Abortion in the French Constitution : Doubts of the French Senate Laws Commission

Abortion in the French Constitution : Doubts of the French Senate Laws Commission

by | February 16, 2024 | Abortion, Press Releases

Abortion in the French Constitution: Doubts of the French Senate Laws Commission

On Wednesday 14th February 2024, the French Senate Laws Commission examined the constitutional bill to register abortion in the French Constitution. Although the commission “acknowledged” the text submitted by the Government, it expressed several reservations on the wording in an official communiqué. The examination during a public session on 28th February will enable the Senators to modify the text through amendments, which could lead to deferring the meeting of the Congress, scheduled for 5th March.

On 30th January 2024, the French National Assembly adopted by solemn vote the constitutional bill intended to register the following sentence under article 34 of the Constitution: “The law determines the conditions under which the freedom is guaranteed to women to be able to resort to an intentional pregnancy termination. “This wording partly picks up on a bill adopted by the Senate on 1st February 2023 according to which: “The law determines the conditions under which the freedom of women to terminate their pregnancy is exercised.“

Is “Guaranteed freedom”, an enforceable right?

By adding the word “guaranteed”, the government intended to provide a pledge to the National Assembly who wanted to register a “right” in the Constitution rather than a “freedom” (see our article Abortion in the French Constitution: The wrong debate)

Nevertheless, during the hearing by the French Justice Minister Eric Dupond-Moretti, and subsequently in their official communiqué, the Senators expressed their doubt on several occasions on the inclusion of the term “guaranteed“. “It introduces a new concept which is found nowhere else in the Constitution […], namely that of guaranteed freedom” declared Senator Agnès Canayer, the reporter for the bill (associated with the Les Républicains party). Senator Philippe Bas, who produced the wording of the bill adopted by the Senate in February 2023, considered: “I wonder whether there are some rights and freedoms in the Constitution which are guaranteed and others which are not.”

Indeed, the guaranteeing of rights and freedoms is an inherent element of a Constitution.

Furthermore, the Senators were concerned about the legal consequences of the introduction of a new concept: “You assure us that it cannot have any major effect regarding the acceptance of responsibility. On that subject, jurists are still quite divided.” according to Agnès Canayer. 

Despite the assurances by the Justice Minister who claimed that the term “guaranteed” does not “in any way create an enforceable absolute unlimited right”, Philippe Bas added:

“If the term has no legal impact, it must not be added. If it does have an impact however, and if it tends to recognise a new power for judges to provide compensation to a person who could not have an abortion because the means are not provided by the government and the parliament, it becomes an enforceable right. This would mean moving power from Parliament to the judges and I would not be in favour.”

Concerns for the freedom of conscience

The second worry for Senators concerns the freedom of conscience for health workers. The January 1975 abortion law was careful to protect the freedom of conscience by introducing a specific conscience clause, which appears at article L2212-8 of the public health code.

As recorded in the communiqué by the commission, “Currently neither the freedom of women to resort to abortion, nor the freedom of conscience of health workers are consecrated as such in the Constitution. It therefore seems questionable to register in the Constitution only one of these two freedoms.”

Indeed, in view of the registration of a constitutional freedom, there is a concern that the specific conscience clause, which appears merely in law, could be perceived at a later date as an obstacle to abortion and therefore deleted by the legislator, as was intended by the initial bill for the extension of the abortion time limit. The freedom of conscience for health workers therefore needs an equivalent legal protection to that provided for abortion.

Possible amendments during the public session

During the examination, at the public session on 28th February, the Senators will be able to present amendments to modify the text. Such amendments could therefore delete the word “guaranteed” or add the freedom of conscience for health workers in the Constitution. In the event of modification of the text, the text would return to the National Assembly until both assemblies can agree on an identical text. That would therefore defer the Parliament Congressional meeting for the final adoption of the constitutional bill, which was initially scheduled for 5th March.

What Is the Latest on the End-of-Life Bill ?

What Is the Latest on the End-of-Life Bill ?

by | February 15, 2024 | End of life, News

What is the latest on the end-of-life bill?

In the aftermath of the conclusions of the Citizens’ Convention last April, Emmanuel Macron announced an end-of-life bill before the end of the summer in 2023.

