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JOHN LICHFIELD

OPINION: A French referendum on the right to die would be a disaster

As France prepares to once again examine the highly controversial topic of assisted suicide and euthanasia, John Lichfield has just one request - spare us a referendum on this most divisive and easily misrepresented of subjects.

OPINION: A French referendum on the right to die would be a disaster
A demonstrator calling for relaxation in France's right-to-die laws. Photo by BORIS HORVAT / AFP

In France, everything is political, even death. One might think that President Emmanuel Macron has enough problems to solve without opening the moral and political Pandora’s Box of euthanasia and/or “assisted suicide”.

During the presidential election campaign earlier this year, Macron promised new legislation on the subject. On Monday, he announced that a Citizen’s Convention will be created next month to report by the end of March on a possible new End of Life law – the fifth on the subject in France in 24 years – by the end of 2023.

The President’s announcement produced an immediate volley of abuse from his political opponents, Left and Right.

Macron was, they said, desperately looking for some kind of legislative monument to his time in the Elysée Palace. He was trying to distract attention from the crisis which threatens the French health service this winter.

A comprehensive law on the End of Life was passed only six years ago, they said. It was still poorly understood by the public and patchily applied. Why now? Why change the law again so soon?

Macron’s timing was forced partly by an independent report, published on Tuesday by France’s principal watchdog on  medical ethics, the Comité consultatif national d’éthique (CCNE). The 40 strong committee – with eight dissenting voices – recommended, with many qualifying adjective and clauses, that French law on Life and Death should be revisited yet again.

Forgive me if I go into some detail. It’s a tricky subject. 

The existing French law from 2016, the Claeys-Leonetti law, forbids both euthanasia (a deliberate act by a medical practitioner to shorten life) and assisted suicide (the provision of drugs by medical staff to allow a suffering patient to take his or her own life).

The law does, however, state that terminally ill patients have a right to “sleep before they die, so as not to suffer”. Anyone with only a short time to live has a right to “deep sedation until death”.

Tuesday’s majority report  by the medical ethical watchdog said that this six-year-old law was no longer in line with advances in medicine and society. Permanent sedation was not suitable for people who might survive for many months.

“Respect for the right to life should not oblige people to endure lives that they find intolerable,” the ethics committee concluded. “There is no obligation to live.”

It suggested that France should consider going further down the legal road – or various roads – already taken by Switzerland, Belgium and the state of Oregon in the United States.

Consideration should be given, with many legal and ethical safeguards, to allow “access to assisted suicide” for “adults with grave and incurable illness producing great suffering” who are expected to die in the “medium term”.

“Euthanasia” – a deliberate act by a qualified doctor – should also be considered for suffering patients who are too physically or mentally incapacitated to end their own lives.  A statement authorising such an act would have to be signed while the patient was still able to do so. In such cases, a final decision would be made by a judge.

If followed, these cautious recommendations would make French “End of Life” law amongst the most liberal in the world – but not quite so liberal as in Belgium or in Switzerland. The Franco-Swiss film director Jean-Luc Godard, who died this week aged 91, is reported to have taken advantage of the legal Swiss right to assisted suicide.

The proposals by the ethics watchdog and Macron’s Citizen’s Convention will doubtless be muddled and misrepresented in the months ahead. Life and Death, and the frontier between them, are difficult subjects at the best of times – open to both honest confusion and deliberate falsification

All the more reason, you might think, to leave such issues alone, if you are a President without a majority in the National Assembly and a traffic-jam of other more pressing problems to address.

In a briefing with Elysée correspondents on Monday,  President Macron said that he was “convinced” that it was time to act because “inhumane situations” still existed. He said he had no ready-made answers  to questions which were “anything but easy” .

In March, Macron praised the existing Belgian law which allows assisted suicide and euthanasia (even for minors). On Monday, the President said that the Belgian model was “not necessarily the one to follow exactly”.

He said that he hoped that the citizens’ convention would come up with a “text” which could go to parliament for amendment and maybe to a referendum by the end of next year.

One of the strongest arguments against a new law is that France has not yet properly absorbed the existing one. The 2016 law insists that all patients near the end of life have a right to permanent relief from suffering.

And yet France has yet to create the medical capacity to make that possible. Palliative care remains a poor relation in the French health service. The Inspectorate general of Social Services reported recently that 62 percent – almost two in three – of dying patients in France do not get the end-of-life care that the law prescribes.

The medical ethics committee’s report this week said that there should be NO change in the law until palliative care in France offered the terminally ill the means of dying in peace and dignity without suicide.

On the other hand, many people who have lost an elderly loved-one to a prolonged illness (me included) know that there is sometimes a well-meaning hypocrisy or deliberate grey zone in palliative care. The difference between “deep sedation” and euthanasia, between sleep and death, is often mercifully indistinct.

Maybe it is best left that way; or maybe people should be given some control over their final days. It is a horribly difficult question. President Macron is perhaps right to raise it again.

But please, please spare us a referendum. The subject is far too complex and emotive for a referendum, which would generate an avalanche of conspiracy-mongering and Macron-hating nonsense on the internet. If anyone decides to change the law (again), it should be parliament.

Member comments

  1. Once the report comes out it will be time for discussion and reflection. A non-binding referendum could be part of that.

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POLITICS

Macron calls for stricter Twitter controls on Covid disinformation

French President Emmanuel Macron criticised Twitter's new boss Elon Musk on Thursday, saying the entrepreneur was wrong to drop the fight against Covid disinformation as he slashes back content moderation on the platform.

Macron calls for stricter Twitter controls on Covid disinformation

With his country facing a fresh surge in coronavirus infections, Macron said the subject of misleading Covid information should be addressed head on, not swept under the rug.

“I think this is a big issue,” Macron, on a state visit to the United States, told broadcaster ABC. “What I push very much, for one, is exactly the opposite: more regulation.”

He said such protections have been implemented and enforced in France and “at the European level.”

Freedom of expression remains paramount, Macron insisted, “but there is responsibilities and limits” to what can be written and disseminated.

“You cannot go into the streets and have a racist speech or anti-Semitic speech,” the French leader said. “You cannot put at risk the life of somebody else. Violence is never legitimate in democracy.”

Macron’s concept of freedom of expression within acceptable limits is far from the libertarian approach of Musk, a self-described “free speech absolutist” who has sacked many of the Twitter employees tasked with content moderation.

Musk has begun to allow Twitter users banned from the platform for posting disinformation, such as former US president Donald Trump, to return.

And it emerged this week that Twitter has stopped enforcing a rule preventing users from sharing misleading information about Covid-19 and vaccine effectiveness.

The billionaire Musk has made no secret of his fierce opposition to health restrictions put in place to fight the pandemic, especially when they meant the temporary shuttering of his Tesla electric vehicle factory in California.

“To say that they can not leave their house and they will be arrested if they do… this is fascist. This is not democratic, this is not freedom,” Musk raged in April 2020 on a conference call with analysts.

On Wednesday the European Union issued a sharp warning to Musk, saying he must do “significantly” more to fight disinformation, such as reinforcement of content moderation, in order to comply with EU law.

“There is still huge work ahead” for Twitter, said Thierry Breton, the EU commissioner for the internal market.

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