Emmanuel Macron unveils the draft law on the end of life in La Croix and Libération

At his request, Emmanuel Macron specifies in an exclusive interview given to La Croix and Libération, the outline of his bill for “assisted dying”, under “strict conditions”.

As expected, the bill will include three parts: a first on supportive care (Or palliative care), a second on the rights of patients and caregiversand a third on assisted dying.

Euthanasia or assisted suicide?

It will be a “assisted dying” which will, according to the President, be “neither euthanasia nor assisted suicide”. Emmanuel Macron specifies that “this new French model does not offer assisted suicide, it does not say that everyone can dispose of their life by requesting automatic assistance from the medical profession.”
However, these two procedures can be considered in a very supervised manner.

Who can request assistance in dying?

The bill provides that assistance in dying may be requested according to three criteria:

• To be of age.
• Being capable of full and complete discernment (patients suffering from psychiatric illnesses or neurodegenerative diseases “which impair discernment”, such as Alzheimer’s) are excluded.
• Being suffering from an incurable illness and having a compromised vital prognosis in the short or medium term.
• Suffering “suffering – physical or psychological – (…) refractory, that is to say, we cannot relieve.”

If these four criteria are met, the patient can then request assistance in dying.

What will then be the role of the medical profession?

According to Emmanuel Macron, it will be up to the medical team to decide whether the patient can receive assisted dying. After ensuring that the access criteria are met, she may, if necessary, seek the advice of specialists or caregivers who know the patient. The bill also provides that it is she who defines, with the patient, the terms of its implementation. The President adds, however, that if the patient considers that he has not been heard, he can refer to another medical team.

Who will carry out the lethal action?

To this question, the President responds by referring to the text of the bill:

“The administration of the lethal substance is carried out by the person himself or, when the latter is not able to do so physically, at his request, either by a voluntary person that she designates when no technical constraint prevents this, either by the doctor or nurse who accompanies him.”

Furthermore, the text of the law provides that this gesture can be carried out in “the most appropriate place, it being understood that none is excluded, home, nursing home or care establishment.”

What will be the implementation time between the patient’s wishes and assistance in dying?

Under the current bill, there will be a two-day wait from the moment the patient makes the request “to test the strength of the determination.” The response will then be given within 15 days. If the answer is positive, the prescription is valid for three months “period during which the patient can, of course, withdraw at any time”, specifies Emmanuel Macron.

What about palliative care?

Emmanuel Macron promises that with this bill, palliative care will be put back at the heart of support. “For patients, it will be a real revolution of humanity and fraternity in action.” He announces that each department without a palliative care unit – there are currently 21 – will be equipped with one, without specifying the timetable for this implementation. Furthermore, Emmanuel Macron affirms that he wants to “continue to deploy mobile teams which help hospital services to better manage pain.”

On the budget side, the President recognizes that to develop palliative care “we will have to deploy resources in particular for nurses and private doctors”. Today, 1.6 billion euros are allocated to supportive care. “With the ten-year strategy, over the entire period, we are going to invest a billion euros more” he specifies.

When will the law be promulgated?

The President does not announce a precise timetable.

First, the text will be transmitted within “eight to ten days” to the Council of State, before being presented to the Council of Ministers in April, then debated in Parliament.

“On a text which raises such issues, we are not asking for urgency, there will be no accelerated procedure” specifies the President, who promises to give parliamentarians time to work on it in committee. “It is a text on which you must have the humility to walk, to move, to accept that your convictions can be shaken up.”