France's National Assembly Reignites End-of-Life Debate with Two Key Proposals
๐๏ธ End of Life: The National Assembly Appoints Rapporteurs for Two Legislative Proposals!
After the dissolution of the National Assembly halted discussions on the initial bill, the debate on end-of-life care officially returns to Parliament. Two new legislative proposals were submitted in early March: one on palliative care, led by MP Annie Vidal (Renaissance), and another on assisted dying, proposed by Olivier Falorni (LIOT).
The appointed rapporteurs will be --- for the PPL on palliative care and โ for the PPL on end-of-life care.
๐ Legislative Evolution
- June 9, 1999: First recognition of the right to palliative care, ensuring end-of-life patients access to appropriate care and support.
- Kouchner Law (2002): Established the right for patients to refuse treatment, enshrined the principle of informed consent, and highlighted the need for better pain management.
- Leonetti Law (2005): Introduced the right to refuse excessive treatment and implemented advance directives.
- Claeys-Leonetti Law (2016): Created the right to deep and continuous sedation until death, without legalizing assisted suicide or euthanasia.
๐ A Turning Point with the CCNE Opinion (2022)
On September 13, 2022, the National Consultative Ethics Committee (CCNE) published a report that significantly influenced the debate:
- CCNE considered that active assisted dying could be envisioned under strict conditions but only with significant improvements in palliative care.
- The committee warned against potential risks and the current insufficiencies in Franceโs palliative care system.
Despite these developments, many argue that the current framework remains insufficient, leaving some patients suffering without adequate solutions. In this context, the April 2024 bill sought to go further by authorizing assisted dying under strict conditions while reinforcing palliative care.
โ๏ธ Why Two Legislative Proposals Instead of One?
In April 2024, the debate centered around whether palliative care and assisted dying should be addressed in a single bill. Eventually, they were split into two separate proposals.
- Clarifying debates and forming political majorities: Separating the topics allows for clearer discussions and better consensus-building. Prime Minister Franรงois Bayrou supports this approach, as do organizations like the French Society for Palliative Care and Support.
- Ensuring coherence: Some argue that palliative care and assisted dying are inseparable and should be addressed together to maintain a consistent legislative approach. National Assembly President Yaรซl Braun-Pivet and MP Olivier Falorni oppose the separation, fearing it will weaken the impact of the assisted dying proposal.
Ultimately, the governmentโs vision prevailed.
๐ฅ Key Debate Points
- Ethical and political sensitivities: Assisted dying remains a deeply personal and divisive issue. By splitting the legislation, the government aims to prevent overall deadlock and enable a more focused discussion on each aspect.
- Guarantees for healthcare professionals: Some fear that legalizing assisted dying without significant investment in palliative care could compromise patient care. A separate palliative care bill reassures professionals of the governmentโs commitment.
- Inequalities in access to palliative care: Nearly two-thirds of patients in need do not have access to palliative care*. If assisted dying becomes more accessible than proper end-of-life care, it raises serious ethical concerns.
- Criteria for assisted dying: Current proposals include strict conditions (incurable illness, refractory suffering, repeated request, etc.). Some find these criteria too restrictive, while others worry about a gradual expansion of euthanasia.
- Coordination between the two laws: Many lawmakers insist that assisted dying should not be implemented until there is guaranteed nationwide access to quality palliative care.
๐ Next Legislative Steps
Both legislative proposals will be reviewed by a special commission before being debated in a plenary session starting in May.
The rapporteurs for the PPL Soins palliatifs are Annie Vidal (EPR) and Franรงois Gernigon (HOR) and for the PPL Fin de vie are Olivier Falorni (DEM, rapporteur gรฉnรฉral), Stรฉphane Delautrette (SOC), Elise Leboucher (LFI), Brigitte Liso (EPR) and Laurent Panifous (LIOT)
๐ฌ What do you think? Should assisted dying be integrated into the existing legal framework or require a specific reform?
*Source: French Society for Palliative Care and Support (SFAP).
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