A bill to change the circumstances of the end of life

Initiated following the CCNE (National Consultative Ethics Committee) report, issued in September 2022 and opening the way for the legalisation of assisted suicide and euthanasia, the debate opened with the wish to reconsider the “end-of-life circumstances”, in contradiction with the claimed neutrality of the ex-minister delegate in charge of territorial organisation and health workers, Agnès Firmin-Le Bodo, among others.

A draft bill which introduces the lifting of the prohibition to kill

Following repeated delays, a draft bill was revealed in Le Figaro on 13th December 2023, less than a week after the presentation of a report entitled “Towards a French model for accompaniment care” and whose proposals are due to feed into the new 10-year plan for the development of palliative care.

The draft version of the text of the law dated October 2023, has 3 parts:

  • Accompaniment care,
  • Patients’ rights
  • Assistance in dying.

The possibility of being able to receive an administered lethal substance would be restricted

  • To French adults,
  • Suffering from “a serious and incurable condition which threatens their life expectancy in the short or medium term” (within a window of “6 to 12 months” – it should be noted that according to an article published in the British Medical Journal, the diagnosis by doctors on the residual life expectancy of patients at their end of life is accurate in a mere 20 % of cases!)
  • Or experiencing “constant or unbearable physical suffering” associated with their disease.

The document provides for self-administration, i.e. assisted suicide, in principle, and administration by a third party (carer or close relation), i.e. euthanasia, in the event of physical incapacitation.

This draft bill consecrates medical omnipotence since it is up to a single doctor to authorise the patient who so wishes to resort to assistance in dying. Worse still, it even considers “reverse life-saving” to hasten death if the dose of lethal product proves inadequate to cause rapid death. As for sanitary or medico-social establishments, they would be deprived of any conscience clause.

Finally, at cross purposes with the rich and complete definition of palliative care provided by the World Health Organisation (WHO), the draft bill limits it to “medical care strictly intended for pain relief.” This restriction is of great concern since palliative care would in the end be incorporated within “accompaniment care”. The fear is that the latter would act as a “Trojan horse” for assisted suicide and euthanasia.

The text was immediately met by opposition from numerous organisations of doctors and nursing staff who denounce its “meagre content” in a communiqué issued by a grouping of geriatricians and carers specialised in palliative care.

What place is left for palliative care?

The opening of the debate on the end of life has highlighted the inadequate development of palliative care. During his presentation to the participants in the Citizens’ Convention in April 2023, Emmanuel Macron declared: 

“I believe that a unanimously recommended solution must now be rigorously implemented. We must better apply the Claeys-Leonetti law, as has already been clearly underlined by the National Assembly evaluation mission. We have an obligation on the subject to ensure universal access to palliative care, to disseminate and enrich our palliative culture and to review our policy for the accompaniment of bereavement.

The national strategy for the development of palliative care (initially scheduled for January) is to be revealed before the President announces the orientations adopted for the bill now referred to as the bill on “active assistance in dying” by Prime Minister Gabriel Attal. The expectations are considerable regarding the funding of the plan because the credibility of what is being announced as a priority will be measured in relation to the additional means to be allocated.

As a reminder, the overall budget for the 2021-2024 plan for the “Development of palliative care and end of life accompaniment”, of some 171 million euros, represents an effort of a yearly increase of 2.85%, which is less than the rate of inflation (at an average of 4% since January 2021). Whereas the PLFSS (Social Security funding bill) was adopted without mentioning any additional funding to be provided for palliative care.

Although the need to deploy palliative care nationwide enjoys unanimous support, many are those who are concerned at seeing this aspect incorporated in the end-of-life bill. “Does this mean we shall have to wait for the law to be adopted, at best by the end of 2024, to establish the announced revolution in the care of the sick, whereas it is well known that 50% of the needs in palliative care are not satisfied and urgent action is required?“, wonders Claire Fourcade in La Croix.

Following the about-turn by the CCNE, Alliance VITA has been alerting about the promise of developing palliative care in order to help carers to swallow the lethal pill of euthanasia and assisted suicide. The right for access to palliative care is guaranteed by the 1999 law and the priority should be to implement that law, there is no need to pass a new law.

Health workers as well as parliamentarians have pleaded for palliative care and assistance in dying to be covered by two distinct texts. The new Minister delegate in charge of Health and Prevention, Frédéric Valletoux, in September 2023 contributed a column in L’Express calling to dissociate assistance in dying from palliative care.

