Legalizing euthanasia in France was one of Emmanuel Macron’s campaign promises during his first presidential campaign. After months of fierce debate, the National Assembly passed the bill in its final reading on Wednesday 15 July by 291 votes to 241.
The intensity of the debate shows that, far from enjoying the social consensus its supporters had hoped for, the reform is causing deep unease. It is set to become one of the most permissive measures of its kind in the world. Opponents of the bill poured all their energy into preventing what they regard as an anthropological shift of exceptional gravity, but ultimately failed to stop it.
On 30 June, the National Assembly reinstated nearly all of its original text during a new reading, reversing the amendments adopted by the Senate, which had repeatedly attempted to impose limits and safeguards on unlimited access to assisted dying. Faced with a majority of deputies determined to reinstate their version without heeding objections, the senators chose on 7 July not to engage in another round of back-and-forth parliamentary proceedings doomed to failure. By adopting a motion for preliminary rejection, they did not seek to endorse the text but rather to signal their refusal to support a reform they consider lacking the essential consensus on such a fundamental issue.
One Cocktail Too Many
Eager to celebrate their victory, the bill’s sponsors, led by the Minister for Relations with Parliament, had planned to host a festive cocktail reception, all at the expense of the Economic, Social and Environmental Council (CESE), one of the government’s major advisory bodies. The CESE’s invitation even offered to cover guests’ transportation and lodging in Paris so they could attend this so-called celebration. The news leaked and caused a scandal on the right – forcing the organizers of this party to postpone it, if not cancel it. The very idea of celebrating the passage of a law that will allow for the administration of death on a large scale was deeply indecent.
Opponents of the bill highlight the particularly dangerous provisions contained in the final text approved by the National Assembly. Grégor Puppinck, of the European Centre for Law and Justice, has compiled a list of no fewer than 27 points that raise serious ethical questions and would make France one of the most permissive countries regarding assisted dying. Reading them reveals the magnitude of the ethical upheaval that may now lie ahead.
A single doctor decides the entire euthanasia procedure. The law does not specify any formal requirements regarding how the wish to die must be expressed; it may be stated in writing or “by any other means of expression appropriate to the person’s abilities”, which leaves the door open to all manner of abuses and interpretations. In practice, it is sufficient for the doctor to state that the person wants to die when the request is not made in writing. No witness is required to attest to the validity of the request to die.
The doctor may meet the person for the first time on the very day the request to die is made. Euthanasia is permitted for individuals under guardianship or conservatorship: this means that people who are effectively under guardianship – and who cannot even sign a check – can request to die within two days. A person with a serious mental disorder, such as suicidal tendencies, is not excluded from the process.
The doctor consults with two people of their choice: a doctor or even a nursing assistant who may be under their supervisory authority. The law does not require these individuals to meet with the person, nor to verify the authenticity of their request to die. The consultation with these two people may be conducted via videoconference. The physician may make a final decision immediately after the consultation, without any delay and without needing to examine the patient a second time. The patient’s reflection period is only two days from the time the physician makes the decision, meaning the entire process can be completed in three days.
The person’s relatives do not have the right to be informed that a euthanasia procedure is underway, but will be informed after the person’s death, with the understanding that they will not have the right to challenge the doctor’s decision in court. The doctor must ensure that the loved ones of the person undergoing euthanasia, if they are aware of the situation, do not exert any pressure on the doctor to cause them to withdraw the lethal substance.
Amendments aimed at separating euthanasia procedures from organ harvesting were all rejected. The entire cost of the procedure, including fees and compensation, will be covered by Social Security – that is, by the contributions of all French citizens.
“A sea blackened with blood”
In the French press, prominent cultural figures have also voiced their disapproval, such as the writer Michel Houellebecq, who could not find words harsh enough to denounce what is happening in an op-ed published by Le Figaro. Seeing, like the poet Yeats, a “sea blackened with blood” rising, he explains that he views this as a highly symbolic decision: “I cannot help but think that by demanding access to euthanasia for its citizens, France is demanding its own euthanasia.”
In France, the Catholic Church is raising its voice. Following warnings from the French Bishops’ Conference, individual prelates are taking a stand. The Bishop of Bayonne, Msgr Marc Aillet, known for his conservative views, has reminded the public that a politician who in good conscience voted in favor on Wednesday should no longer be admitted to Holy Communion.
The Catholic website Hozana launched an initiative called “Pray for a Lawmaker”. The idea was to create a chain of prayer in which each believer committed to including a lawmaker in their prayers, in the hope that he or she would change their mind before the final vote. The gap between the “for” and “against” camps continued to narrow with each vote, fueling the hopes of the faithful who had committed to praying.
In Châteaudun, a priest reminded the congregation during his homily on Sunday 12 July that euthanasia is fundamentally contrary to Christian anthropology: “You do not care for life by taking a life”, he said. The priest also invited the faithful to “pray for life” and to “pray for the lawmakers so that they do not do something reckless”.
The bill’s sponsor happened to be present at the Sunday service. Representative Philippe Vigier took great offense at the priest’s remarks, stating that he felt “insulted” and “deeply hurt”, and demanded an apology from the priest – who was careful not to comply.
For believers, the absence of a collective conscience clause is a matter of the utmost gravity. The bill grants an individual conscience clause to healthcare professionals but refuses to extend this protection to the institutions themselves. This distinction, which may have seemed technical at the start of the debates, has now taken on considerable importance.
Hospitals run by religious orders or foundations whose mission of care is explicitly based on the refusal to cause death now fear being faced with an impossible choice: either to accept within their walls a practice they deem incompatible with their identity, or to cease operations – which would pose an unprecedented threat to the pluralism of the French hospital system. Some religious congregations are concerned that they may even have to close their doors and move abroad.
A Constitutional Matter
It is this issue in particular that prompted Senate President Gérard Larcher to announce that he would refer the legislation to the Constitutional Council following its passage. A member of the center-right Les Républicains party, the senate president – the second-highest-ranking official in the state according to the French Constitution – is a politically moderate figure who is not particularly known for conservative positions on social issues. But this time, he considers the situation serious enough to warrant referring the legislation to one of the highest institutions of the state.
In his view, the bill raises several major constitutional issues, particularly regarding the principle of safeguarding human dignity, the protection of the right to life, equality before the law and the clarity of the criteria for accessing assisted dying. He also believes that the safeguards put in place to protect vulnerable individuals and the freedom of conscience of healthcare providers remain insufficient. Referring the matter to the Constitutional Council would suspend the legislation’s promulgation until its members render their decision.
By doing so, he aims to restore the upper house to its rightful place in parliamentary debates – a position from which it is often sidelined – following the example of what happened a few weeks ago in the United Kingdom, where opposition from the House of Lords led to the suspension of the assisted dying bill.
In an unexpected move, Prime Minister Sébastien Lecornu, personally opposed to the bill, announced on 14 July that he too would refer the legislation to the Constitutional Council.
The National Assembly passed the “right to assisted dying” in its final reading by 291 votes to 241, compared with 295 to 232 in favor during the previous reading on 30 June. After initially supporting the bill, about ten members of the Assembly ultimately decided that it was important to put a stop to what they regarded as madness. It was not enough to change the outcome.
For Houellebecq, the signal this sends for the future is deeply troubling: “We are entering a world where it will be easier to die; I would have preferred a world where one can live”, he concludes.