Critics suspect that it is a disguised form of euthanasia

The French National Assembly has approved a law which creates a right to terminal sedation until death, but not to euthanasia or assisted suicide.  The law has been debated for years and the present text is a consensus which tries to maintain a middle ground between voluntary euthanasia and therapeutic obstinacy.

Patients have a right to request “deep, continuous sedation altering consciousness until death” but only if they are at the end of life. Doctors may stop life-sustaining treatments, including artificial hydration and nutrition. Sedation and painkillers will be allowed “even if they may shorten the person’s life”.

Socialist Alain Claeys, co-author of the bill, said: “Our text has one purpose: fighting a bad dying that still happens too often in France.” The conservative co-author Jean Leonetti, explained: “At end of your life, if the suffering is unbearable, you’ll be allowed to get to sleep, soothed and serene.”

The law also directs doctors to honour advance directives when patients are no longer able to communicate.

The new law contains ambiguities which will soon be put to the test. Pro-euthanasia sociologist Philippe Bataille told L’Humanité that the law enshrined a fundamental contradiction: it “makes euthanasia both possible and prohibited at the same time. That is to say, it prevents the doctor from intentionally causing death” but it also “allows a simple ‘letting die’ (not a ‘kill’), that is to say only the suspension of hydration and nutrition, accompanied by palliative care until death ensues”.

The anti-euthanasia group Soulager mais pas tuer (Care not killing) said that “The introduction of a ‘right of continuous deep sedation until death’ indeed opens the door to euthanasia. Its promoters have issued reassuring statements, but they have always refused to include black and white provisions in the law that the intention of this type of sedation must not be to cause death. In endorsing this deliberate blurring, this text weakens the relationship between carers and patients, since the new law does not clearly close the door to hidden euthanasia.”

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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