Legalize active assistance in dying while strengthening palliative care so that access becomes truly “universal”: this is the will expressed by candidates like Jean-Luc Mélenchon or Anne Hidalgo. The socialist candidate plans to make the end of life one of her first measures if she is elected, while before moving forward on the subject, Emmanuel Macron proposes to resort to a citizens’ convention.
This prospect of legalizing euthanasia while developing palliative care satisfies Yoann Brossard, the general delegate of the Association for the right to die with dignity (ADMD). “These are two complementary components, which do not meet the same needshe explains. Palliative care is useful, if it is the patient’s choice. But they can’t do much about pathologies like Charcot’s disease. »
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Furthermore, palliative care does not necessarily correspond “to the convictions and personal choices of each”continues the activist. “Some patients will want to live things to the end. But others feel cornered and do not want to wait for their vital prognosis to be committed “in the short term” to die. Everyone should be able to decide to stop whenever they want, depending on what they feel capable of enduring. »
Choosing his end of life, a decision “free” that several candidates defend in this campaign. “From the moment a person has made their choice, they must be granted this possibility, including that of assisted suicide”, advocates Yannick Jadot. Jean-Luc Mélenchon sees in it a “fundamental freedom”.
Two opposing philosophies
A vision of things that many experts in palliative care do not share. “Palliative care is holding hands, euthanasia is holding a syringe. Recognize that it’s not quite the same philosophyworries Henri de Soos, jurist and author of the book The dead end of euthanasia (Ed. Salvator). In the first case, it is an accompaniment; in the second, a renunciation. The dividing line is the ban on killing. The legalization of euthanasia would open a breach in this foundation of our society. »
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On the right, Valérie Pécresse joins this line of opposition to euthanasia and calls above all for better application of the current law: “The scandal is that today 50% of French people do not have access to palliative care. I want a palliative culture that grows everywhere,” she declared in January on France info. Eric Zemmour doesn’t want to go either “beyond the law”.
Yoann Brossard challenges: “In Belgium, euthanasia is considered by some palliative care practitioners to be the ultimate care. » If the number of euthanasia increases (2.5% of all deaths in the country in 2019), “the workload of specialized palliative care teams has increased significantly in recent years”noted, in 2020, the latest report from the federal palliative care evaluation unit, while inviting teams and resources to be strengthened.
A “dull” pressure
On the ground, in Belgium but also in Quebec, where medical assistance in dying has been legalized since 2014, caregivers note however that “the spirit of palliative care has been short-circuited by euthanasia”. They describe a pressure “deaf” that patients sometimes put on to die ” quickly “, for fear of being a burden on their family.
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The use of medical aid in dying “causes distress among palliative care caregivers and impacts their relationship with patients,” indicated a Canadian study published in February 2021 by the American scientific journal Palliative Medicine.
“To kill is not the role of the doctor, there is a conflict of values, insisted Henri de Soos. He cannot, on the one hand, find the means to relieve the last moments of a patient and, in the next room, practice euthanasia. »