In its 1st report on end of life, CCNE takes stock of the debates that have been held in France for two years. The right to sedation in all circumstances is increasingly demanded.
What are the points of agreement and disagreement between the French on the difficult question of the right to die with dignity? In an attempt to answer this question, the National Consultative Ethics Committee (CCNE) returned this Thursday a report on the public debate concerning the end of life. This is a summary of the public debates that have been held in France for two years on the subject. The 71-page document is supposed to help the deputies Jean Leonetti (UMP) and Alain Claeys (PS) to whom the government of François Hollande has entrusted a mission on the end of life. This should normally lead to a new bill in March 2015.
Demands shared in public opinion
On the CCNE side, it emerges first of all from the public debates that “very largely” people share the fact that advance directives are real directives. That is to say, they are binding on doctors and caregivers, with some exceptions when the situation does not lend themselves to it. Second, the French are calling for the development of palliative care. Access to this care remains very uneven in the territory.
The third demand “very widely” shared is the right to obtain deep sedation (drug to fall asleep) until death when one is in the terminal phase of end of life or when a decision has been made to discontinue treatment.
On this point, Prof. Régis Aubry (1), head of the palliative care service at Besançon hospital and member of the CCNE, even thinks that we could soon see the emergence of a new right in terms of end of life.
Listen to Professor Régis Aubry, member of CCNE: ” There would be a new right. That of being able (when one is in the terminal phase of a serious illness) to benefit from a sedation even though one does not have a refractory symptom, or of discomfort… “
Finally, according to CCNE, people want the so-called “collegial” procedure (today it is the doctor’s decision after consulting a certain number of people) to be truly collegial when the person is not able to. decide, and involve relatives equally.
“All of these shared demands are fundamentally about respecting the will expressed by the person. They are all almost unanimous ”, hammered Jean Claude Ameisen, president of CCNE, during a press conference.
Points of debate on the methods of application of the measures
But in these discussions between CCNE and public opinion, points of debate have also emerged as to the modalities of application of certain measures.
Among them, “Should the directives be imposed in all cases, or only when the person is ill and knows a little what the future is likely to be?” Or should deep sedation until death accompany the sleeping (unconscious) person until death, or could it accelerate (if the person has requested it) the onset of death ? », Indicated Jean Claude Ameisen.
Moreover, in the very specific case of a person who is not at the end of life, unable to express his will, and without advance directives (case of Vincent Lambert), the CCNE reiterated its position. He always pleads for a collective deliberation procedure, where everyone (relatives, caregivers) is on the same footing of equality. Without an agreement, there must be a new mediation.
The sticking points: euthanasia and assisted suicide
Finally, on medical assistance for suicide and euthanasia, CCNE notes that there are again profound differences with regard to these questions. “There, we see that there is no agreement,” concluded Jean Claude Ameisen.
Listen to Prof. Jean Claude Ameisen, president of CCNE: ” On assisted suicide and euthanasia, there are profound differences, even on the terminology and on the terms used. There is a deep disagreement between the French. “
(1) President of the National End of Life Observatory (NFB)
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