Two rights for the end of life in France
In these times of government inertia and parliamentary upheaval, when anathema and political posturing often overshadow constructive dialogue, the debate on assisted dying – which is set to be the subject of a double vote at the Assemblée Nationale on Tuesday, May 27 – is nothing short of remarkable.
Firstly, in terms of form, since the subject, which was explored by a citizens' convention in 2022-2023, has resulted in two bills, one on palliative care and the other on the "right to aid in dying." Both of which are issues that are at once deeply personal and universal. The French MPs, who are often quick to highlight their divisions, conducted a high-level debate and managed to move forward by listening to one another. Neither the dissolution of the Assemblée Nationale in June 2024 nor the prime minister's hesitations regarding the second bill prevented the examination of legislation that could help French society progress on a question long shrouded in fear and taboo, and for a long time dominated by religion: death.
The progress made possible by these bills address fundamental concerns shared by everyone – the fear of suffering and loneliness at the time of death and the freedom to choose one's end of life – while also seeking to preserve a collective imperative: the protection of the most vulnerable. With regard to decriminalizing, in exceptional circumstances, the transgressive acts of assisted suicide and euthanasia, the second bill, on the right to aid in dying, followed the "path toward an ethical application" of this right, as identified in 2022 by the National Consultative Ethics Committee (CCNE, a governmental advisory council on bioethics issues), provided that "strict conditions" were met. These five conditions were outlined in detail during the debates.
Need for real equality in access to care
Reference to the "quality of life," rather than the unpredictable length of life, was added when describing the situation of patients who would be eligible for the new right. The requirements for collaborative deliberation before granting the right, a two-day reflection period and an explicit, free and informed request from the patient, seemed to strike the necessary balance between the exercise of individual liberty and the prevention of possibleabuses.
Such abuses could include economic, social or family pressures, or a lack of palliative care influencing the decision. Only real equality of access to medical care, which is currently at risk, and in particular the possibility for everyone to have access to palliative care, which is today scandalously reserved for a minority but promised in one of the two texts to be voted on Tuesday, can respond to these legitimate concerns.
Under these strict conditions, and provided there is regular evaluation of their implementation, these bills should help ease the burden each person faces in the inevitability of death. They guarantee, for the vast majority of the population, an end of life that is supported and peaceful, where every effort is made to prevent physical and psychological suffering; and granting the individual right – which compels no one – to exercise an "ultimate freedom" by choosing to end one's life in specifically defined circumstances and under precisely limited conditions.
In addition to this encouraging progress, a final vote on both bills – whose examination will continue in the Sénat – would bring a positive development: France can move forward on a sensitive social issue without necessarily being consumed by political instrumentalization, nor remaining paralyzed by partisan divisions.
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