Citizens' assembly on assisted dying in France

08. September 2022
Rike / pixelio.de

French President Emmanuel Macron announced on 8 September 2022 that he wants to convene a citizens' assembly on assisted dying. With this, Macron wants to implement a promise made before the last presidential election. "Nothing is easy, but I believe that we have to move, for more humanity," Macron explained.

The citizens' assembly is scheduled to start on 9 December 2022 and last until mid-march 2023. The citizens' assembly will be organised by the Conseil économique, social et environnemental (Economic, Social and Environmental Council), the third chamber of the French parliament. Experts are to provide the participants with the necessary information.

Debates throughout the country

In parallel, debates are also to be organised in the regions of the country to reach out to all citizens and give them the opportunity to inform themselves and identify the challenges associated with assisted dying. In addition, the government also wants to exchange views on the issue with MPs and senators. By the end of 2023, this should result in clarifications and further developments of the legal framework.

"The debate on this delicate subject, which must be treated with great respect and caution, must give each of our fellow citizens the opportunity to consider the subject, to become informed, to appropriate the common reflection and to seek to enrich it",  reads a press release from the Élysée Palace. "The necessary time will be taken, and all guarantees must be given to ensure the conditions for an orderly, serene and informed debate."

Referendum on recommendations?

During the presidential election campaign, Macron had promised to "submit to the National Assembly or the people the decision to complete the path that is recommended". It would thus also be possible to hold a referendum on the assembly's recommendations on assisted dying after its conclusion.

Although there is broad support among the parties in France for allowing assisted dying, very conservative MPs and the Catholic Church continue to oppose it. Opponents of assisted dying, for example, consider palliative care in France to be too inadequate to allow assisted dying. Palliative medicine combats the effects of life-shortening illnesses.

Current regulation

Today, the Claeys-Leonetti law provides the framework for the end of life of terminally ill people in France. The law, passed in 2016 after an initial version in 2005, prohibits assisted suicide, but allows for "deep and continuous sedation until death" for terminally ill people with very severe suffering whose life prognosis is in danger "in the short term".

The law provides for the discontinuation of treatment in cases of "unreasonable obstinacy": At the patient's request, treatments can be "discontinued" if they "appear unnecessary or disproportionate or have no effect other than to maintain life artificially". If the patient cannot express his or her will, the decision must be made "collegially" by the doctors.

Ethics Council: "Allow assisted dying"

In a statement published on 13 September 2022, the National Ethics Council recommended allowing active assisted dying, but "under certain strict conditions". A new regulation of the law on the end of life must be inextricably linked to a strengthening of palliative care and must follow certain ethical criteria. According to the Ethics Council, this option should be open to persons of full age who suffer from a serious, incurable disease that causes therapy-resistant physical or psychological suffering and leads to death in the medium term. The wish for active euthanasia must be expressed by a person who has autonomous decision-making capacity and who expresses his or her wish in an informed and repeated manner.

However, the Ethics Council also sees an inequality if those who are physically incapable of these conditions fall outside the scope of the law: "The Council leaves it to the legislature to determine the most appropriate approach to regulating these situations when addressing this issue," the statement reads verbatim. Eight members of the Ethics Council expressed a reservation on the council's statement.

Jersey Citizens' Jury supports assisted dying

On the British Channel Island of Jersey, a citizens' jury had voted overwhelmingly in spring 2021 to change the law on assisted dying. 78.3 percent of the jury participants voted in favour of allowing assisted dying for adults under certain conditions. However, strict rules should be followed. A majority of 69.6 per cent also believed that assisted dying should be available for people with a terminal illness or unbearable suffering. 22 per cent were of the opinion that this option should be limited to terminally ill people.

On 24 November 2021, the island's parliament had approved the legalisation of assisted dying in principle. In 2022, a further debate on the procedure and safety rules is to take place. If these proposals are supported, a draft law could be debated and voted on in 2023.

Second national citizens' assembly in France

The Citizens' assembly on assisted dying in France would be the second national randomly selected assembly in the country. In June 2020, a 150-member climate assembly, also convened by President Macron, had adopted 149 recommendations. These included far-reaching proposals for the economy, transport, housing, trade and food in a 500-page citizens' report. With the proposed measures, the country's CO2 emissions should be reduced by 40 per cent by 2030. Critics had complained that not even ten percent of the recommendations of the citizens' assembly would be implemented.

Background