2023-11-09 07:30:09
Lhe great debate on the end of life will have given birth to a mouse if the long-awaited law does not give, in addition to details on palliative care, only very limited hope to patients who have exhausted all possibilities of care and request to be helped to die. However, this is what the indications given by the minister make us fear. [déléguée chargée de l’organisation territoriale et des professions de santé] Agnès Firmin Le Bodo on the bill which will be presented in December to the Council of Ministers. Here we are facing the risk of a new law for (almost) nothing.
The worst is not so much the priority that would undoubtedly be given to the self-administration of the lethal product by the patient (known as “assisted suicide”), an option preferred at this stage by the government – under pressure from medical institutions. It would fortunately be tempered: abandoning to their fate those who cannot make the last gesture themselves would be so unfair that a “law of humanity” – in the words of the minister – allowing administration of the lethal product by a third party (“euthanasia exception”it is said) is under study.
This arrangement is fragile, whereas the best would be for all patients eligible for assisted dying to have the choice between the two modalities, but always with the assistance of a caregiver who can place an IV, even if it means that the patient turns the wheel itself. This would avoid the regurgitation incidents sometimes deplored elsewhere, and would respond as much to a spirit of solidarity as of freedom.
What is “the medium term”?
Even more dangerous is the condition, presented as obvious by the minister, of a “vital prognosis engaged in the medium term” to benefit from active assistance in dying. It would in fact empty the law of a large part of its practical scope.
It is said to be a ” Red line “ posed by the President of the Republic. His speech on April 3, 2023 to the members of the citizens’ convention was, however, far from it. Listing the conditions of eligibility for assistance in dying, he identified discernment, the incurable dimension of the illness, the refractory nature of psychological and physical suffering, before mentioning, but as hypothetical and without further clarification, “vital prognosis commitment”.
We must therefore recall the true origin and potential effects of a vital prognosis condition engaged “in the medium term”. It comes to us from the all too famous “Oregon model” which the 2012 Sicard report described as the least bad form of assistance in dying, while refusing it on principle. To benefit from a prescription for a lethal product, a patient must only have a life expectancy of six months maximum. In 2022, opinion 139 of the National Consultative Ethics Committee placed this question of the foreseeable period of death at the heart of its reflection.
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