2023-05-08 17:39:52
After the opinion of the National Consultative Ethics Committee (CCNE), published in September 2022, then the recommendations of the Citizens’ Convention made public at the beginning of April, it is the turn of the Economic, Social and Environmental Council (Cese) to take a position. in the national debate on the end of life, by asking for the opening of a “active assistance in dying”.
A little over a month after the announcement by President Macron of a bill expected before the end of the summer, the third assembly of the Republic meeting in plenary must examine, Tuesday, May 9 at the beginning of the following day. – noon, a draft opinion in response to the question addressed by the Prime Minister: “Is the end-of-life support framework adapted to the different situations encountered or should any changes be introduced? »
“The legislative framework does not respond to all medical situations”
Not surprisingly, this draft opinion that The cross was able to consult, titled “End of life: changing the law? »drawn up between the beginning of October 2022 and the end of April by a temporary commission appointed by the 19 groups that make up the Cese, is in favor of an opening towards the“active assistance in dying”in other words the legalization of euthanasia and assisted suicide.
In this respect, it is in line with the opinion “End of life: France at the time of choice”, adopted in 2018 by the same Cese which already advocated “to widen the field of possibilities” by allowing as “last care” a “explicitly lethal sedation”.
At the time, this point caused disagreements within the committee. This time, the thirty or so members came out unanimously in favor of a change in the law affirming “that at the end of life the right to support is open until active assistance in dying”. It remains to be seen if this unanimity will be found at the time of the vote in the Plenary Assembly or if, on the contrary, the Cese will be divided on this subject as was the Citizens’ Convention, 25% of the 184 participants opposing this development.
To justify its position, the Temporary Commission puts forward three arguments. “The first is that the current legislative framework, regulated by the so-called Claeys-Leonetti law of 2016, does not respond to all medical situations, in particular those of patients suffering from serious and incurable pathologies but whose vital prognosis is not is not committed in the short term, as in the case of Charcot’s disease”underlines Dominique Joseph, rapporteur of the opinion and secretary general elected the Mutualité française.
Fight against inequalities
The other strong reason given is the fight against inequalities. “It is not normal that French people who have the right information, networks and financial means can resort to active assistance in dying by going to Belgium or Switzerland when others are deprived of the right to choose freely. Equal access to the same rights for all has been the common thread of our thinking”, continues Dominique Joseph. Finally, the Commission emphasizes its concern to put an end to the “illegal euthanasia”both a source of legal risks but also of potential abuses.
Nevertheless, its members defend themselves from promoting active assistance in dying “open to all winds”. First, because the draft opinion advocates recognizing the right of health professionals to refuse to practice it by asserting a conscience clause. Above all, because the text devotes a long development to the urgent need to improve the application of the regulations in force, in particular to increase the human and financial resources granted to palliative care, as had already been strongly recommended I’CCNE opinion 139 and the report of the Citizens’ Convention on the end of life.
“To oppose active assistance in dying and palliative care would make no sense. This would be going against the humanist vision of a united, inclusive and emancipatory society supported by the Cese and in which this draft opinion is part., insists Dominique Joseph. The vote expected Tuesday at the beginning of the afternoon will indicate the level of membership of the 175 members of the assembly, if it recognizes itself in this project. A result that will weigh heavily in the foreseeable political consequences of this case since it will express the opinion of nearly 80 civil society organizations – employee and employer unions, business sectors, associations – in all its diversity.
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The main recommendations
Besides asserting a “right to open support up to active assistance in dying”,the Cese’s draft opinion lists 12 others “recommendations”.
Numbers 4 and 5 aim to promote the drafting and consideration of “advance directives”.Number 7 recommends upgrading leave compensation “caregiver” et “family solidarity” and strengthen the role of volunteers.
Number 8 suggests reviewing the financing of palliative care, via a programming law and a reform of hospital pricing. Number 10 invites the defender of rights to consider the situation of the most vulnerable with regard to their access to end-of-life rights.
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