His Minister in charge, Catherine Vautrin, the Minister for Work, Health and Solidarities seems on her part to confirm that the text will include two blocks: the management of pain through the ten-year old strategy for the development of palliative care and the establishment of “assistance in dying” i.e. assisted suicide and euthanasia.  On 14th February, the Minister declared that she was “very proud to present this text”.

What is the time-table for the French model for the end of life?

After meeting representatives of the main religions in France, doctors and other personalities, on Thursday 9th February, the President must make the “final decisions” during February.

In substance, nothing new has leaked out following this meeting, apart from a sentence by Emmanuel Macron, reported by the co-president of the Buddhist Union in France: “To manage to find a space which is neither a freedom nor a right, but merely a possibility which would be the least evil […] that is the question which needs answering. The state of the law does not currently manage it completely. That is duly acknowledged”.

On his part, Gabriel Attal assures that the bill on “active assistance in dying” will be examined “before the summer”, whilst promising to “considerably” reinforce the palliative care units.

In fact, by focussing on the possible legalisation of euthanasia and assisted suicide, the debate on the end of life prevents consideration of all the other questions surrounding the end of life: Where will we die? Will we be properly accompanied? Will there be adequate pain relief? How to fund home nursing? How to support local carers? How to ensure we age well?

In that regard, although the Senators have adopted a bill to “establish a society for ageing well in France”, the political leaders and the professionals who accompany the aged are still waiting for a presentation by the government of a law to establish the means for facing up to the shock of the ageing population! As for the health system, its dysfunctions are a major concern for the French public whose priority is nationwide access to health care rather than access to assistance in dying.

Concerning the mission to re-evaluate the Leonetti law in 2008, Robert Badinter, who died on 9th February, had stated: “Nobody can end another person’s life in a democracy.” if only those words could be heard by those in charge.

Further reading:

  • Time for action! Appeal to the Health Minister!
  • Chronicle by Tugdual Derville in Famille Chrétienne : “Bill on the end of life: the government’s “mortal logistics”

Press release: Palliative care: beyond the intentions, what are the means?

The extension of Euthanasia to Mental Disorders in Canada Has Been Deferred

The extension of Euthanasia to Mental Disorders in Canada Has Been Deferred

by | February 9, 2024 | End of life, Euthanasia and Suicide, News

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Euthanasia in Canada: The extension of euthanasia to the mentally handicapped has been deferred.

On 1st February 2024, the Canadian Government announced it was deferring till March 2027 the possibility of authorising euthanasia and medically assisted suicide in the event of mental disorders.

The federal government accepted the recommendation in the report by the Special Mixed Committee for Medical Assistance In Dying (MAID), which considers that the “Health system in Canada is not ready for medical assistance in dying when mental disorders are the only medical problem involved.”

According to the report, the availability of euthanasia for those suffering from mental disorders is particularly inappropriate notably for the following three reasons:

  • The question of the irremediable nature of the disorders,
  • The lack of consensus between the psychiatric staff,
  • The priority commitment for the protection of the most vulnerable.

The statement by Dr. K Sonu Gaind, Head of the psychiatric department is most telling on the subject.

“It would be discriminatory to administer MAID under the pretext that it is an irremediable health problem, whereas in fact, marginalized Canadians suffering from mental disease, who could see an improvement in their condition, would be given MAID during periods when they are overcome with despair and social suffering.”

As underlined by the social network “Vivre dans la dignité” (living with dignity) in a press release, “The challenges thrown up by the committee report should lead to the total cancellation of this new authorization for medical assistance in dying …”

In a previous report in 2023

The Canadian Government on 2nd February 2023 had already submitted a bill to defer for one year the access to euthanasia and medical assistance in dying for those whose only medical problem is mental disease.

The gradual sliding of the law

In 2016 Canada legalised what its law calls Medical Assistance in Dying (MAD) which covers the practices of euthanasia and assisted suicide.

In 2021, a mere five years later, a new law extended these practices to those people suffering from a serious and incurable disease but whose life is not threatened in the short term.  The criterion has become even more uncertain and extendible, as it is based upon the fact, for patients, that they themselves consider their physical or mental suffering to be unbearable. A physically handicapped person or suffering from a chronic disease is now eligible for euthanasia. The legislator additionally intended that the law should be applicable to people suffering from mental disorders from 17th March 2023, leaving time for thought about the conditions to be met in order to ensure the safety of patients.

