Assisted dying: MPs voted for the five cumulative conditions for a patient to be eligible
This is the heart of the debate. After three days of heated discussions, on Tuesday, May 20, MPs defined all the conditions required for a patient to be eligible for assisted dying. With 164 votes in favor and 103 against—primarily from the right and far right—the National Assembly approved the key article establishing five cumulative conditions.
The first concerns age: the person must be at least 18 years old. Amendments by La France Insoumise MPs to allow sick minors, aged 16 and over, with their parents' consent, to apply, were rejected on Saturday evening.
You will then need to be a French national or have a stable and regular residence in France. For Olivier Falorni, the author and co-rapporteur of the bill, the right to assisted dying "must be part of a comprehensive care package" that only a stable residence permits. Left-wing MPs have denounced the regular residence requirement, seeing it as an attack on the universality of France's social protection system.
The difficult notion of “advanced phase”The third condition requires that the person be suffering from "a serious and incurable condition, whatever the cause, which is life-threatening, in an advanced or "terminal" phase. The concept of "advanced phase" has been a matter of debate for several weeks among MPs, some of whom consider it too vague.
On Monday, the government adopted an amendment based on a definition adopted by the High Authority for Health (HAS), characterizing the "advanced phase" as "the entry into an irreversible process marked by the worsening of the sick person's state of health which affects their quality of life." Opponents of the text denounced this notion which, according to them, would open up assisted dying to patients who still have "several years to live." For its supporters, it would notably open up the right to people suffering from Lou Gehrig's disease.
"We organized everything with my wife and children. I don't want to be hooked up to a machine to breathe when there's nothing left, no future. I don't want to suffer and especially make my family suffer (...). I registered in Switzerland for assisted suicide, all the papers are signed": the former sports journalist Charles Biétry, 79, who suffers from Charcot's disease, an incurable illness, told the daily L'Equipe on Saturday, April 8, that he had organized his assisted suicide abroad. "You have to take the last pill yourself. That gesture, it's easy to say "I'm going to do it" when I'm at the seaside in Carnac [where he lives] . When someone hands you the pill and tells you that two minutes later, you'll be dead, it's not so simple. But in any case, everything is ready."
To be eligible, the person must also "exhibit physical or psychological suffering" which is "either resistant to treatment or unbearable depending on the person" when they have chosen not to receive or to stop treatment. On Monday evening, Horizons, Liot and Les Républicains (LR) deputies adopted amendments emphasizing that psychological suffering must be "constant" and above all that "psychological suffering alone cannot in any case allow one to benefit from assisted dying."
The last condition requires that the person be able to express his or her will in a free and informed manner.
Request “in writing”After adopting this article establishing the conditions, the deputies moved on to examine another, defining the procedure for requesting assistance in dying. They wanted to specify that the request made by the patient to the doctor must be expressed "in writing or by any other means of expression adapted to his or her abilities." The initial version only mentioned an "express request," referring the details to a decree in the Council of State.
"There is unanimity in this chamber among the various groups who do indeed want the request to be better formalised and for this request to be in writing. However, we all know that there may indeed be people who, due to their state of health, are unable to write," declared the Minister of Health, Catherine Vautrin, who initiated the adopted amendment.
In the evening, the deputies began to discuss the paragraph of the text which provides that the request must be made to a "practicing doctor" who is "neither his relative, nor his in-law, nor his spouse, nor his cohabitant, nor the partner to whom" the sick person "is bound by a civil solidarity pact, nor his beneficiary" .
The most ardent opponents of the text attempted to amend it. For example, Macronist MP Charles Sitzenstuhl proposed that only doctors who have been practicing for more than twenty years be able to collect the application. This was in order "to protect young doctors." His amendment was rejected, like the others.
The possibility of early application rejectedConversely, MPs, mostly from the left of the House, attempted to broaden the right to assisted dying. Amendments aimed at recognizing the possibility of requesting it through advance directives from the patient and/or a trusted person were defended, but all rejected.
For MP Danielle Simonnet (ecologist and social group), preventing advance directives from being taken into account means taking "the risk" that a person will ask for "earlier death" , before their capacity for discernment has been impaired, so that their wishes can be respected.
Conversely, MP Patrick Hetzel (LR), opposed to the text, argued that these amendments posed in his eyes "an ethical problem" , believing that the will could fluctuate over time, and that it would be impossible to verify it at "time T" .
To confirm these votes, the article as a whole must still be adopted. Debates are scheduled to resume Wednesday afternoon after the government question session scheduled for 2 p.m.
The vote on the entire text, in first reading, is scheduled for Tuesday, May 27. More than 1,200 amendments remain to be studied.
The World with AFP
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