FRANCE 
Tactical pre-election manoeuvring and a significant criminal case

In France, freedom of choice regarding one’s own end in life remains denied to citizens despite numerous law proposals. Political decision-makers shy away from dealing with assisted suicide or voluntary euthanasia, even though surveys show that over 90 per cent of the population [1] and over 70 per cent of medical doctors [2] are in favour of it in principle. In addition, criminal proceedings are underway against several persons associated with the organisation "Ultime Liberté" (http://ultimeliberte.fr/guppy), in the course of which interesting fundamental questions could arise on existing legal restrictions regarding the right to a self-determined end of life and access to information and means for its implementation.

Little progress in France

When it comes to self-determination regarding one's own end in life, there has been considerable progress in Western Europe in recent years. In Germany, the prohibition of repeated and thus professional suicide assistance ("geschäftsmässige Förderung der Selbsttötung"), which had been in force since 2015, was lifted in 2020 [3]. In Austria, the section in the Criminal Code that makes any kind of suicide assistance a punishable crime will be repealed at the end of 2021 [4]. In Spain, a law regulating voluntary euthanasia and assisted suicide has been approved in March 2021 and is due to enter into force in June, and this should also be the case in Portugal in the not too distant future.

In France, on the other hand, law proposals by various organisations and activist groups have so far failed to achieve their goal. Some progress has been made in recent years around the area of living wills, withdrawal of life-sustaining measures and palliative care [5]. However, palliative sedation is only permitted for individuals in their very last days of life. This means that many people who are suffering seriously are still excluded from the right to end their lives legally and safely in France if they so wish. They are forced either to undertake the often arduous journey to an assisted suicide in Switzerland, to procure a lethal medication illegally, or to recur to risky and unsafe methods to make a lonely suicide attempt; the majority of such suicide attempts fail, often with dire consequences.

A flood of law proposals and a lack of political will

On 11 March 2021, a bill tabled by Senator Marie-Pierre de La Gontrie was discussed for several hours in the Senate. However, the bill had already been rejected by the preliminary committee before the Senate debate; the debate turned into a political showcase in which individual party representatives positioned themselves eloquently. The French Minister of Health, Olivier Véran, took the position that the existing laws regarding the end of life provide a sufficient basis and held out the prospect of expanding palliative care. It has long been known that palliative care cannot replace voluntary euthanasia or assisted suicide, but that they are in fact complementary choices to reduce suffering.

Four law proposals from the ranks of deputies of the "Assemblée Nationale" are also up for political debate. On 8 April 2021, the French Parliament will debate for the first time the proposal submitted by MP Olivier Falorni in October 2017 [6]. French President Emmanuel Macron, who spoke out in favour of voluntary euthanasia at the beginning of his term in office, has remained stubbornly silent on the subject of a law. The majority in parliament currently seems to support a law, but in view of the crisis in the French health system, which has been significantly exacerbated by Covid-19, and the upcoming election campaign (presidential and parliamentary elections will be held in spring 2022), it is highly unlikely that a law will be enacted in the current legislative period.

Fundamental questions regarding freedom of choice over one's own end of life

In France, there are still many taboos surrounding the end of life, especially suicide. Anyone who wants to end his or her life seems to be suspected of being either incapable of judgement or mentally ill. Suicide is not forbidden but giving access to information about suicide methods is a punishable offence; a person who knows about another person's intentions to end his or her life but does not "save" them can be punished for failing to provide assistance, and individuals who want to end their lives can be psychiatrically detained under the pretext of protecting life.

A truly open social debate about a self-determined end of life is thus all but made impossible. Individuals and organisations who publicly advocate for this right and freedom, especially assisted suicide, are viewed with suspicion by the authorities. At the end of 2019, house searches were carried out in France on more than 100 private individuals who on the internet had bought Nembutal (a trade name for sodium pentobarbital, the medication used in professionally assisted suicide in Switzerland), which is prohibited in France. Officially, this was part of an international operation to stop an illegal trade in medical substances from the USA. The premises of "Ultime Liberté" an organisation that has been campaigning for self-determination over one's own end of life in France for many years, were also searched.

A large proportion of the private individuals targeted by the searches are elderly people who want nothing more than to decide for themselves when their live ends and to do so in a safe way. They know that in France they do not have this option and, reasonably enough, they are unwilling to jump off a bridge, walk in front of a train or otherwise expose themselves to the risk of a failed suicide attempt. With its bans, the state is depriving them of their freedom of choice, thereby encouraging the illegal trade it claims to be fighting.

In the meantime, criminal proceedings have been opened against around a dozen people associated with "Ultime Liberté"; the charges range from importing and possessing illegal substances, to providing information on how to access and acquire such substances, to actively helping to acquire and prepare them. The proceedings are likely to raise interesting questions about the freedom and right to access information on and to be assisted in ending one's own life in a self-determined manner.

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[1] http://www.dignitas.ch/index.php?option=com_content&view=article&id=70&Itemid=138&lang=fr (in French)

[2] http://www.dignitas.ch/index.php?option=com_content&view=article&id=70&Itemid=138&lang=fr (in French)

[3] https://www.bundesverfassungsgericht.de/SharedDocs/Pressemitteilungen/
EN/2020/bvg20-012.html;
see also: http://www.dignitas.ch/images/stories/pdf/medienmitteilung-26022020-e.pdf

[4] https://www.vfgh.gv.at/rechtsprechung/Ausgewaehlte_Entscheidungen.en.html; see also: http://www.dignitas.ch/images/stories/pdf/medienmitteilung-11122020-e.pdf

[5] LOI n° 2016-87 du 2 février 2016 créant de nouveaux droits en faveur des malades et des personnes en fin de vie; 
https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000031970253?r=hMFAQjT2cS (in French)

[6] https://www.assemblee-nationale.fr/dyn/15/textes/l15b0288_proposition-loi (in French)

Newsletter 2021-1-3-e