End of Life: France May Soon Follow in the Footsteps of Belgium

The French National Consultative Ethics Committee has just opened the way to ‘active assistance in dying,’ and President Emmanuel Macron has already indicated his preference for the permissive Belgian legal model.

Alain Cocq, suffering from an incurable orphan disease, touches his phone in his medical bed at his home in Dijon on April 6, 2021.
Alain Cocq, suffering from an incurable orphan disease, touches his phone in his medical bed at his home in Dijon on April 6, 2021. (photo: Jeff Pachoud / AFP/Getty)

A major turning point is about to take place in France concerning the approach to the end of life. 

After the National Consultative Ethics Committee (CCNE) issued an opinion favorable to assisted suicide on Sept. 13, President Emmanuel Macron announced the launch of a broad citizen consultation on end-of-life starting December 2022, with a view to a possible new “legal framework” by the end of 2023.

These announcements make opponents of euthanasia fear that the French government will do everything in its power to hasten the legalization of this practice, at the beginning of Macron’s second mandate, to please his base of voters. Their concern was strengthened by Macron’s declared “penchant” for the Belgian model regarding the end of life; abuses in that model were recently brought to light again in two high-profile cases.

Pope Francis himself expressed his concern to French elected officials who were on a pilgrimage to Rome on Oct. 21, renewing his call to “accompany life to its natural end.”

Since 2016, the Leonetti-Clayes Law has been the end-of-life framework in France. While favoring the access to palliative care, the law allows dying people whose pain is too great to receive “deep and continuous sedation maintained until death.” Active euthanasia is still forbidden.


‘Complete Turnaround’

This new opinion from the CCNE results from a self-referral in June 2021, in the context of the debate surrounding a bill on the end of life filed in the French parliament in January 2021 that eventually failed due to too many amendments from the legislation’s opposition. 

The committee has just recognized the existence of a “path for an ethical application of active assistance in dying,” referring to assisted suicide and to euthanasia for those who are in incapacity to trigger the process themselves, although “under certain strict conditions.” It also advocates accelerating efforts in favor of palliative care, calling for it to be imposed “among the priorities of public-health policies.”

Nevertheless, such an approach marks a decisive shift with respect to the CCNE’s last opinion on the matter, dating back to 2013, in which it excluded euthanasia, considering as essential and useful the distinction made by the law between “letting” die and “causing” death. It also ruled out assisted suicide.

“This new opinion is a complete turnaround, with respect to what the committee said in the past, and it is at the same time very poorly substantiated and pernicious,” Tugdual Derville, general delegate of the pro-life association Alliance Vita who participated in the committee’s discussions as an expert, said in an interview with the Register. “It is pernicious because the committee advocates for palliative care at length, and highlighted the risks connected to euthanasia, but still paved the way for its practice.”

This point of view is shared by Archbishop Pierre d’Ornellas of Rennes, who was also present during the discussions of the committee. Its final opinion, according to him, “throws fog” on the ongoing discussion. The CCNE, he wrote in a statement published on his archdiocesan website, “uses the same word ‘fraternity’ to qualify both active assistance in dying and accompaniment by palliative care. But how can we call fraternal the gesture that gives death to our brother who asks for it? It is not in the fog that one discerns the project of society to be built!”


Breaking a Lock

According to Derville, the publication of this opinion, although purely consultative in nature, communicates a specific and destructive political agenda. 

“I am convinced that the committee’s objective was to make things evolve after the 2016 Leonetti law, and President Macron based himself on this new opinion to launch the participative process that risks leading to the legalization of euthanasia in France,” he said, adding that out of a total of 45 experts selected to participate in the discussions, only eight had reservations on the matter.

Derville said the committee’s objective was to “break a lock” by providing the necessary ethical justifications for a change in society.

“It is also a very bad signal on a political level,” he continued, “as at the same time, the government has just abandoned its ‘Advanced Age and Autonomy Act,” referring to a bill intended to facilitate greater autonomy and prevent the “social death” of elderly people. 

He considered the opening of a debate on whether or not to prohibit euthanasia to be “a form of indecency,” in the context of a weakening of the foundation of the French health system that has already plunged into a deep crisis, aggravated by the COVID-19 pandemic.

Derville also highlighted that although the CCNE claimed the necessity to strictly frame these laws to guard against the so-called slippery-slope effect, its drift on the issue actually corresponds with such a societal shift. “From the right to ask for euthanasia to the duty to ask for it, there is only one step,” he warned.


The Belgian Model and the Myth of Safeguards

Belgium, one of the first countries in the world — with the Netherlands — to have legalized euthanasia, in 2002, constitutes the greatest example of its intrinsically uncontrollable character, in the eyes of the opponents of the practice. First limited to adults, this “right” was then extended in 2014 to minors who ask for it, without age limits.

The wave of emotion caused by the October euthanasia of a 23-year-old female survivor of the 2016 Brussels airport Islamist attacks, due to her mental trauma resulting from that event, has focused public attention on a little-known reality. 

In fact, this high-profile case is only the tip of the iceberg, judging by an in-depth study published in 2021 entitled, “Euthanasia in Belgium: Shortcomings of the Law and Its Application and of the Monitoring of Practice.” The study, published by The Oxford Journal of Medicine & Philosophy, denounces the widening of the use of euthanasia in Belgium and the failures of safeguards and procedural guarantees. 

This issue was further illustrated by another high-profile case recently brought before the European Court for Human Rights (ECHR), brought to the court against Belgium by Tom Mortier — the son of Godelieva de Troyer, who was euthanized in 2012 on the grounds of “untreatable depression” without prior consultation with her family. 

In its Oct. 4 ruling, the ECHR did not rule that the overall Belgian legal framework fundamentally contradicts the right to life, which is protected Article 2 of the European Convention on Human Rights. But it condemned Belgium for violating Article 2 in the specific circumstances of Godelieva de Troyer’s death because of the lack of impartiality of its Federal Commission for the Control and Evaluation of Euthanasia and because of the failure to promptly move forward with a criminal investigation.

Such findings have shattered the argument of reliability of the Belgian model, championed by the French promoters of a similar legal framework for euthanasia. 

“This judgment makes clear the lie that ‘safeguards’ can somehow make the intentional ending of life safe,” Robert Clarke, deputy director of the faith-based legal organization Alliance Defending Freedom International and lead counsel for Tom Mortier before the ECHR, told the Register. 

Noting that seven people are euthanized every day in Belgium — an ever-growing figure — and that the youngest child to have been euthanized was just 9 years old, Clarke argued that France, should it follow a similar path as Belgium, would “inevitably incur significant societal destruction, in addition to the loss of many lives.” 

Said Clarke, “Those in France looking to the Belgian ‘model’ have to ask what kind of society they want to live in: Do we want to live in a society that responds to suffering with death, or one that responds with treatment, care and compassion?” 

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