Bonnemaison Affair: Between relief and dismay

Bonnemaison Affair: Between relief and dismay

by | October 27, 2015 | Euthanasia and Suicide, End of life, News, Publications

Tugdual Derville speaks on the conviction following appeal for Dr. Bonnemaison, by the Assize Court in Angers, to two years of suspended prison sentence for a single poisoning. What is your opinion of this sentence?

One must situate this sentence in the context of an appeal process: after at first being scandalously acquitted in June 2014, an indictment was essential. By totally absolving Dr. Bonnemaison, the court of assize in Pau sent a dramatic signal: a doctor could kill his patients without incurring penal sanction…

Dozens of caretakers from his hospital in Bayonne participated in several indecent demonstrations of support for Dr. Bonnemaison, seeming to demonstrate that the life of elderly, vulnerable patients near the end of life did not carry weight against the reputation of a colleague, a well-loved native.

Seventeen months ago, we demonstrated to request the public prosecutor to appeal the case. And we are now assisting at the same turnaround as in the Debaine case, in 2008: it involved the murder of a handicapped person by his desperate mother. Lydie Debaine had initially benefitted of an acquittal before being, as well, condemned to a symbolic sentence after appeal.

For Nicolas Bonnemaison at the Assize Court in Angers, farther away from the emotional confusion witnessed in Pau, the stakes were not so much the nature of the sentence as the principle of a sentence. It’s according to this logic that the condemnation to a two-year suspended prison sentence is partially reassuring. The ban on killing a patient remains an intangible principle.

Nonetheless, one single poisoning out of seven was sanctioned…

We were obviously not present during the jury deliberation, but in fact the verdict is puzzling and, to be honest, absurd. Most of the media agree in saying that such a verdict only adds to the confusion.

The general impression is that the jury did not consent to absolve the doctor, who had already been blacklisted by his professional order. But that they didn’t intend to crush him. Everyone well knows, however, that the other six cases merit to be sanctioned.

One might wonder why the « case » of Mrs. Iramuno – the only patient for which Nicolas Bonnemaison was indicted for poisoning – was particular: a very brief delay between the injection of Hypnovel and the death of the patient; a determined gesture performed by a single doctor in an expeditious manner, then abandoning the follow-up to a young nurse’s aide left alone to accompany the patient; the incredible bet on the death of this victim, which prize (a chocolate cake) was reclaimed once death was achieved; and of course, the fact that Mrs. Iramuno’s son constituted the civil party. In the end, the jurors could not help to be impressed by the conjunction of specific accusations by the caretakers and the disarray of the patient’s family.  

 

Why is it that the accused is condemned for using Hypnovel (a powerful sedative) and not for the two cases of administrating a derivative of curare, which is not a medication authorized for the end of life?

Precisely, in my opinion it’s because the families of the two « victims » of Norcuron support the doctor. They would have loudly protested at a sentence. Here again, emotion neutralizes one’s ability to reason. When you think about it, it is frightening in view of the principle of equality in the judicial system.

Our individualistic society is also one of almighty power for the strongest and fittest. We’ve come to maintain a fusional approach of the family, which affects the protection of the most vulnerable. It is as if the healthy ones were to decide the fate of those who are dependant… In the absence of a “parental project”, life is not considered worthy of respect at its’ beginning. Likewise, elderly people deprived of “brotherly support” are less protected when they approach the end of their life. In fact, asking a member of a family to pronounce a life or a death sentence for a vulnerable person, it to grant him an exorbitant power, inhuman in every sense of the word.

What impact does this trial have on Parliament’s debate on the end of life?

We have avoided the jurisprudence of de-penalizing euthanasia which an acquittal would have induced. The parade of euthanasia supporters, who even came from Belgium, to Angers to support the accused, made the courtroom a rather confusing forum with their claims. We at least have the proof that sedations for euthanasia exist, since it is exactly with such a very classical sedative that Nicolas Bonnemaison poisoned Mrs. Iramuno. Our warning on profound and continuous sedation until death, contained in the bill of law on the end of life is completely justified, all the more so as the authors have refused to specify in their text that the question of the intention – or not – to induce death, should not enter into account.

The line of argumentation adopted by certain witnesses is worrisome in regards with their conception of the end of life: more than the principle of provoking death, it is the lack of collegiality in the decision to prescribe and the absence of information to the loved ones that was contested.

Doctor Bonnemaison continues to contend that he always had the intention to « relieve pain but not kill”, and Jean Leonetti also used this formula to defend his new law. The PMs who finish examining the text in these coming weeks need the wisdom to clearly make amendments in this direction, if they want to be coherent with this intention.

Comments reported by Frédéric Aimard

Bonnemaison’s trial: “partially reassuring sentence”

by | October 24, 2015 | End of life, News

At the announcement of the verdict concerning Dr Bonnemaison decided by an appellate judgment at the Angers Court of Assizes for seven presumed cases of euthanasia from 2010-2011 at the Bayonne hospital, Alliance VITA joins the following press release, published by the movement Soulager mais pas tuer (Relieve Suffering Without Killing), one of VITA’s partners.

