France’s Constitutional Court approves assisted dying bill, highlights reservations
The bill was approved in its entirety but three clarifications made
France is set to officially legalise assisted dying after the country’s Constitutional Council approved a recently-passed law on the matter.
The council approved July’s bill – passed following years of debate on the topic – in its entirety in a verdict given on August 14, although it highlighted that certain sections required further clarification by the council itself.
The Conseil Constitutionnel can read laws after they have been approved by MPs and senators, to ensure they comply with the nation’s constitution – in this case “the principle of safeguarding human dignity.”
Passage through the council was the bill’s final potential legal obstacle. The health ministry will publish several administrative / practical related decrees over the coming months, with the law set to fully come into force in 2027, once facilities are prepared to carry out the procedure.
Once in force, long-term residents of France or French citizens over the age of 18 will be able to request assisted dying if they are suffering from a “serious and incurable condition” which is “life-threatening” and in an “advanced or terminal phase.”
They must either be unresponsive to treatment, or have stopped it/refused it and be in “unbearable” pain.
The method will be self-administered where possible or by a healthcare professional if not.
Approval of assisted dying was touted as a flagship policy by French President Emmanuel Macron during his re-election campaign in 2022.
It is another major legislation passed in the president’s second term, including enshrining the right to an abortion in the French constitution.
The council’s decision “brings an exemplary democratic debate to a close" and "provides an essential guarantee for our fellow citizens,” the president’s office said in a statement following the verdict.
“It is now possible to move forward with the implementation of this reform, certain that it rests on fully established democratic, ethical, and constitutional foundations,” the statement also said.
Clarification
Total approval means that no sections need to be cut before it is enshrined into French law, and the text can remain as-is without being submitted to further votes.
The council however required clarification on three main areas, requiring decrees to regulate concerns.
Firstly, it requires a decree to confirm the right of private healthcare facilities to refuse to offer assisted dying services if it goes against their stated mission (typically religious charities, etc), provided that there are no other facilities in the area that can carry it out.
These are the same rules that apply to facilities in relation to abortion.
In cases where the facility is the only one able to provide the service within a given area, they must allow the act to take place on the premises.
This can be undertaken via an external team that comes to provide the injection. Workers at the facility do not need to take part.
Secondly, the conscientious objection clause for those who do not want to administer the injection needs to be expanded to include pharmacists, as it currently only accounts for doctors and nurses.
This would include exonerating pharmacists from preparing lethal injections for other healthcare professionals to use.
Finally, it clarified rules for ‘legally protected’ adults who are under the guardianship of someone else.
The law states that only those who are “severely impaired” in their judgement – those not “capable of freely and knowingly expressing their will” – cannot give their consent, but concerns were raised that this reading would be extended to those under guardianship, even if they were otherwise mentally capable.
However, the council confirmed that the law was sufficient. Physicians will need to take into account the comments and opinion of the legal guardian during the process, but their opinion is not binding on the healthcare professional’s final decision.
