France: euthanasia controversy rekindles end-of-live care debate

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Par Le Figaro pour le cercle :

For now, there is no evidence that Dr. Bonnemaison, suspected of having ended the lives of four patients in Bayonne, committed euthanasia, as defined by a deliberate act intended to put an end to a person’s life at his request. But this incident revived the debate on end-of-life care.

• What does French law say?

Unlike countries like the Netherlands, Belgium or Luxemburg, which have legalized euthanasia, this practice remains illegal in France. However, the Léonetti law of 23 April, 2005 established the right to “let die.” The law opposes the “unreasonable obstinacy” of undertaking or continuing “unnecessary or disproportionate” treatment, “with no other effect than maintaining life artificially.”

The law also allows a person “in the advanced or terminal phase of a serious and incurable affection” to request limiting or ending treatment. The physician must respect the person’s “will after having informed him of the consequences of his choice.” If the patient is not able to express his wish, the decision can be made by the medical team, in consultation with the family, a person of trust or a loved one.

• Has the situation changed?

With the new system, which applies to most situations, many practitioners confronted with end-of-life patients have begun to change their habits. “This law makes it so one doesn’t have to act alone and enables all those – doctors, nurses, physiotherapists, etc – that surround the patient and take concrete decisions to meet together,” said Pr. Alain Serrie, responsible for the pain and palliative care unit at the Lariboisière Hospital, Paris. “Furthermore, an external doctor, who gives his opinion after reviewing the record and the patient, is always called in.”

Thanks to the current system and to considerable progress in pain management in recent decades, “pain should no longer be a motive for requesting euthanasia,” according to Pr. Serrie. More than five years after its creation, the Leonetti law remains however little known. According to a survey in early 2011, more than two in three French people “do not know that there is a law banning the prolonging of life by medical means,” and one in two feels insufficiently informed about palliative care.



• A bill defeated in the Senate

In January, a bill establishing “medically-assisted death” was discussed in the Senate. For the first time, parliamentarians from several groups supported it: Senators Alain Fouché (UMP), Jean-Pierre Godefroy (PS) and Guy Fischer (Communist). The Senate’s Committee on Social Affairs adopted the text initially but later changed its mind. The majority party (UMP) rallied behind Prime Minister François Fillon against the project. In the minority party (PS), some elected officials are also opposed to euthanasia, including Robert Badinter.

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» Related article: Euthanasia, a French doctor under investigation

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