Soulager mais pas tuer considers Dr Bonnemaison’s conviction by the Court of Assize in Angers partially reassuring, in spite of the confusion maintained in the courtroom surrounding the practices of hidden euthanasia.

Tugdual Derville, one of the spokespersons for the movement Soulager mais pas tuer and the author of The Battle of Euthanasia (Salvator Editions) and the Alliance VITA’s General Delegate: “We are partially reassured, in spite of the confusion maintained during this trial by euthanasia supporters. This conditional sentence, voted by the popular jury during the appeal, has the merit to partially rebalance the judiciary treatment of this painful affair. The acquittal in Pau gave rise to troubling consequences, seeming to clear a caretaker of committing a solitary deed to end the lives of those who are very vulnerable. This is the reason why we requested that the public minister appeals this decision. By distancing the trial from Bayonne, it was hoped that the second trial would be more serene and less emotionally charged. It would certainly have been considered too excessive to punish the doctor too harshly, since he is already suffering from the scandal and the judiciary procedure, and has already been sanctioned by his professional order. This sentence, which remains a little bit symbolic, gives justice to one of the suffering civil parties. The parade of multiple witnesses having no link with the concerned accusations, some coming from Belgium, transformed the courtroom into a stage for euthanasia supporters.

This verdict especially confirms the ambiguity in the protocols of “deep and continual sedation until death” which the End of Life law proposal promotes and whose discussion will soon be finished in Parliament. This second trial for Bonnemaison confirms the urgency to clarify sedation: this practice would be discredited if it transgressed medical integrity which calls for the caretaker to always relieve suffering without ever killing. More specifically, there are millions of elderly people in our country who can legitimately ask about the level of protection when they arrive in overcrowded emergency services. Will they really be taken care of? Who will protect them from an all-powerful practician committing an act in solo, tempted to prescribe a sedative overdose to practice masked euthanasia. With the civil parties and the number of caretakers shocked by the Bonnemaison case, we see that a part of society prefers to protect a doctor by clearing him of unjustifiable protocols. It’s as if the ban on killing should have exceptions in cases of extreme vulnerability, either linked to age or dependency of severe illness. On the contrary, it is when life is most vulnerable that the ban to kill is even more indispensable to establish trust between caretakers and patients. It is on this basis that dialogue between the patient and his family and the medical team – which was often lacking in Dr. Bonnemaison’s practice – which must constantly be established and renewed. Today, we take note with this verdict, which corrects the one given by the Court of Assize in Pau, that it could be no jurisprudence for decriminalization of euthanasia.

The movement Soulager mais pas tuer remains active to insure that the future law about end of life does not further accentuate the confusion surrounding the doubtful practices of sedation.”

Extending Medically Assisted Procreation: a new attack?

by | October 21, 2015 | Bioethics, Medically Assisted Procreation, News

In an interview with TV Channel France 2 on Wednesday October 21, Minister of Justice, Christiane Taubira, declared that she is favorable to open the discussions in France about artificial reproduction for women living as couples. She was interrogated about her statements diffused the evening before on TV Channel Canal+ “1995 – 2015: 20 years of Gay Revolution!” And she judges that it is “legitimate” for women couples to claim a right to medically assisted reproduction and she calls for the politicians to have “the courage to fight this battle.”

She confirmed by declaring: “I repeat, I think that this demand is legitimate. The socialist group has already tried to introduce the debate. Personally, I think that it is legitimate; as a consequence the debate should be held.”

Recall that precisely one year ago, when the Government stated its position, Manuel Valls declared about medically assisted reproduction for lesbian couples: “ The position of the government on this subject is clear: we will go no further on this question as long as we have not received the the National Ethical Consultative Committee point of view.”

Mrs. Taubira’s declaration appears just after the publication of a decree aiming to increase the number of gamete donations in France, and on the same day that the State Council held an audience on the possible partial removal of the anonymity of the donor, as requested by a young woman born from a sperm donation.

Alliance VITA emphasizes that France is opposed to medically assisted reproduction for women, alone or in same sex couples, in order to respect the rights of the child, and to not deliberately deprive a child of his father, a position that is reinforced by the state council’s advice in 2009. That means to misuse the techniques reserved for cases of medical infertility, which is widely excessive and a source of injustice for children.

Tugdual Derville, Alliance VITA’s General Delegate, recalls: “we do not approve the approach in this debate which makes having a child a right, while denying his right to have a father. We appreciate those who protect the interest of the child, notably the homosexuals who publically protest the practices of medically assisted reproduction or gestational surrogacy by two persons of the same sex. To deliberately deprive a child of his father is an original form of maltreatment. Like during the preceding offensives on this subject, we are strongly involved and we remain constantly vigilant.”

Euthanasia in Belgium: the Control Commission ineffective

by | October 21, 2015 | End of life, News

The federal Commission established to control and evaluate application of the law on euthanasia (for which the mandate expired on October 18, 2015) was not renewed, due to the lack of candidates with all the required conditions.

