End of life: what products will be used for “assisted dying” in France?

This is a major step towards the creation of assisted dying: on Tuesday, May 27, MPs adopted the two end-of-life bills at first reading. One strengthens palliative care, the other paves the way for a system of assisted suicide , if the text is approved by the Senate next September.

But several questions remain about the practical implementation of this new option, which has been requested for a long time. One of them: what product will be used to end the lives of the people concerned?

Article 18 of the bill tasks two health agencies with establishing the protocol: the High Authority for Health on the one hand, and the National Agency for the Safety of Medicines and Health Products on the other.

These two bodies are tasked with "evaluating the lethal substances that will be used for the implementation of assisted dying." The HAS will have to "establish good practice recommendations, including a list of products that may be used, either individually or in combination, in the context of assisted dying," the article further specifies.

"At this stage, we must wait to know the definitively adopted provision and the referral before starting our work," the agency explained to BFMTV on Wednesday, May 28.

While the case of France is not yet decided, other neighbouring countries are suggesting a list of potentially usable molecules. In Belgium, euthanasia has been legal since 2002 .

As the Association of Physicians and Former Students of the Free University of Brussels points out in a publication, several classes of medications are used for this purpose. "The first-line medications to be used are barbiturates (thiopental, secobarbital, pentobarbital), neuromuscular blocking agents, and anxiolytics, mainly benzodiazepines," they explain.

According to the Belgian Centre for Pharmacotherapeutic Information, thiopental is used in this practice, or propofol in the event of a shortage of the first product.

In Switzerland, regulations allow for assisted suicide but not euthanasia involving the direct action of a caregiver. Doctors can prescribe pentobarbital to people, as recalled in an article on the regulatory framework published by the University of Lausanne .

This drug, pentobarbital, has also been used in France in clandestine euthanasia and assisted suicide. In 2019, a crackdown by the National Gendarmerie led to the seizure of 130 bottles of this product across France. These were held by clandestine euthanasia associations .