “Reconquête” group mentions the objective of “Achieving the abolition of surrogate motherhood in all the EU member States” and the “PCF” expresses a firm position against it in the following terms :

“We are calling for action by the EU on all governments, in order to take all necessary measures whether legal or other, in order to prevent substitution motherhood throughout Europe and internationally. At the same time, we wish that criminal proceedings be brought against the clinics and establishments of the womb rental industry in all States worldwide, and that all publicity for that industry to be prohibited. The fight against reproductive exploitation of women must be firmly incorporated in EU law, notably through a revision of directive 2011/36/UE concerning the fight against human trafficking.”

European health research

“Les Républicains” group wish to encourage investment in European research programmes aimed at finding effective treatments against cancer, diseases associated with ageing, diabetes, endometriosis and mental diseases. The “Rassemblement National ” group supports “Reinforcing scientific exchanges : the fight against cancer, agronomic research, green chemistry, etc.

II- claims which do not come under European competence

Registration of the right for abortion within the European Charter of fundamental rights

The most emblematic proposal submitted by several groups concerns the registration in the European Charter of fundamental rights, of the right to abortion.

That position was expressed by the Presidential Majority (Renaissance /Horizons/Modem/UDI/Parti radical groups) La France Insoumise (LFI), Communist Party (PCF), Ecologie 2024 and Place Publique / Parti Socialiste

The absence of competence by the EU with respect to abortion has been confirmed on several occasions by the European institutions (European Parliament, European Commission and European Council). On 30th April 2012, Commissioner M. Dalli answered a question asked by the MEPs (E-002933/2012) :

“In view of the ethical, social and cultural aspects of abortion, it is up to the member States to elaborate and ensure compliance with their policies and their legislation on the subject. The Commission does not intend to supplement the national public health policies on the subject.”

Additionally, the provisions of the Treaty do not confer any additional latitude on the subject, with respect to action outside the Union whose main objective remains “The reduction and, eventually, the eradication of poverty” (Article 21). The European Court of Human Rights also recognised the diversity of the legislative solutions concerning abortion and the broad margin of appreciation of the member States on the subject.

As the modification of the European Charter of  Fundamental Rights is subject to the same procedure as the Treaties, a unanimous vote by the member States is required. In this case, and under the current conditions, such a unanimous result could not be achieved. Moreover, the principles of the European Charter must be linked to the EU competences.

On its part,” Reconquête” wishes to make birth rate a major European objective.

Several manifestoes contain proposals in support of “LGBTQIA+ rights”.

“Renaissance” proposes to prohibit conversion therapies. “France Insoumises”, “Ecologie 2024” and “PCF” have various proposals such as opening the right to adoption for all and repealing the bilateral treaties which prevent homosexual couples from adopting ; the recognition of rights and the depathologisation of trans people throughout Europe  for “PCF.” The “Ecologie 2024” and “La France Insoumise” added further proposals such as to allow the recognition between States of same sex couples, and also of trans parenthood; guaranteeing the free of charge provision of health care specific to transgender people, such as hormone treatments and surgical operations.

Conclusion

In principle, a vote is dictated both by the nature of the competences of the institution concerned by the vote, and by the convictions considered as priority by voters.

The European Parliament has limited competences on the subject of life. Certain groups are in fact centred exclusively on the question of Europe. In certain groups incidentally, it is possible to find, in eligible positions, certain candidates who have expressed their constant commitment in favour of the respect for life, and others who have taken up opposite positions, as recently, concerning surrogate motherhood, the registration of abortion in the constitution or on the subject of the end of life. But other subjects may legitimately be considered (security, immigration, social action, health, diplomacy, defence etc.).

In practice, other considerations come into play. Many voters choose more or less explicitly to vote more according to the national impact of their vote rather than according to what they expect in concrete terms from the MEPs. This point is controversial. Especially as certain groups play on the ambiguity of competences. For example by claiming “libertarian” positions which do not lead to normative consequences, since they are beyond the scope of competence of the European Parliament. It is more their cultural impact which is to be feared, because, for example, the LGBT claims have penetrated the European authorities.

The Eclectic Announcements Intended to Lift the Birth Rate

The Eclectic Announcements Intended to Lift the Birth Rate

by | May 31, 2024 | News

Demography: The eclectic announcements intended to lift the birth rate

The French President attempted in early May to detail his plan, announced in January, to lift the birth rate through two important measures whose methods are highly controversial: a plan to combat infertility and a new post-natal leave allowance.

The fall in birth rate has persisted for 10 years

The fertility rate, i.e. the number of children per woman has fallen from 2.0 to 1.68 over a ten-year period, bearing in mind that the rate of renewal for generations is 2.1. From 811,000 births in 2013, the figure has dropped to 678,000 in 2023.

