France's assisted dying law 'too restrictive', advocates say

France's new ‘right to aid in dying’ law is a significant step that has been a long time coming, say campaigners, although they believe it remains too restrictive.

Philippe Lohéac, general delegate of the Association pour le droit de mourir dans la dignité (ADMD), said it brings France closer to countries such as Belgium and Switzerland, but does not yet go far enough.

The law will come into effect once ministerial decrees are published. The right will be available to adults capable of expressing a free and informed decision who have a serious and incurable condition that endangers their life and is in an ‘advanced’ or ‘terminal’ phase.

This must be accompanied by suffering that cannot be alleviated by treatment, or that is unbearable when a patient has chosen to stop or not receive treatment.

How the new law changes the rules

Under existing laws, patients could refuse treatment even if this might shorten their lives, while doctors were required to avoid treatments considered to be serving only to keep someone artificially alive.

In certain circumstances, patients expected to die in the short term could also request profound and continuous sedation until death.

Mr Lohéac said the latter essentially applied to people “in the very final hours of their life”.

“Now we’re talking about the administration of a lethal drug, at the person’s request, for people whose lives are certainly at risk, but without a specific time period. That takes us a great deal further.”

He gave the example of someone with incurable cancer and extensive metastases who is suffering but is not yet considered to be in a terminal phase.

Campaigners say law remains restrictive

Many supporters compare assisted dying with putting down a suffering pet.

“They tell us: ‘When my dog was ill, I did what was necessary. He died without suffering. And my husband was in agony. He was screaming, but we didn’t do anything.’”

Mr Lohéac stressed that ADMD does not make this comparison, as an animal cannot express its wishes.

He said the requirement for a condition to be ‘life-threatening’ should leave doctors some flexibility in their interpretations.

However, ADMD is concerned by the exclusion from the law of people whose suffering is purely psychological.

“There are some very serious, life-threatening illnesses, such as motor neurone disease, which sometimes do not cause physical suffering until the most advanced stages… We are excluding people who are, in fact, in appalling situations in terms of their health.”

Calls for wider choice

ADMD would also wish people to have a free choice to request euthanasia by a doctor, whereas the law says the drug will be self-administered unless the person is physically incapable of doing this.

Mr Lohéac would also wish people to be able to request aid in dying through their living wills (directives anticipées) - for example, if they later develop serious dementia.

As it stands, patients must still be capable of a lucid decision when the act takes place.

The Connexion spoke several times to former ADMD vice-president Jacqueline Jencquel, from Paris, who wanted people approaching advanced old age to have the right to choose to die before experiencing the frailty and illness that can accompany it.

She died by suicide aged 78.

Mr Lohéac said that she is missed, but she probably would not have benefitted from the new law.

Though he said her full health situation was not known, “in Jacqueline’s case, there was above all a weariness with life, which is perfectly understandable, but there we’re dealing with something entirely different”.

He added: “That’s legitimate and respectable, and we can’t judge, but the law cannot cover this sort of life plan, which isn’t based on a medical condition but, rather, on a philosophy.”