Medical definition, what does the law say in France?

Euthanasia which consists in provoking the death of a patient for medical reasons is illegal in France but that could change. Emmanuel Macron launched in December 2022 a citizen convention on the end of life. The government has been working since a bill to set up a framed “assistance” since on a drafted bill, including assisted suicide where the patient receives a lethal substance to administer himself or a provision by a third party (doctor, nurse, close …). Final adoption is not expected before 2027. In the meantime, the Leonetti law of 2005 adopted in 2016 applies. This law does not allow euthanasia or assisted suicide but establishes a right to deep and continuous sedation until death in a patient in a state of expressing his will or unable to express his will.

What is the definition of euthanasia?

Euthanasia consists of cause a patient’s death for medical reasonsin particular the incurability of a pathology associated with suffering or unbearable pain. “There is Not really a standard definition euthanasia because it supposes Give a definition of the end of life and therefore of life. However, there is no unanimous. These are therefore committees that meet, on a case -by -case basis, to give their opinion on end -of -life conditions. The fact remains that euthanasia is the Provocation of the death of a person with an incurable disease who suffers unbearable from this disease. It cannot be a simple malaise which certainly, arouses suffering but which we do not consider that it is incurable “, specifies Maître Muriel BODIN. L’act is practiced by a third person while in thesuicide assistancethese are third parties who give an environment conducive to the person who will commit the fatal gesture itself. Both are prohibited in France.

What does the law in France say on euthanasia?

In France, A doctor does not have the right to deliberately kill a patient. Euthanasia is prohibited. This act remains a criminal offense. On the other hand, laws are published to supervise the support at the end of their life of the patients. The most recent is the Claeys-Leonetti lawvalidated by the French Parliament in February 2016. It establishes a right to “Deep and continuous sedation” Until death for terminal patients,

What does the 2016 Claeys-Leonetti law say?

In February 2016, the French Parliament approved the Claeys-Leonetti law on the end of life which establishes a right to “Deep and continuous sedation” Until death for terminal patients, When the patient has a “serious and incurable affection”,, and that he presents a “Suffering refractory to treatments”. On the other hand, It does not allow euthanasia or assisted suicide. “The debate in such a case is always around the definition of life which is more or less objective depending on the convictions of each”Comments Maître Muriel Bodin.

What does the Léonetti law of 2005 say?

The Léonetti law affirms a right to “let die” without avoidable suffering and in respect of the dignity of the patient. The law recognizes the refusal of the therapeutic relentlessness, authorizes the treatment or limitations of treatment and expressly admits that to relieve the suffering of a person at the end of life, can be taken the risk of treatment against pain having the side effect of shortening life. All person thus has the right to die with dignity and to be accompanied as much as possible without suffering, thanks to the sedation or palliative care. There sick person, aware and in a state to express their will, can refuse any investigation or treatment even if this refusal endangers their life. On the other hand, if the person is not at the end of his life, the doctor has the obligation to do everything to try to convince him to accept the essential care, including by calling on another doctor and does not follow up on his will only at the end of a reasonable period allowing him to repeat his wish, at the end of life; The doctor must then, without delay, respect the will thus expressed by the patient, after having informed him about the consequences of his choice. There decision to stop care must be collegialafter having “Consulted the confidence referred to in article L. 1111-6, the family or, failing that, one of their relatives and, if necessary, the anticipated guidelines of the person” (Article 9). For lack of writing, it is up to the judge to decide. “When a person, in advanced or terminal phase of a serious and incurable condition, whatever the cause, decides to limit or stop any treatment, The doctor respects his will after having informed him of the consequences of his choice.“” “”In the Lambert case, the doctors considered collegially that he no longer responded to the definition of a person alive and that continuing to administer food by probe, it was artificially pursuing a semblance of life “, illustrates the lawyer in health law.

What is active euthanasia?

Euthanasia is said to be “active” when the death is due to the administration of a lethal product by a third person.

What is passive euthanasia?

Euthanasia is qualified as passive when a Curator care is initiatedand only so -called “comfort” treatments are provided (analgesics for pain, respiratory comfort …). We also talk about‘Suicide aid When a framework and material to kill themselves are brought to the patient. L’active euthanasia is considered a crime Especially since the Leonetti law of 2005, and the report of Professor Sicard of 2012 aims precisely to best adapt the care of people at the end of their lives.

How does euthanasia take place?

