ParisAP —
France’s parliament on Wednesday gave final approval to a bill that would allow adults with incurable illnesses to be given lethal drug treatments, the culmination of years of debate over end-of-life care.
The House of Representatives supported the bill on its previous three readings and approved it by a vote of 291-241. The vote completes parliamentary work on the bill announced by French President Emmanuel Macron more than three years ago.
“In 2022, I vowed to forge this path together with the French people,” President Macron said in a message posted to X. “With all seriousness, humility, and with the utmost respect for our democracy, that promise has been fulfilled.”
According to various estimates, approximately 300 million people worldwide have access to assisted dying, with euthanasia legal under certain conditions in some countries, and assisted suicide permitted in other countries and some US states. France’s population is aging and the number of patients requiring care for chronic diseases is increasing.
France, a traditionally Catholic country, has grappled with legal, medical, moral and religious questions regarding end-of-life options. These include existing laws that allow doctors to keep terminally ill patients under sedation before death, but not assisted suicide or euthanasia.
“Representatives of the people have risen to the occasion in these debates. This is the longest debate since the 1980s,” said National Assembly Speaker Yael Brown Pivet.
Many French people have traveled to neighboring countries where medically assisted suicide or euthanasia is legal. Medically assisted suicide typically involves a patient voluntarily taking a lethal drug prescribed by a doctor. Euthanasia involves administering a lethal injection by a doctor or other medical professional at the patient’s request.
End-of-life options are also being debated in the UK. The bill to legalize assisted dying in England and Wales is due to formally return to parliament on September 11, five months after time expired in the last parliament.
The proposed measures in France primarily provide for medically assisted suicide by allowing patients to administer and self-administer lethal drugs under strict conditions. Only those who are unable to do so due to poor health may receive assistance from a doctor or nurse.
Patients wishing to end their own life must be over 18 years old and must be a French citizen or legal resident of France.
Doctors must first consult a team of medical experts and then confirm that the patient has a serious, life-threatening and incurable disease. The patient must be in advanced or terminal stages, experiencing pain that cannot be relieved or intolerable, and voluntarily seek lethal drug treatment.
Lawmakers specified that mental suffering alone does not qualify for medically assisted dying.
People with severe mental disorders or neurodegenerative diseases such as Alzheimer’s disease are also excluded.
Patients will initiate an application, which will be reviewed by a medical professional within 15 days and approved after a deliberation period lasting at least two days.
If approved, people would be able to take the lethal drug at a location of their choice, such as their home or a medical facility, with a loved one present if they wish.
On the selected day, the doctor or nurse should remain nearby to confirm that the patient still wishes to proceed and to intervene if complications arise.
France’s national health insurance system will cover all related costs.
A 2023 report found that most French people support legalizing end-of-life options, with opinion polls showing support has increased over the past two decades.
The Right to Death with Dignity Association said the law would allow people to “freely and knowingly choose to end excruciating suffering”. “The law that creates new rights does not force anyone to exercise them, but it ensures that everyone … remains at the center of the medical decisions that concern them and that their wishes are respected,” the association’s president, Jonathan Dennis, said in a statement.
Opponents say the measure could put pressure on older people and people living with illness or disability.
Anti-euthanasia group Alliance Vita said in an open letter to Mr Macron: “Every effort must be made to ensure that those who suffer have immediate access to palliative care and support. Presenting death as a desirable solution is never an acceptable response to suffering and is contrary to human dignity.”
The conservative-controlled Senate rejected the bill. However, in France’s legislative process, the National Assembly has the final say if the two houses of Congress disagree.
Senate President Gerard Larchet and Prime Minister Sébastien Lecornu said they would refer the bill to the Constitutional Council, which would have up to a month to decide whether it was constitutional. The law will only come into force after its review is completed.
“There was extensive debate in Congress about this bill, but the debate in the Senate did not allow for such thorough consideration in order to create a bill that responds to both the aspirations of its supporters and the concerns of those concerned about how the bill would be implemented,” Lecorne said.
Opponents of a bill to legalize assisted dying in the United Kingdom blocked its passage in the House of Lords after introducing more than 1,200 amendments over a range of concerns, including the potential for coercion of vulnerable people and the lack of safeguards for people with disabilities.
That was in April after elected members of the House of Representatives passed it.
The bill, which is expected to be reintroduced, proposes allowing adults in England and Wales with less than six months to live to apply for assisted dying, subject to the approval of two doctors and a panel of experts. One of the aims is to ensure that people no longer have to travel to other countries, such as Switzerland, to receive assisted dying.
In Germany, the Bundestag considered two proposals to regulate assisted dying in 2023 and rejected both.
