The French National Advisory Council of Ethics (CCNE) has published a voluminous report on the end of life in October. The report found consensus on the issue of the wishes of the person, the urgency of improvements of conditions of support for the end-of-life by the health system, of the imperative obligation of the treatment of pain. In contrast, the CCNE observed a continuation of deep differences on the issues of assisted suicide and euthanasia.
Concerning the consensus the key point is the emergence of the will of the person and the respect of his rights. From there arises the need to make binding and enforceable advance directives for the relief of pain, up until deep and extended (terminal) sedation until death, at the initiative of the doctor and/or the patient who is going to die.
The risk however still is to recognize such a desire if it is opposed to the expertise of the doctor. For example, the advance directives could not be truly enforceable only if they are written in direct cooperation with the doctor.
More interesting is the critical analysis of differences re assisted suicide and euthanasia. A very long exposition of 19 pages in the report shows the importance of the word of opponents to the autonomy of the person. Almost all contributions expressed the point of view of professionals or health institutions. They oppose the positions taken by the citizen conference of end of 2013.
The contributions to the CCNE report on assisted suicide and euthanasia do not correspond with the reality of the requests for aid in dying. These concern most often situations of repeated, consistent and firm refusal or continuation of care.
The consensus on the improvement of the conditions at the end of life is on the point of being formalized. A speedy consensus on choice in dying is unlikely. What is to be built is a consensus on the observance of the death chosen, even if it only concerns a minority.
As Lord Falconer (UK) said, “it is not a question of whether legalization will happen, but is a matter of when it will happen”.
(thanks to Daniel Carré)