The question of legalising assisted suicide is becoming increasingly relevant in France due to current and changing legislation in other European countries, and recently established domestic laws which give dying patients more autonomy. French public opinion largely supports legalising assisted suicide in certain circumstances; 93% of French people favour a law which allows doctors to perform medically assisted suicides with the patient’s consent on those suffering from an intolerable or incurable illness.
Where euthanasia requires a doctor to administer a lethal substance to a patient, assisted suicide requires that the patient administer it themselves (after receiving a doctor’s prescription).
Euthanasia therefore poses a significant ethical problem to doctors who, despite the patient’s consent, would be responsible for their death. The French National Medical Council’s President asserts that the Council is against euthanasia, but if assisted suicide or euthanasia are legalised, doctors should be legally protected.
Emmanuel Macron announced a citizens’ convention on September 13, where the government will consider changes to the laws regarding euthanasia and assisted suicide. A consultation will start on December 9, with a report due in March that will guide governmental discussions. Any modifications to legislation will be executed by the end of 2023.
Although in recent decades, various changes to legislation have given patients more autonomy in the time leading up to death, the French government is reluctant to pass a law which legalises assisted suicide.
In 2005, the Leonetti law allowed doctors to withhold or withdraw life support treatment and intensify use of medications that may hasten death. Though patients could refuse treatment, physicians were not obligated to accept their decision. A 2009 survey shows the relevance of this law with 47.7% of deaths following at least one medical decision that may have quickened death.
In 2016, the Claeys-Leonetti Law granted patients the right to refuse all treatment and receive continuous deep sedation. Although this method allows patients to avoid intense pain before death if they choose to withdraw all treatment, death may take up to weeks. In this way, one can choose to die, but not in a sudden way, which is allowed in other European countries.
Multiple neighbouring countries have legalised euthanasia or assisted suicide, including Belgium, Switzerland, the Netherlands, Luxembourg, and Spain. Switzerland currently allow access to assisted suicide to foreigners who have no connection to the country, the reality being that many French people travel there to die. French Deputy Olivier Falorni says that it is a ‘national hypocrisy’ that assisted suicide is still illegal in France in light of the fact that many French people die using medical assistance either illegally in France or legally abroad.
In 2020, Alain Cocq, a French man who suffered from an incurable illness, died through medical assistance in Switzerland. He had twice tried to die through refusing food and medical care (with rights to do so established under the Claeys-Leonetti law), but stopped due to intense pain. He even urged President Macron in an open letter to allow him to receive an assisted suicide but was denied the procedure.
Cocq’s case is often referenced in the debate over what dignity looks like in the final period of one’s life.
The 2016 Claeys- Leonetti Law aims to allow patients to keep their dignity at the end of their life by reaffirming their rights to stop all treatment. This law establishes that ‘everyone has the right to a dignified and peaceful death’, and that medical professionals should use all available resources to respect this right. However, 69% of French people say that the Claeys-Leonetti law should be strongly modified or abolished due to its ineffectiveness.
Alain Cocq, in his open letter to Macron, explains that he is not living a dignified life because medical support is no longer effective in reducing his symptoms or providing effective care. In his case and many others, the right to stop all treatment did not allow him to keep his dignity but instead only heightened his suffering.
Alternatively, the Catholic Church argues that assisted dying lacks dignity and that the practice wrongfully promotes the idea that once life reaches a certain stage it is not worth living.
Pope Francis strongly opposes medically assisted death, commenting that, ‘If we kill with justifications, we’ll end up killing more’. He believes that doctors are employed to ‘provide care and relief’ and thus ‘we cannot ask caregivers to kill their patients’. Despite France’s political secularism, his opinion is still pertinent; an estimated 63% of France’s population identify as Catholic. Regarding religion, the debate boils down to whether lives and deaths are determined by God or individuals.
French public and political opinion suggests that the laws towards euthanasia may change by the end of 2023. Though President Macron is largely silent regarding the issue, he has expressed that he is in favour of moving towards the Belgian model. In an interview in 2017 he said that he would like to choose the conditions of his death. Nonetheless, there is still significant backlash from religious groups and medical professionals due to the moral implications of assisting a patient in death. The outcome of this debate is likely to highlight the strength of religiously based morals, despite France’s secularism, in the country’s public and political life.