The persistent fall in birth rate has at last alerted the public authorities. The reasons for this reduction are complex. The National Institute for Demographic Studies (INED) or organisations such as the National Union of Family Associations (UNAF) regularly conduct studies on demographic evolutions in order to detect their causes. The results are summarised in an Expert Notam released by Alliance VITA in December 2023: Analysis of birth rate variations in France.

Procreation standards have led to mothers having children at an ever later age, the deterioration of material conditions and of family policies, with in particular the crucial matter of the availability of childcare facilities are also crucial challenges. These are currently additional to social phenomena such as eco anxiety, the difficulties involved in durable commitments or even the evolutions of parental requirements and injunctions.

The fight against infertility as a means for a “demographic reset”?

In a burst of confusion of genders, President Emmanuel Macron appears to have linked infertility and the fall in birth rate to two proposals, which have been criticised by the experts.

  • The establishment of a fertility check-up at around 20 years of age available to all and fully funded by social security. This is a nonsense according to the president of the national college of obstetric gynaecologists (CNGOF): “A check on the ovarian reserves of the general population who have not yet had any children is of no value for prediction purposes”. On the contrary it could be a source of anxiety and cause panic in young women for no reason.
  • The opening of lucrative private centres for the self-preservation of oocytes goes against the fundamental principle in bioethics for non-commercialising of the human body.

The freezing of oocytes for no medical reason but for the hypothetical purpose of having children later, was the subject of strong controversy during the last bioethical law revision. Although it is authorised for women between 29 and 37 years of age who have not yet had children, this procedure is far from being an insurance for future maternity (20% success rate) and involves secondary risks in some cases.

According to Agnès Buzyn, the ex-health minister, when interviewed by Le Figaro, “The answer to the fall in birth rate cannot lie in the extreme medicalization of couples”.

The working group set up following the adoption of the bioethics law in 2021 to elaborate a plan to combat infertility stressed in its report issued in 2022 that the major cause for medical appointments associated with infertility was essentially social. It is linked to the delaying of the maternity age which is currently established at an average of 31 years. The authors issued a warning about the limits of medically assisted procreation (ART).” It has to be understood that almost half of the couples who resort to ART techniques will not achieve a child at the end of the procedure.”

The report highlights the social factors involved in the delaying of maternity: The extension of the duration of studies, advancement in female employment, general availability of contraception and abortion, the difficult question of choices – job, partner, environment – reconciliation of work and family life, professional and affective stability. “Women wait to find their partner (…)  with whom to conceive a child, and must also wait for their partner to be ready to commit himself.

Other factors are environmental and concern their way of life: exposure to endocrine disruptors, tobacco, drugs, obesity etc. other more specific reasons identified require further research (endometriosis, azoospermia etc.)

It goes without saying that the “solutions” put forward by President Macron are out of touch. During the revision of the bioethics law, Alliance VITA made several proposals, in particular to provide better information on fertility through campaigns aimed at young people. Moreover, instead of proposing devices such as the preservation of oocytes, it is better to improve living and working conditions so that couples can procreate at a younger age as recommended by the CCNE (National Consultative Ethics Committee) and the Biomedicine Agency orientation committee.

Is a shortened and better paid post-natal leave really appropriate?

The government proposal is also to shorten the duration of post-natal leave to 6 months (versus 3 years currently) split into 3 months for each parent. It would be better paid than the current parental allowance. The allowance would be 50% of salary up to the social security ceiling of 1,900 euros.

Currently mothers are given 16 weeks paid maternity leave which increases to 26 weeks from the 3rd child and fathers are also given 28 days paid leave. The parental leave is additional to these as would be the post-natal leave: it is paid at 448 euros and lasts up to two and a half years for one of the parents and six months for the other.

The national union of family associations is pleading for coexistence of the two systems. Because being unable to stay longer raising their children, if they so wish, mothers would have to give up their jobs to remain beyond the 3 months.

In view of the urgency to put back humanity at the centre of public policies, Alliance VITA has put forward 10 ideas to promote an ecosystem for a lasting family, some of which aim to solidify the conditions for having and raising children. Reinforcement of the family policy through general support for couples should be a political priority to support demography.

Further reading:

The Alliance VITA proposals to combat infertility

The urgency to promote an ecosystem for a lasting family

VITA Expert Notam : Analysis of fertility variations in France

 

Decoder #4 : The French Assembly MPs modify the access conditions for “assistance in dying”

Decoder #3: The French National Assembly Has Adopted an “Enforceable Right” of Access to Palliative Care

by | May 31, 2024 | End of life, Euthanasia and Suicide

DECODER #3: THE FRENCH NATIONAL ASSEMBLY HAS ADOPTED AN “ENFORCEABLE RIGHT” OF ACCESS TO PALLIATIVE CARE

THE EVENT

Since Monday 27th May 2024, the French MPs have been examining in public session, the bill on the accompaniment of the sick and the end of life. The text contains two sections.