A group of experts was therefore established, as intended by the 2021 law. In May 2022, the group submitted a report including 19 recommendations to the ministers of Justice and of health. They concerned the need to pay particular attention to the conditions for determining the incurability, the irreversibility of a pathology, the contours of a persistent and intolerable suffering, taking into account suicidal tendencies, the capacity for decision making and the consent of people confronting vulnerability, and the means for pain relief.

In that context and after the reservations expressed by psychiatric specialists an announcement was made to defer the application of MAD until 17th March 2024 for people suffering from mental disorders.

The major challenge of suicide prevention

Indeed, the Canadian Association of Psychiatric Presidents, which includes the heads of the psychiatric departments of the 17 medical faculties, signed a declaration in December 2022 calling for deferment of the application of MAD to mental disorders.

They underlined that patients need better access to treatments, including for addictology and drug addiction. In particular, patients in rural communities may not have access to mental health treatments, as well as those facing dependency. This situation is of particular concern in the post covid period which is experiencing an epidemic of psychiatric consultations and long waiting times before receiving suitable treatments.

Apart from the serious question of access to treatment, many questions remain controversial with respect to the definitions of eligible people, the evaluation of their condition, the improbable discernment between a request for suicide to be prevented by seeking a suitable treatment or to “assist” by abandoning all treatments.

Whilst the national week for suicide prevention was under way since 5th February 2023, Georgia Vrakas, an associate professor in the department of psycho-education and social work at the university of Quebec made a public testimony.  “I am a clinic psychologist and university professor. My fields of expertise are mental health and suicide prevention. And I have been living with a serious mental condition for at least the last 23 years, if not longer. I only discovered in 2021 that I have a bipolar condition. Until then, my doctors had all diagnosed a major recurrent depressive condition.” She explained having wished “to die to put an end to my suffering”. She explained that during a severe crisis, she called the suicide prevention centre and her doctor, which led her to find a psychiatrist who was finally able to give the correct diagnosis and start a suitable treatment in May 2021. “Where indeed should one draw the line between suicide and medical assistance in dying for people living with a mental disorder? Irrespective of the supervision and safety measures established, it is impossible to draw a line which does not exist.” She recalled the total contradiction of the slogan “It is better to prevent than to die” which was chanted during the suicide prevention week. She concluded that the Federal Government should take heed and consider the means to be established in order to truly reduce the suffering of people living with a mental disorder. According to John Maher, a psychiatrist specialised in mental diseases and chief editor of the Journal of Ethics in Mental Health “MAD deeply undermines the decades of efforts made in suicide prevention.”

The challenge of suicide prevention is key: will Canada be able to take it into consideration in order to protect the most vulnerable Canadians? In the debate opened by the French Government on the end of life, Alliance VITA recalls that suicide prevention can suffer no exceptions. “Nobody should be excluded from suicide prevention.” recalls Tugdual Derville in his essay published in January: Doctor, do I have the right to live a little longer?

Reported Suicides

Reported Suicides

by | February 2, 2024 | Euthanasia and Suicide, News, suicide

Reported suicides : Lauren Hoeve and Thomas Misrachi

On Saturday 27th January 2024, the media reported two suicides, which occurred under very different circumstances.

The first concerned a young 28-year-old Dutch woman, suffering from autism. Lauren Hoeve had for years been calling for euthanasia due to a syndrome of chronic fatigue causing her great suffering. In a final message posted on X (previously Twitter), the young woman wrote: “I am being euthanised”, the message included a picture showing a young child wearing sunglasses giving a thumbs up next to a doctor.

The euthanasia suicide, completed in the presence of her parents and her best friend, had been announced a few days beforehand, to her 7,800 followers on X: “My last day will be Saturday 27th January. My euthanasia will take place between 13:30 and 14:30.”

The second report was by a French journalist on TF1. Thomas Misrachi was invited on the same 27th January on France 5 for the release of his book “Le dernier soir” (The last evening), published by Grasset, which describes the end of life of Jacqueline Jencquel.

