End of life: MPs approve the right to assisted dying

On Saturday, May 17, MPs approved the creation of a "right to assisted death" and re-established the principle that patients must self-administer the lethal substance, except when they are unable to do so, during the examination of Olivier Falorni's bill.

The article creating this right was adopted by 75 votes to 41. A vote on the entire text relating to "the right to assisted dying" is scheduled for May 27. The chamber returned to the version adopted in committee in mid-April, which granted the person wishing to resort to assisted dying the freedom to choose between self-administration of the lethal product and administration by a doctor or nurse.

This Saturday, MPs adopted a government amendment specifying that this will only be possible when the patient "is not physically able to do so," reverting to the initial version.

"The government's position is to say that the principle is self-administration, the exception is support," declared Health Minister Catherine Vautrin in the chamber.

For several MPs, this was "a breaking point in the balance of the text," in the words of Horizons MP and former Health Minister Agnès Firmin Le Bodo, who argued for the need to "listen to caregivers in the construction of this text."

Conversely, the author and rapporteur of the text, Olivier Falorni, expressed his "disagreement" with the questioning of "free choice," recalling that this was one of the "crucial points" for the Citizens' Convention that had been set up by the President of the Republic to reflect on the subject.

What "I fear," explains Olivier Falorni, "is that a "patient who has said 'yes doctor, I want it, I persist, I maintain, I want assistance in dying'" may ultimately be "unable to do so for "various reasons," such as "anxiety" or "stress."

For Catherine Vautrin, self-administration translates into action, right up to the last moment, the patient's "will" to die. But perhaps "indeed, the case of the patient who said yes, I self-administer, but who, at the moment of drinking the product, for example, or injecting it, is not capable, perhaps requires support at that moment," she suggested.

"If we leave it to the doctor to determine what constitutes a physical inability to do so," some might consider stress to be one of them, while others might not. "It's not acceptable," worried Socialist Party MP Stéphane Delautrette.

An amendment to allow a "close relative" to administer the lethal product was rejected. Another amendment seeking to open the possibility of assisted dying, taking into account advance directives, was rejected. In the evening, the House began discussing another key article, the one defining the eligibility criteria for assisted dying .

Five cumulative criteria are provided for in the text from the commission: being at least 18 years old; French or resident 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" which is resistant to treatment or unbearable; being able to express one's wishes freely and in an informed manner.

Shortly before midnight, an amendment seeking to open access to assisted dying from the age of 16, with parental consent, put forward by the rebellious MP Hadrien Clouet, was rejected.

Earlier in the day, MPs debated the definition of assisted dying and its semantics, with some opponents attempting, unsuccessfully, to replace it with the concepts of "assisted suicide" and "euthanasia."

Others have sought to challenge the notion of a "right" to assisted dying, believing that "a right" was going too far and preferring the simple "freedom" that offers a possibility. The right experienced the same setbacks when it tried to clarify the notion as "active" assistance in dying.

"Assisted dying already exists. And all doctors and nurses provide assisted dying. We provide assistance without causing death," worried Philippe Juvin (Les Républicains).

"Administering a lethal substance, how can that be helpful? It will always be administering death," fumed Christophe Bentz (National Rally).

Crossing political divides, the bill on assisted dying is expected to continue to be fiercely debated in the House starting at 9 a.m. on Monday. Some 1,774 amendments still need to be considered.