  • The first section (Title I) aims to reinforce “accompaniment care” palliative care and the rights of patients.
  • The second section (Title II) establishes the possibility of “assistance in dying”, i.e. assisted suicide or euthanasia.

The MPs completed their examination of article 1 on Wednesday 29th May, seeking stronger guarantees for access to palliative care. They then ratified an “enforceable right” to palliative care (article 1 b) and introduced a “programming law for palliative care”, against the government’s will.

THE FIGURE

3360 amendments were submitted for the public session debate.

SUMMARY OF THE DEBATES FOR THE FIRST THREE DAYS

Through numerous amendments submitted by the left or the right, the MPs decided to improve access to palliative care and to combat territorial inequalities. Thus, an amendment completes the title of the 1st section with the words “Throughout French territories”. Within the text of article I, amendments have added the words “guarantee” and “guaranteed” to the text. According to the new wording, palliative care and accompaniment are intended to “guarantee overall and local care for the patient.”

An amendment submitted by the communist MP Pierre Dharréville clarifies what is meant by accompaniment care, which refers to palliative care and “support and comfort care“, to meet the physical, psychological, social and spiritual needs of the person.

Several other amendments also reinforce the support for family members, for example the amendment by Julie Delpech (Renaissance) who added “psychological and social support or the amendment by LIOT MP Laurent Panifous which calls for support for the entourage following a death. Among the other additions, the organisations specialised in chronic pain will have to be associated with the accompaniment of the sick, a representative will be appointed in each department of public health establishments, and an information booklet will be provided to each patient.

Article 1, considerably reinforced and enriched, was thus adopted on Wednesday afternoon, with 123 voting for and 55 against. The MPs in the LR and RN groups largely voted against this article 1, considering that accompaniment care is too vague in the absence of adequate clarification and could include “assistance in dying”. An amendment by Christophe Bentz, an RN MP, who suggested explicitly excluding euthanasia and assisted suicide from accompaniment care, was rejected.

After including in the text a recommendation from the Chauvin report on the structuring of territorial organisations providing accompaniment care, the MPs debated on an additional article to establish an “enforceable right” to palliative care, just as there is an enforceable right to housing. This article establishes the possibility of appealing to an administrative jurisdiction if a person “whose state of health so requires” and “has asked for palliative care” and has not been offered “a proposal for palliative care”. An amendment by MoDem MP Nicolas Turquois proposed its deletion.

Health minister Catherine Vautrin and reporter Didier Martin were in favour of its deletion, referring to the delays in the courts which are not compatible with the life expectancy of those at their end of life. Finally, against the advice of the government and the reporter, the MPs rejected the amendment and adopted the additional article, with the support of some Renaissance MPs.

Through two amendments, one by LR MP Thibault Bazin, the other by the socialist MP Jérôme Guedj, the MPs also included in the law the principle of a “programming law for palliative care”. Thibault Bazin explained that the current bill does not anywhere specify the funding required for the development of palliative care, and that only a programming law would enable “the State to make funding commitments spanning several years.”, as already exists for defence and the law.

The government and the reporter were both opposed to this programming law. Catherine Vautrin objected that “programming laws concern only State funding and not Social Security funding.” According to her, the social security funding law (PLFSS), which is adopted each year, should establish the budget for sanitary and social action. The MPs finally adopted these two amendments, once again with support from a few Renaissance MPs.

OUR ANALYSIS

Despite the efforts by MPs to strengthen the guarantees for access to palliative care in article 1, the notion of “accompaniment care” introduced in this article remains vague. The government opposed the amendment which proposed to specify that the said accompaniment care would exclude euthanasia and assisted suicide.

Consequently, it is plain to see that the intention is to include “assistance in dying” within care, in a continuum with palliative care, whereas euthanasia or assisted suicide are clearly incompatible with palliative care and completely disrupt the relation of trust between doctors and patients by lifting the prohibition against killing. The minister in fact acknowledged that euthanasia and assisted suicide could be conducted in “accompaniment establishments” created under article 2 of the bill.

In truth, the text states that “assistance in dying” may be performed anywhere, in the home just as in retirement homes and health establishments, including in palliative care wards.