The composition of this commission is defined by the Law of May 28, 2002, Article 6 relative to euthanasia. Amongst the 16 members, eight must be medical doctors and four university professors. Today the medical doctors are lacking. Actually, in addition to professional qualifications, other conditions are required to respect the internal equilibrium: the balance between men and women, the division between French and Dutch speakers, as well as the diversity of philosophical and religious opinions (1).

However, in an analytical report published by the European Bioethical Institute in 2012, ten years after the application of the law, it is underlined that “in spite of all precautions, it is surprising that almost half the voting members of the Commission are collaborators or members of the Association for the Right to Die in Dignity, an association which openly fights in favor of euthanasia and the expansion of legal conditions.”

Besides, the caseload is constantly increasing: the growing number of euthanasia cases may render the task incompatible with one’s professional responsibilities. According to the latest statistics, the number of declared cases of euthanasia has increased 90% in the past 3 years on record, growing from 953 in 2010 to 1807 in 2013.

The commission has performed verifications, following the statements that the doctors must fill out, after having performed euthanasia. And it is based, as the commission itself admits, on subjective criteria such as the aspect of insupportable suffering or by the level of psychic suffering. The multiple law’s interpretations make verifications inoperative: no case has been sent to the King’s procurer since the existence of the law, which creates serious doubts about the quality of such inspections (2).

One can wonder about this commission’s interest in its work and about the reasons for the lack of candidates, when the recent cases of euthanasia were the subject of intense criticism in the national and international media. For example, in July 2015, a young 24-year-old woman obtained authorization for euthanasia because she suffered from depression. This case constitutes a serious alert in the psychiatric and psychological communities.

One question remains: shouldn’t the law itself and its terms be questioned, and not only the qualification of the Control Commission members, who visibly do not control much of anything?

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  1. Extracts from article 6 of the law May 28, 2002:” the members of the commission are named, by respecting linguistic parity – each linguistic group including at least three candidates of each sex – and assuring a pluralistic representation, by royal decree deliberated in the Council of Ministers, by a double list presented before the Senate, for a renewable term of 4 years.”
  2. Numerous cases of euthanasia remain hidden, as shown by a study carried out by researchers at the Brussels University and Gand University published in Social Science & Medicine in July 2012: and after this study, 10 years after the law was enforced, 27% of the euthanasia cases in Flanders and 42% in Wallonia were not declared. See VITA decoder, “Euthanasia in Belgium”, November 2013.

Donating gametes: the removal of anonymity debated by State Council

by | October 21, 2015 | Bioethics, Medically Assisted Procreation

On Wednesday, October 21, 2015, the State Council held an audience to decide the partial removal of the anonymity of sperm donors. The decision is being deliberated, and will be made public at a later date.

The request comes from a 35-year-old woman, conceived using artificial insemination by a donor, and who has been fighting a legal combat for years to obtain a partial removal of the secret covering her origins.

The young woman, a professional lawyer, petitioned the administrative court, after having discovered at 29 years of age that she was conceived by artificial insemination. But she continually faced the refusal of Public Assistance – Hospitals of Paris, where the anonymity is specified by French law. Starting with her requests to the administrative court, followed by the administrative court of appeals, she requested the highest administrative jurisdiction arguing that the French law violated article 8 of the European Convention of Human Rights on the “right to respect private and family life”.
 In a decision dating from 1992, the European Court for Human Rights (ECHR) stated that those in such a position like the applicant « have a vital interest to obtain information which is indispensable to discover the truth about an important aspect of their personal identity ».

The woman’s lawyer, Julien Occhipinti, explains: « We have the impression to face a huge mental block by fear that donations decrease. The objective of our procedure is to have the State Council declare the French law unconventional regarding the ECHR. The lawmaker’s task will then draw conclusions and rewrite the law.”

Using the pen name of Audrey Kermalvezen, the young woman is the author of the book “Mes origines : une affaire d’état”(My origins: a State Business) and precises her actions: “I never considered the genitor of sperm as my father, a member of my family, but he makes up part of me. This is not an affective quest; it’s just to know where I come from, who I am. I would like to know what he looks like”. Among her requests, she would like to know if she and her brother, also born from a donor sperm, were conceived by the same donor. Today married with a man who was also born from a gamete donation, she indicates a potential risk of consanguinity due to the impossibility to obtain any information on her genitor and the one of her husband.

For Audrey Kermalvezen it is a race against the clock, since the Code of public health requires sperm banks (Cecos) to conserve the donor’s name for a minimum delay of 40 years. “Afterwards, we don’t know what will happen to the files”, she emphasizes. Even though no official numbers are available, it is generally estimated that between 50,000 and 70,000 infants are born via sperm donation in France since the first sperm banks were established in 1973.

Audrey participates in an association, Medically Assisted Anonymous, which fights for controlled and limited access to one’s origins, at political, legal, and media level. Founded in 2004 by Dr Pauline Tiberghien, doctor in reproduction, the association’s objective is to alert health professionals, legislators, and the public to the harmful consequences of total anonymity of gamete donations, whose irreversible character was included in the first French bioethical law in 1994.