Why this precaution?
Out of a duty of honesty, but also to avoid falling into ideology. Because it is one thing to hear social rumors – the demands, for example, of people afraid of dying badly – and another to think about the response we give them. Part of the difficulty in debating this subject in the political world comes from this difference in approach.
Is this how you reflect on the desire for assisted suicide or active euthanasia desired by some today?
Yes, by emphasizing that, despite appearances, we are in two different dynamics. Someone who commits suicide, even with assistance, believes they are performing an act of ultimate sovereignty – even if the latter seems illusory to me. But in doing so, this individual does not involve anyone else in his decision, except a prescribing physician. For euthanasia, third parties are involved in deciding death. And that changes everything. Blurring this difference between assisted suicide and euthanasia, I find it regrettable that certain ethics organizations in France have believed it necessary to offer euthanasia to people allegedly incapable of committing suicide alone. If assisted suicide is akin to a form of resignation from the social body, euthanasia which causes death represents a colossal change in our ethics. A paradox for countries which have abolished the death penalty.
Is this a religious conviction?
But no. The late Michel Vaxès, to whom I felt close on these questions, a communist deputy and declared atheist, therefore hardly suspect of collusion with the Vatican, declared: “A civilization only begins with the prohibitions it proclaims.” The healthcare personnel I meet in the field understand this very well intuitively. Recently, nearly 800,000 of them launched an appeal to emphasize that killing can never be considered treatment. And among doctors saying they are in favor of euthanasia, the vast majority are not in regular contact with the end of life. The less direct relationship you have with death, the more you are in favor of euthanasia. And vice versa.
What is likely to happen when Emmanuel Macron wants to change French law?
We will see. But we take the risk that many, even in the medical profession, will give up. We would then renounce this treasure of the therapeutic alliance which constitutes the bond of trust between a doctor and his patient. We thought we had gotten rid of the old paternalism of the medical profession, but we are currently replacing it with a consumerist link where the patient only becomes a customer. But we can resist. Moreover, if 90% of healthy people say they are in favor of access to euthanasia, only 0.3% of seriously ill people persist in such a request when they are accompanied, relieved, supported. Do we really need a law for this? A law addresses the general, common human experience. It cannot respond to the specific demand of each citizen.
However, the subject is very much in tune with the times.
This is the problem with the media which transmit the message of unlimited freedom, forgetful of the common good. Faced with a person who repeats that it is not worth living but who rejoices in the presence offered to him, how will it be possible to do work of humanity if society whispers to him through its device that can she “leave”?
Some speak of a “dignified death”.
The philosopher André Comte-Sponville, although a pro-euthanasia activist, rejects this expression of “dying with dignity”. One thing is the sense of dignity that we can lose, and another the inalienable dignity that is ours as a human being. This constitutes a terrible narrowing of this beautiful word that dignity represents. Let us pay attention to these terms whose meaning changes over the course of ideological discourse and the lexicons that are prepared for us. Also take the example of compassion. Unilluminated by intelligence, it can ultimately prove more dangerous than indifference. In the Bible story, I remember old King Solomon asking to receive an “intelligent heart.” Isn’t that a wonderful request for enlightened compassion?
However, what should we do with certain personal situations that seem unbearable to live with?
The question is always and again: how to make situations bearable? The ambiguity of the discourse for euthanasia is to make people believe that existence could do without tragedy. A solution should be found to every situation, even death. Now, life has its own share of mystery. We don’t know and we can’t do everything. Is our society still ready to take it on? This does not mean that we remain indifferent. And there are two mistakes to avoid: on the one hand, remaining deaf to the suffering of people, on the other hand, dismissing oneself by saying that we would indeed grant a request for euthanasia, but that it is not possible since the law prohibits it. No, it’s my relationship with the living person that forbids me. The law invites me to internalize this fundamental prohibition. It is not up to doctors to be the final judges of the right to live or die.
But can’t the law strictly regulate acts of voluntary euthanasia?
Both in Quebec and in the Benelux where laws have been passed to this effect, the eligibility criteria are continually broadening and the number of euthanasias carried out continues to increase. And I’m not even talking about undeclared euthanasia or those disguised in the form of deep sedation to circumvent the law. Quickly, the practice of euthanasia infiltrates people’s minds and normalizes them. In some regions of the Netherlands, more than one in seven people already die through this. We also see this in statistical terms: in North American federal states which severely prohibit euthanasia but authorize assisted suicide, deaths by assisted suicide are eight to ten times lower than in countries which have decriminalized euthanasia. euthanasia.
The Leonetti law invites citizens to write advance directives to clarify situations at the end of life. Have you done it yourself?
Not yet, because what I would have to write there is already in French law: no relentless therapeutic treatment, no unnecessary suffering. On the other hand, if I am the victim of a pathology with a predictable progression, I will write them down. But, in my eyes, it is even more important to appoint someone I trust who can speak on my behalf. I am this myself for several people that I accompany and support.
October 23, 1945 Born in Puybelliard (Vendée).
1966 University studies in Nantes (Loire-Atlantique). Degree in letters, philosophy, and sociology.
1969 Associate Professor and Doctor of Philosophy.
1988 Lecturer in bioethics at the philosophy department of the university, in Nantes.
1992 Presence in palliative care and training of care staff.
From 2007 to 2019 Author of several works, including Thinking about the end of life, ethics at the heart of a social choice, Ed. Ehesp Presses.