What the law adopted by the National Assembly contains

Tuesday, May 27, the text “end of life” has taken an important stage in its legislative journey. Meeting in a solemn vote, the deputies adopted it, 305 pronouncing in favor, while 199 requested his rejection.

The most important provisions of the law “end of life” are found in its article 2. A new “right to help die” is defined, as consisting in authorizing and accompanying a person who expressed the request to resort to a lethal substance (…) so that they are administered or, when it is not physically able to proceed, to be administered by a doctor or by a nurse “.

It is therefore above all a right to assisted suicide that is created, with an exception of euthanasia. Caregivers-doctors and nurses-are therefore involved directly in the act when the patient cannot do it himself. Despite the requests of certain deputies, the words “euthanasia” and “assisted suicide” are not included in the bill.

Article 4 comes to define the conditions of access to these new rights. First of all, only French people and of French nationality or residents in “a stable and regular way in France” will be able to use it. For this, it will be necessary to “be able to manifest your will in a free and enlightened manner” and “to be suffering from a serious and incurable affection, whatever the cause, which engages the vital prognosis, in the advanced phase”. In committee, the deputies discussed at length on what the “advanced phase” meant. This is “characterized by entering an irreversible process marked by the worsening of the health of the sick person who affects their quality of life”.

Last condition: it is necessary to “present a constant physical or psychological suffering linked to this condition, which is either refractory to the treatments, or unbearable depending on the person when the latter chose not to receive or stop receiving treatment”. A significant restriction has been added by the deputies in committee: “Psychological suffering alone can in no case allow to benefit from the help of dying. »»

“Collegial procedure”

The bill carried out by Olivier Falorni also specifies the procedure of this “right to die”. The patient must make the request to a doctor in a “written or any other mode of expression adapted to his capacities” during a physical appointment (that is to say not in a teleconsultation). Once the request has been received, the doctor must verify that the patient is able to formulate it, then inform him of the possibility of palliative care. He must also propose to the sick person to meet a psychologist or a psychiatrist – an extended possibility in committee to the patients of the patient. The patient is also well informed that he can give up at any time.

After this appointment, the doctor must put in “place a collegial procedure”, that is to say bringing together “a multi-professional college”, bringing together at least one doctor and an auxiliary-marketer or a caregiver. The doctor must make his decision at the end of this meeting, and must notify it “orally and in writing” to the patient by motivating him. The procedure must take a maximum of fifteen days from the day the request was made.

On the day fixed for the act of euthanasia or assisted suicide, the patient must be accompanied by a doctor or a nurse. He can also be surrounded by relatives. Even in the event of assisted suicide, the healthcare professional will have several missions. First of all, he will have to check that the person “confirms that he wants to proceed” and that he does not undergo pressure – neither in one direction nor in the other. In addition, he “prepares” the administration of the lethal substance, “monitors” the self-administration of the substance or “administers” the substance in the event of incapacity. Once the product has been injected, the healthcare professional should no longer necessarily remain nearby, but remain “close enough and in direct vision” to intervene “in case of difficulty”. He then established the death certificate.

Consciousness clause and offense of obstacle

A conscience clause is provided: “The health professional who does not wish to participate in these procedures must, without delay, inform the person or the professional requesting him of his refusal and communicating to them the name of health professionals willing to participate in the implementation of these. On the other hand, health establishments will not be able to refuse in principle the realization of acts of helping to die on their premises.

In addition to helping to die itself, another provision of the law has been particularly controversial: the creation of an offense of obstacle. Thus, “preventing or attempting to prevent from practicing or inquiring about helping to die by any means (…) for a deterrent”, is punished with two years in prison and 30,000 euros fine. These obstacles could be done by disrupting access to the place where “help to die” is practiced or by “exercising moral or psychological pressures”, on patients, on those around them or on health professionals.

Just before this text, a bill aimed at largely developing palliative care and their access was adopted unanimously by the National Assembly. The two proposals will now be able to be examined by the Senate. If the senators vote them in the same terms – which is unlikely, in any case for the text on “the help of dying” – the proposals will be definitively adopted. Otherwise, they will return to the deputies for second reading exam.