MPs pass end-of-life bill in France – what does it contain?
The aim is to create new legislation on the right to die
French MPs have approved a revised text that outlines certain conditions for the access and administration of the right to die
sasirin pamai / Shutterstock
French MPs have approved in first reading a revised bill that aims to create new legislation on the right to die.
It comprises two texts – one strengthening palliative care and another establishing a conditional right to assisted dying.
The bill will now return to the Senate in April (a previous version was rejected outright at first reading there in January).
This is the second time that MPs have voted on the bill. It was passed after its first parliament reading last May, by 305 votes to 199. The most recent version passed by 299 votes to 226, on February 25.
The latest version includes amendments and provisions for controversial elements of the text that have been under discussion for years, including new agreements on the development of palliative care for terminal patients.
It comes after President Macron promised in 2022 to create a regulated system for the right to die in France - also known as ‘assisted suicide’ or ‘euthanasia’, although these terms do not appear in the text.
“I think of all these sick people. Of their loved ones. They are the ones who made me understand that sometimes there is something worse than death,” said Olivier Falorni, Democratic Movement (MoDem) MP and general rapporteur of the text, in the chamber.
“Today, we are telling them that we have heard them and that they will finally have the right in our country to be able to die in peace, in freedom and with humanity.”
President Macron followed the debates surrounding the texts closely and welcomed the fact that they took place in a respectful context, which allowed "the wording to be balanced and progress to be made towards a humane model”, his office said in a statement to news television channel LCI.
What does the text include?
The text outlines certain conditions for the access and administration of the right to die, including:
Eligibility
To be eligible for assisted dying, the applicant must meet five conditions:
be of legal age
be a French or resident in France
suffer from a ‘serious or incurable condition’ that is ‘life threatening’
be ‘able to express their wishes freely and in an informed manner’
be suffering in a manner that is ‘either resistant to treatment or unbearable, according to the person when they choose not to receive or to stop receiving treatment’.
MPs spent much time considering the definition of ‘suffering’, and the conditions in which a patient should be able to access the right to die or not.
The text had stated that the patient must be experiencing ‘physical or psychological’ suffering, but MPs revised this provision before the most recent vote. The new wording specifies that ‘psychological suffering alone cannot under any circumstances qualify a person for assisted dying’.
The measure is intended to prevent people from seeking assisted dying on the grounds of psychological distress that may prove temporary, even if it does not seem so at the time.
Examples include a person “who is diagnosed with advanced cancer with a life-threatening prognosis” who is “without significant physical pain but experiencing psychological distress”, said Health Minister Stéphanie Rist.
Their psychological state in this case could “reflect a temporary vulnerability”, and their request to die would not be considered “a free and informed choice”, she said.
MPs also discussed how to find a balance between the protection of vulnerable people, and the individual freedom of people who want to choose to end their life.
Collective decision
The decision cannot be made by one doctor alone. A doctor who receives a request for assisted dying must organise a meeting, with:
A close relative of the patient can also be present if the patient so wishes, MPs added to the bill.
Decision parameters
The decision cannot be made in a single day.
The decision of whether to grant the request will be made within 15 days. The patient will then have two days to confirm their choice.
The patient may withdraw at any time for any reason. In as many cases as possible, the patient should administer the end of life procedure themselves, with medical staff only stepping in when the patient is ‘physically unable to do so’, the text states.
The text also provides for the creation of support homes (maisons d’accompagnement) for patients, to act as an intermediary space between hospital and home.
Criticisms
The text is not without its critics or opponents.
Government spokesperson Maud Bregeon has said that in her personal view, the text “goes too far”. She told FranceInfo: “I think that this bill is opening a Pandora’s box and does not set sufficient limits to protect society from abuses.”
She said that the bill should be “limited to incurable diseases leading to death in the short term”, but the version passed goes further than this.
Senate debate
The text must now return to the Senate in April, for further debate. The higher chamber rejected the previous bill.
“The journey, as you know, is not over,” said Yaël Braun-Pivet, president of the Assemblée Nationale. “We are in a long legislative process. We must take our time. I hope that the Senate will also take the time to examine this text and try to find a way forward.”
After examination in the Senate, the bill will then be presented to a joint committee in a bid to find consensus on any still-debated points – although this is expected to be hard due to the controversy of the text. The bill will then be subject to a new reading and debate in the Assemblée and Senate.
