“There is a way for an ethical application of active assistance in dying” : in an opinion made public on Tuesday, September 13, the National Consultative Ethics Committee (CCNE) opens the door to a break in end-of-life support in France. While the Claeys-Léonetti law of February 2016 prohibits euthanasia but provides for the possibility of resorting to “deep and continuous sedation until death for sick people whose vital prognosis is engaged in the short term, with cessation of all treatments”, CCNE sets out the “strict conditions” in which a person could be actively accompanied in his desire to end his life (assisted suicide) or to call on a doctor to kill him.
The text marks a turning point for the institution. In its previous opinion on the subject in 2013, the Committee considered “dangerous for society that doctors can participate in killing”. The 2016 law took this position into account.
The evolution of CCNE, which took up the issue of end of life on its own in June 2021, is motivated by two observations: “deep and continuous sedation” is authorized for vital prognoses committed in the short term and the progress of medicine allows patients suffering from pathologies such as cancer to be kept alive for longer and longer with vital prognoses in the medium or long term without relieving pain . Patients suffering from neurodegenerative disorders for many years, without hope of remission are, for example, not necessarily doomed to die in the short term.
It also happens that in rare cases, “deep sedation” is not operative. Beyond several days under injection, it may happen that “the patient’s situation deteriorates without death occurring quickly”, notes Professor Régis Aubry, co-author of the opinion.
“No obligation to live”
CCNE also justifies its new position by societal changes: “The end of life is no longer perceived as an essential time of human experience. Rites of passage are disappearing, secularization is progressing, symbolic and spiritual representations are gradually fading. The committee points out that “ respect for the right to life is not equivalent to having to live a life deemed unbearable by those who cross it. There is no obligation to live”.
However, he does not go so far as to advocate a new law leaving the government responsible for opening up the political field or not. On the other hand, it sets out safeguards: “If the legislator decides to legislate on active assistance in dying, the possibility [d’une] assisted suicide should be open to adults suffering from serious and incurable illnesses, causing refractory physical or psychological suffering, whose vital prognosis is committed in the medium term. »
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