Why it matters. End of life: Tense debates on assisted dying expected in the National Assembly
The end of life is back before the National Assembly . After the dissolution that abruptly interrupted the debates in June 2024, the deputies will be considering not one, but two bills starting this Monday, in accordance with François Bayrou 's wishes . On one side, there will be palliative care and on the other, active assistance in dying. On the latter, the discussions promise to be very tense. Already in the Assembly's Social Affairs Committee, it took 75 hours of debate for the deputies to arrive at the version presented in public session, approved by 28 votes to 15.
"It's a balanced text, between those who find it too restrictive and those who find it too permissive," says Olivier Falorni, rapporteur for the bill on assisted dying. For the latter, "it's not about ending life, but about ending agony."
Unanimity to develop palliative care
If there is one issue that generates consensus, it is palliative care . On April 11, MPs unanimously approved in committee the bill put forward by Anne Vidal (EPR) and François Gernigon (Horizons) aimed at strengthening it.
While barely 50% of patients currently have access to palliative care, the proposed law creates an enforceable right to such care, extended to the patient's trusted person or a loved one. People at the end of their life who do not need to go to hospital but who can no longer remain at home will be able to be accommodated in personalized support homes. These establishments will not be able to be managed by the private for-profit sector, the proposed law specifies. Finally, the implementation of the ten-year strategy, which is expected to commit an additional €1 billion by 2035, will be the subject of an annual report followed by a debate in Parliament.
This ten-year strategy plans to strengthen home care, notably through the establishment of rapid intervention palliative care teams in all regions. Hospital care must also be strengthened, with the creation of palliative care units (USP) in all departments. Finally, around thirty university positions will be created by the start of the 2025 academic year to train future palliative care physicians.
Vilified by the right and the far right, supported by a large majority of the left and Macronists, the text creates a "right to active assistance in dying" for patients meeting five cumulative criteria: being at least 18 years old; being French or residing in France; suffering from a "serious and incurable condition, whatever the cause, which is life-threatening, in an advanced or terminal phase"; the latter causing "physical or psychological suffering" that is unbearable or resistant to treatment; and being able to express their wishes freely and with full knowledge of their wishes. In its initial version, the bill stipulated that life-threatening conditions would be "in the short or medium term," but the High Authority for Health prefers to take into account the "quality of life of the remainder of life." The patient will also have to reiterate their wish to die at the last moment, which rules out the possibility of including active assistance in dying in advance directives.
The deputies also introduced the possibility for the patient to choose between administering the lethal product to himself in the presence of a doctor (assisted suicide) or asking a doctor, who has not exercised his right to withdraw, to do so (euthanasia).
"The patient must administer the lethal substance to himself, that must be the rule," insisted Catherine Vautrin, the Minister of Health, in an interview with Le Parisien on Sunday.
On the eve of the debates in the chamber, supporters and opponents of assisted dying continued to put forward their arguments. In La Tribune du dimanche , a text signed by Gabriel Attal and Line Renaud advocates "offering patients freedom of choice." "Opposing any change in the law out of conservatism is putting one's dogmatism before the suffering of patients. It is failing in one's duty to listen and to be humane in order to impose one's morality," they write.
A fervent opponent of assisted suicide and euthanasia, Bruno Retailleau criticized in the JDD a "deeply unbalanced" text that "breaks all the barriers. It is not a text of appeasement, it is a text of anthropological rupture," he stated. Another sign of the deep political division engendered by this text is that Alain Claeys (PS) and Jean Leonetti (LR), despite being co-authors of the 2016 law on the end of life, do not agree. Alain Claeys believes that more must be done, while Jean Leonetti is opposed to a new law.
More than 2,600 amendments have been tabled on the bill on assisted dying alone. However, it is both texts, palliative care and assisted dying, that MPs will have to examine in just two weeks, before a formal vote on May 27. Olivier Falorni warns in the event of obstruction: "The vote will take place on both texts. If we don't complete the second, there will be none."
L'Est Républicain