Catherine Vautrin has regularly sought to reassure concerning the will of the government to provide access to palliative care for the entire French population, in particular through its ten-year strategy for accompaniment care. However, the government wished to delete from the text the principle of an “enforceable right” to palliative care. Philippe Vigier a government MP (MoDem), even argued, by recognising the current powerlessness of the health system: “Have you even considered, even for a second, what would happen if an enforceable right to palliative care were to be established? There would have to be an enforceable right to medical appointments, for access to care! But finally, have you considered the state of this nation?”

The government also opposed the introduction of a programming law, which would have enabled the State to make funding commitments. Could the ten-year strategy therefore be a mere communication stunt? The current text does not include any funding arrangements and a programming law is the only possible means for providing them. Hence, one can truly question whether the first section of the bill on “accompaniment care” could merely be a device to ensure the acceptance of the second section on “assistance in dying“, as has been suggested by several MPs.

Last September, MPs from all sides asked through a column for the bill to be split in half in order to separate “assistance in dying” from palliative care”.

The debates on the programming law were an opportunity for questioning the minister Catherine Vautrin on the programming law for old age, intended as part of the “aging well” law promised in November 2023 by the previous Prime Minister Elisabeth Borne, for adoption scheduled before the end of 2024. Last January, Catherine Vautrin stated she had appealed to the Council of State on the subject due to a constitutional difficulty.

During the animated debates on Wednesday evening, the minister admitted however that the General Secretary of the government had in fact never forwarded the request to the Council of State, resulting in a general outcry in the chamber. Not only is the government incapable of making funding commitments for palliative care, neither has it held its promise on old age. In that context, the MPs on the right and the left expressed their concern regarding the legalisation of “assistance in dying” which could become the only solution in the absence of access to care.

OUR FAVORITE CONTRIBUTION

At the beginning of the examination of the text, Pierre Dharréville, the communist MP for the Bouches-du-Rhône, gave a vibrant presentation of the reasons for his opposition to the bill:

 “When can one consider that a life is no longer worth living? When can society allow itself to decide that, and to act in consequence? As if dignity is lost because one is too sick, too handicapped, too diminished. It is essential to proclaim equal dignity for all humans irrespective of their state of health. To change our view.“

OUR ALERT CALL

The minister admitted during the debates that her so-called appeal to the Council of State on the programming law on old age had in fact never been forwarded…This admission damages confidence in the government and throws doubt on its will to accompany old age with dignity, whereas the bill on “assistance in dying“, on the other hand, has suffered no delays.

Demonstration Against the End-of-life Bill : Don’t Kill Fraternity!

Demonstration Against the End-of-life Bill : Don’t Kill Fraternity!

by | May 27, 2024 | End of life, Press Releases

Demonstration against the end-of-life bill : Don’t kill fraternity!

Whilst the French MPs are debating the end-of-life bill, Alliance VITA organised a series of demonstrations in Paris, Marseille, Nantes, Bordeaux, Toulouse, Nice and Dijon. Presented in the name of fraternity, the bill establishes the legalisation of assisted suicide and euthanasia, disguised under the sweetened term of “assistance in dying”.

By demonstrating in Paris and 6 major cities, the participants warned against the domino effect which would be generated by the end-of-life bill regarding:

  • suicide prevention which would be weakened by assisted suicide,
  • palliative care which would be diminished by the so-called “assistance in dying”,
  • advances in the fight against pain would be discouraged,
  • patient-carer trust would be ruined by the lifting of the prohibition against killing,
  • social peace would be disrupted by the conflicts inherent in the practice of assisted suicide and euthanasia,
  • the protection of the most vulnerable would be eroded by the encouragement of self-exclusion.

The legalisation of assisted suicide and euthanasia could destabilise them one after the other and finally undermine the very fraternity which the bill is claiming to promote.

Following a play-act, successive speakers expressed their opposition to an upheaval as drastic as the lifting of the prohibition against killing.

Tugdual Derville, the Alliance VITA spokesman reminded the government of its responsibility:

“Instead of undermining all these foundations of fraternity, the government would do better by reinforcing them, first of all by looking after our so fragile health system, the aged and dependent, and finally all those who have doubts, due to their solitude, their insecurity or their dependence, to the extent of wondering whether they still have a right to a place in society”.

Theo Boer, a professor of the ethics of health and member of the Dutch Health Council, gave a message as a stark warning: “The legalisation of euthanasia is not a solution. It sets in motion a dynamic which changes our entire society. Nobody should therefore be under any illusion that legalising euthanasia is a mere question of individual freedom: it sends a message according to which it is better for some people to cease their existence. The cynicism of that freedom must not be under-estimated.”

This demonstration was the first act of a protest which will continue for the entire duration of the debates, in defence of our society founded on a fraternity in support of life, and never promoting death.

See the page on our action.