End-of-life bill: Not a new right or freedom, says Catherine Vautrin

End-of-life bill “It’s not a new right, it’s not a freedom,” but rather an “ethical response to patient support needs,” Health Minister Catherine Vautrin said at the conclusion of the Council of Ministers where the end-of-life bill was presented this Wednesday morning.

The text “relating to the support of the sick and the end of life” represents the main social reform of the second five-year term of Emmanuel Macron, who has long pledged to change legislation in this area. However, it runs the risk of awakening strong ethical and religious contradictions based on the legalization of euthanasia and assisted suicide.

Very strict conditions

The Executive refuses to use these two terms and prefers the term “assisted dying”. But the point is to offer certain patients the means to commit suicide, and when they are unable to carry out this fateful gesture, to do it for them.

The fact remains that the conditions will be very strict, as Catherine Vautrinová, who carries the text in the government, detailed again on Wednesday.

Aid in dying will be reserved for the patients born in France or long-term residents of the country who are able to express their wishes clearly.

The text “excludes psychiatric diseases”, the minister specified in particular.

It will also be necessary to experience unbearable and impossible to cure suffering, physical or psychological. Finally, the crucial prognosis must be made in the short or medium term, a formulation that actually leaves caregivers with a lot of room for judgment.

“The average time is six to 12 months,” explained Catherine Vautrin, while many caregivers worry that it will be difficult to make reliable medical predictions in this time frame. However, the responsibility of carers will be central. Once a patient requests assisted suicide, it will be up to the doctor’s decision after the procedure, which will give him up to fifteen days. He will do it himself, even if he has to consult with another doctor and nurse. In other words, it will not be a “collegial” decision, contrary to what Macron announced.

The “French model” of the end of life

For the head of state, these conditions allow for a “balance” by creating a “French model” of the end of life. However, this proclaimed middle path does not fully satisfy either opponents or supporters of the legalization of assisted suicide or euthanasia.

The former express a strong rejection in the face of what they consider to be a fundamental deviation. These include people of faith, particularly Catholics and Muslims, as well as many carers, particularly in palliative care.

According to them, we should first deal with the development of this care, which is still not very accessible in France, to ensure that patients do not ask for death because they cannot find care adapted to their last days.

According to a study by the French Society for Support and Palliative Care (Sfap) published in La Croix, 80% of professional members “refuse to prescribe, provide, prepare and/or administer a lethal product”.

A year of reflection marked by many postponements

The subject of palliative care is certainly also included in the bill. And their development is the subject of a “ten-year strategy”, which was also presented to the Council of Ministers.

In particular, it plans to gradually increase public spending in this area to reach 2.7 billion euros per year in 2034 – compared to the current 1.6 billion.

But “for the moment, the means are not there at all”, says Olivier Marleix, the leader of the LR deputies, to Franceinfo.

Proponents of assisted dying are disaffected but less virulent. If they regret overly restrictive conditions, they will be relieved to see that the text they feared would fall by the wayside arrives.

The Executive Director actually took his time to develop this project: a year, marked by many delays. Deputies will start discussing the text in the chamber at the end of May, which is the beginning of a long parliamentary journey that could take up to two years before the law is adopted in its proper form.

On Wednesday afternoon, a special ad hoc committee will meet to nominate its key positions and decide on the work schedule. MOD MP Olivier Falorni, a long-time advocate for the legalization of euthanasia and assisted suicide, is strongly expected to win the key position of chief rapporteur.

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