The activist for assisted suicide ended her days in March 2022, at 78 years of age, whilst she seemed to be in good health. Thomas Misrachi, who also belonged to ADMD (Association for the Right to Die with Dignity), not only admits having “held her hand” whilst she took the lethal substance, but again shared his decision to “program” his own death at the age of 75 (he is currently 53), whilst readily admitting that it will be difficult to explain to his daughter, who is currently a child.

Although very different, these two cases caused quite a stir in the media: The first because Lauren Hoeve, who had many followers in social media, was in no way at her end of life, nor suffering from any fatal disease; the second because Thomas Misrachi claims the right for assisted suicide without any health criteria, in the name of absolute autonomy and an aversion to old age.

The suicide of the young woman was conducted quite legally in Holland, whereas Thomas Misrachi asserts and seems to accept the risk of being sentenced for “non-assistance to a person in danger” and for “the encouragement of suicide”. It would appear – if his witness statement is true – that the very last post by Jacqueline Jencquel who claimed to die alone, is untrue. But it has also been confirmed that her suicide was also associated with financial difficulties.

Living in a superb apartment in the 7th district in the capital, she had problems to pay the rent after spending a lot of her savings, whilst thinking of ending her days sooner.

Whilst in France the possibility is being considered to make assisted suicide available to those suffering from a condition where their life expectancy is threatened in the medium term, these two cases show that such a breach would not prevent claims for assisted suicide and euthanasia for those suffering from no fatal condition, or even no pathology at all.

But especially, one can only be astounded by the social upheaval of such an anticipated suicide announcement by a person in good health, on the sole criterion of age. How can one reconcile this type of claim with the policy of suicide prevention?

The public authorities are justifiably alarmed at the high suicide rate in France for the over 75s. Sociologists have described the Werther effect, the contagion of suicides for those whose background is comparable to those who have ended their days. The implicit and unconscious message broadcast by this young fifty-year-old to the aged, after severely stigmatising their state of dependence, is as follows: Make a success of your exit before reaching vile dependence! In other words: you are no longer welcome among us, the healthy population.

What about fraternity?

 

Abortion in the Constitution: What Guarantees Against an Enforceable Right?

Abortion in the Constitution: What Guarantees Against an Enforceable Right?

by | January 30, 2024 | Press Releases

Abortion in the Constitution : What guarantees against an enforceable right ?

PRESS RELEASE – 30th January 2024

The French National Assembly has adopted the bill for constitutional reform which aims to register the “guaranteed freedom” for women to resort to abortion. Alliance VITA denounces such an abuse of the constitution to introduce an enforceable right to abortion and deplores an approach which blatantly ignores the difficulties which push women to resort to abortion.

The Justice Minister may well have claimed otherwise when the text was examined during the parliamentary debate, there is nevertheless a severe risk of breakdown of the legal framework in the future. The successive revisions to the 1975 law decriminalising abortion have gradually deleted the benefits, the information, the support, the distress criterion, in other words, the measures intended to protect women from external pressures and the precipitation towards an irreversible act is far from trivial.

Worse still, no evaluation has been made of the impact of these legal provisions on the lives of women despite the fact that economic conditions have worsened over the last few years. The escalation has intensified to such an extent as the years have gone by that it is no longer possible to count on the promises made by the government facing partisans who advocate a right to abortion “without constraints” as is being claimed by the Family Planning president.

How can one believe in good faith that, once abortion is registered in the French Constitution, the freedoms which are guaranteed in law such as the conscientious objection clause specific to health workers, will not be deleted as was attempted in 2022 by the law extending the abortion qualification period?

How can one guarantee that abortions will never be approved with no qualification period or according to the sex of the foetus?

According to Alliance VITA which has been providing support for over 20 years to women experiencing difficulties, the inclusion of abortion in the Constitution is not only unjustified and dangerous but is also totally disconnected from the social urgency.

This bill to register in the constitution the guaranteed freedom to resort to abortion gives a miss to a true preventive policy. Remember that Simone Veil herself, presented her bill in 1975 as follows: “if the bill […] admits the possibility of an abortion, the intention is to control it, and as far as possible, to dissuade women.” Even today, 73% of the French population believe that “society should provide greater support to women to avoid resorting to abortion” (IFOP opinion poll in 2020).

Alliance VITA calls on the government to face up to the reality of abortion by evaluating its causes and its consequences and by establishing a true preventive policy.