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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Pope arrives in Marseille for trip shadowed by migrant crisis

Pope Francis arrived in Marseille on Friday for a two-day visit focused on the Mediterranean and migration, bringing to France a message of tolerance amid bitter debate over how Europe manages asylum seekers.

Pope arrives in Marseille for trip shadowed by migrant crisis

Marseille was decked out in the yellow and white colours of the Vatican for the first visit by a pope to France’s second-largest city in 500 years, where 100,000 people are expected to turn out to see the pontiff in his “popemobile” on Saturday.

The 86-year-old is visiting to take part in a meeting of Mediterranean-area Catholic bishops and young people — but his trip comes at a politically sensitive time.

The pontiff disembarked at Marseille airport from his plane away from the view of cameras. He was then wheeled in a wheelchair towards Prime Minister Elisabeth Borne, who was waiting on the airport tarmac to greet him, an AFP correspondent said.

He then stood up from his wheelchair to acknowledge the welcome of a military band.

A surge in migrant boats arriving from North Africa on the tiny Italian island of Lampedusa last week trigged outrage in Italy and a heated debate across Europe over how to share responsibility for the numbers.

Marseille is a historic gateway for immigrants and also home to some of the poorest neighbourhoods in Europe, many of which are plagued by drug trafficking.

The desperate conditions that cause many people to leave their homes for a new life, and the risks they take to do so, have been a key theme during Francis’s decade as head of the Catholic Church.

Speaking at the Vatican on Sunday, he noted that migration “represents a challenge that is not easy… but which must be faced together”.

He emphasised the need for “fraternity, putting human dignity and real people, especially those most in need, in first place”.

Ahead of what will be his 44th overseas trip, Francis acknowledged this month that papal voyages were not as easy as they used to be.

He underwent hernia surgery in June, less than two years after having colon surgery, and routinely uses a wheelchair because of a troublesome knee.

Meeting pilgrims

Despite the decline in France of Catholicism, the once dominant faith, the pope’s visit has sparked huge enthusiasm, with almost 60,000 people expected at a mass on Saturday afternoon.

“Habemus papam” headlined regional newspaper La Provence, using the famous Latin phrase meaning “We have a pope!” used  on the election of a pontiff.

For Joseph Achji, a 25-year-old Syrian Christian originally from Aleppo, the pope’s visit is a “chance of a lifetime”.

He will head to the Basilica of Notre-Dame de la Garde, a symbolic monument overlooking the city, for a prayer with local clergy on Friday afternoon.

That will be followed by a moment of meditation with representatives of other religions at a memorial to sailors and migrants lost at sea.

The United Nations estimates that more than 28,000 migrants who have tried to cross the Mediterranean since 2014 have gone missing.

After 8,500 migrants landed on Lampedusa in three days earlier this month, the European Union promised more help for Rome.

But France, amid wrangling over a draft law governing migrant arrivals there, said it would not accept anyone from the island.

“We are expecting very strong words” from the pope, said Francois Thomas, head of Marseille-based SOS Mediterranee, which operates a migrant rescue boat in the sea.

“It is our humanity that is sinking if Europe does not do something.”

Mass with Macron

On Saturday morning, Francis will take part in the closing session of the “Mediterranean Meetings” event.

As well as migration, it will cover issues such as economic inequality and climate change — also themes close to the pope’s heart.

On Saturday afternoon, Francis will lead a mass at the Velodrome stadium, with French President Emmanuel Macron among those due to attend.

Macron’s attendance has sparked controversy among left-wing politicians in the officially secular country.

Some right-wing politicians have criticised the pope’s stance on migrants — but Marseille mayor Benoit Payan said the pontiff “has a universal message… of peace”.

Francky Domingo, who runs a migrant association in Marseille, said he hoped the visit would “give back a little hope” and “ease tensions at the political level”.

“Marseille is a cosmopolitan city, multicultural, multi-faith,” he told AFP, but faces “enormous difficulties”.