The Citizens’ Convention on the End of Life believes that France needs “active assistance in dying”

The ball is now in the courtEmmanuel Macronwho initiated the creation of the Citizens’ Convention and will receive the participants this Monday : should we open up the possibility of euthanasia in France or not, and if so under what conditions? The members of the Convention are in any case mostly for, even if they also ask for important safeguards.

In

its report validated this Sundaythe Convention details the positions of its participants: 82% of them consider that the current framework ofend of life support “is not suitable for different situations” ; and an almost unanimity of 97% think that it is necessary in any case “improve it”. They make 65 proposals in this direction, which broadly consist of “respect the patient’s choice and wishes”, “develop home support”and above all guarantee “access to palliative care for everyone, everywhere”.

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Read the full report online (PDF)

It is only after stating this observation on end-of-life support that the Convention considers situations where it is no longer possible. “For a majority of citizens of the Convention (76%), access to active assistance in dying must be open” in France, asserts the report. The remaining 23% believe that the Claeys-Leonetti law of 2016 is sufficientand only lacks a notoriety deficit.

Assisted suicide, euthanasia, both?

Among the 76% who are in favor of the possibility of this active assistance in dyingthis choice meets several requirements: “respect everyone’s freedom of choice; make up for the shortcomings of the current support framework (in particular the limits of deep and continuous sedation); put an end to the ambiguous situations observed”.

On what this “active assistance in dying” covers, the participants are however very divided: only 10% are for assisted suicide alone (in other words, helping people who wish to kill themselves), and even less (3%) to only offer euthanasia (thus the possibility for a doctor to actively end a person’s life). For 28% of Convention members favor assisted suicide, and resort to euthanasia only as an exception. Finally, the solution that gathers the most votes (40%) consists in proposing, indifferently, the two solutionsassisted suicide and euthanasia.

In all cases, they want very strict conditions. “The first of these being the will of the patient”clarifies the text. “The discernment of the person is an essential condition.” This leads to all kinds of questions about what defines this discernment (what to do when a patient is no longer in a state to specify his choice?), and about the different possible situations: “incurability”, “refractory suffering and physical suffering”, “vital prognosis engaged”… Without forgetting the complex issue of minors: “Opinions remain very divided”recognizes the report when it mentions the possibility of giving them access to active assistance in dying.

Emmanuel Macron will have to decide

The participants of the Citizens’ Convention produced this report after several weekends of intense debates, and after obtaining information and opinions from speakers on all sides : from caregivers to associations via religious representatives.

It is the President of the Republic who will decide taking into account their recommendationsor not. In 2021, he had already sought the opinion of a Citizen Climate Convention, promising to take up their ideas “without filter”. But the executive had finally rejected 28 of the 146 measures proposed, and had most often taken up the others by modifying them beforehand.

Emmanuel Macron’s position on the end of life is still a big unknown. For several months, he has carefully avoided the question, claiming to want to avoid “simplistic alternatives”. It is served: if the final report proposes an orientation clearly “for” active assistance in dying, it is however, like its problem, particularly complex.

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