To answer this question, it is necessary to differentiate well what is authorized in France and what is practiced in Belgium for example. According to the has, 6 Characteristics differentiate deep and continuous sedation maintained until the death of euthanasia ::

• L’intention : on one side “relieve refractory suffering”, the other “Respond to the patient’s death demand.”
• THE AVERAGE :: “Alter consciousness deeply”; “Provoke death.”
• There procedure :: “Use of a sedative drug with suitable doses to obtain deep sedation”; “Use of a lethal dose medication.”
• THE result :: “Deep sedation pursued until the death due to the natural evolution of the disease”; “Immediate death of the patient.”
• There temporality :: “Death occurs within a period that cannot be provided”; “Death is quickly caused by a lethal product.”
• There legislation : deep sedation is, in France, authorized by law when euthanasia is illegal considered as homicide, poisoning, even an assassination.

Euthanasia has a final character and supposes the voluntary intervention of a third party. It can be practiced orally or intravenously. Most often, it is this second method that is privileged. After administering a particular psychotropic to the patient to sedate it, that is to say the search for a decrease in vigilance, which can go as far as loss of consciousness, it is plunged into a deep coma thanks to a general anesthetic. As soon as the patient finds himself immersed in a deep unconsciousness, a neuromuscular paralyzing is injected to him in order to cause respiratory stop and consequently, his death which must be noted by a third party doctor.

What is the deadline before death?

For euthanasia in Belgium, the period between the administration of the product and the death varies from one person to another, it generally occurs Between 30 minutes and 3 hours. In France, deep sedation can lead to death between 48h and 8 daysit all depends on the natural evolution of the sedated person.

What conditions to use euthanasia?

In France, euthanasia is prohibited. Only the cessation of treatments is authorized. According to the Léonetti law, “When a person, in advanced or terminal phase of a serious and incurable condition, whatever the cause, decides to limit or stop any treatment, the doctor respects his will after having informed him of the consequences of his choice. The patient’s decision is included in his medical file.” In other words, the patient may indicate in his directives that he does not want care to be prosecuted, which will ultimately lead to his death by the normal consequences of the disease. The case is difficult when the person does not suffer from the disease but from their consequences.

What are the conditions of euthanasia in Belgium?

Belgium has legalized euthanasia with a very strict framework. The conditions of the procedure are specified in article 3 of chapter II of the law relating to the euthanasia of May 28, 2002. She establishes that the doctor who practices euthanasia must ensure the following points:

• The patient is major or minor emancipated, capable or minor with the capacity of discernment and is aware at the time of his request;
• The request is made voluntarily, reflected and repeated, and that it does not result from external pressure;
• The patient (major or emancipated minor) is in a medical situation with no exit and reports a constant and unbearable physical or mental suffering which cannot be appeased and which results from a serious and incurable accidental or pathological condition;
• It is specified that it is necessary “Leaved at least a month between the patient’s written request and euthanasia.”

What are the conditions of euthanasia in Switzerland?

In Swissassisted suicide is more tolerance than a law. “The Swiss have not legislated to authorize assisted suicide because tolerance is enough to reassure them on the fact that they will be able to have their own life and they consider that it is not up to the State to decide this. As for euthanasia, it is prohibited as in France as soon as it could be a third party”, Indicates Maître Muriel Bodin. Article 114 of Swiss Criminal Code prohibits euthanasia and article 115 Prohibits the incentive and assistance to suicide unless it is performed without “selfish mobile.” “”Whoever, pushed by a selfish mobile, will have prompted a person with suicide, or will have lent him assistance for suicide, will be, if the suicide has been consumed or tempted, punished with a private sentence of five years at most or a pecuniary penalty. ” However, Active euthanasia on request is tolerated in the event of “Serious and insistent request” and “Honorable mobile, especially pity.“” In other words, active euthanasia remains condemnable. There is only a tolerance for suicide assistance, that is to say when you give a fatal substance to a person and that it injects it itself as well as for passive euthanasia (cessation of care).

Thank you to Maître Muriel BODIN, lawyer at the Paris bar, specialized in health law.

Sources:

• Differences between deep and continuous sedation maintained until death and euthanasia, High Authority for Health
• Law n ° 2005-370 of April 22, 2005 relating to the rights of the sick and the end of life, Legifrance, April 2005
• Euthanasia practical guidelines for the pharmacist, APB, 2018
• May 28, 2002. – Law relating to euthanasia, ejustice Belgium
• Swiss / Death Criminal Code caused, European Bioethics Center, March 2009