what is contained in the bill revised by the deputies which worries the medical profession

what is contained in the bill revised by the deputies which worries the medical profession
what is contained in the bill revised by the deputies which worries the medical profession

DECRYPTION – While certain “locks” in the government’s text have been broken, deputies are wondering about the limits of the law and the government wishes to take control of its text. Caregivers fear the passing of a very transgressive law.

New French end-of-life model or dizzying leap into the unknown? A climate of uncertainty hovers over the contours of the law on assisted dying, Emmanuel Macron’s second major societal reform after PMA for all.

After two years of promises and mysteries maintained by the head of state, it is the turn of the deputies of look death in the face ». Starting Monday and for two weeks, they will focus on the perilous subject of the end of life. If this text is one of those that should be written with a trembling hand », it appears above all to be a real puzzle as the limits of access to a right to die seem difficult to define. Where to draw the red lines? How to guarantee them? The Minister of Health, Catherine Vautrin, prefers to invoke what is necessary balance » of the text and promises to restore it.

But the legislative battle will probably be tougher than expected. From the work in the special committee, carried out at full speed, the first disagreements gave a glimpse of possible bidding wars in the Hemicycle. And the rewriting of the text, in a few days, gave the impression that the government had lost control.

Anthropological progress or rupture?

Progress or major anthropological rupture? The future of the text is all the more difficult to predict as the dividing lines between elected officials defy the logic of political groups. The presidential majority is “ very largely united behind the balance proposed by the government “, wanted to reassure Gabriel Attal in La Tribune Sunreed.

What to do during treatment? There is a risk that fragile people, with poorly calmed pain, will ask to die at the start of treatment.

Jérôme Barrière, member of the Scientific Council of the French Cancer Society

At the heart of the debates, the criterion of vital prognosis engaged in the medium term » has disappeared, leaving room for expanded access to assistance in dying for patients terminally ill or advanced ». People suffering from chronic illnesses such as diabetes or with advanced cancers with several years left to live could become eligible for planned death. Oncologist Jérôme Barrière, member of the Scientific Council of the French Cancer Society, warns: Cancer patients who were once considered doomed are still alive at more than five years of follow-up thanks to immunotherapy. If treatment is stopped, doctors can make a decision. But what to do during treatment ? There is a risk that fragile people, with poorly calmed pain, will ask to die at the start of treatment. » Conversely, France Assos Santé, which represents sick people, welcomed an improvement in the text: If this criterion is reestablished, there is a good chance that it will become the adjustment variable for receiving or rejecting a request (…) to the detriment of the rights of sick people. »

Another uncertainty, will assisted suicide really be the main modality of assisted dying? Will euthanasia remain a exception » for people who would not be not physically able » to proceed? As it stands, the text contains a contradiction. In committee, a shift took shape with the adoption of an amendment leaving the patient the choice between these two procedures.

Messy print

The same confusion surrounds the notion of free and enlightened will » of the patient. This criterion, designed to exclude people suffering from psychiatric disorders or Alzheimer’s from assisted dying, still appears in the text. But an amendment opened up the possibility of requesting assistance in dying in advance directives, last medical wishes drawn up in the event of loss of consciousness. Creation of an “offence of obstruction” of assisted dying, the patient’s reflection period possibly shortened, absence of a real collegial procedure to grant authorization for assisted dying… In a few days, the subjects of contention on the text have multiplied, giving an impression of disorder and comforting hostile caregivers in the idea that France is heading towards the most permissive law in the world ».

In committee, our deputies did anything. They got LFIsed!

An influential member of the majority

Among parliamentarians, these modifications are already at the heart of all discussions. We will give a signal to the elderly, push them towards the exit. This law is dangerous because its scope will continue to open up a little more in the years to come », warns LR MP Émilie Bonnivard. Even within the presidential majority, we are concerned about a text which will now way too far », says a Macronist heavyweight. Last Tuesday, during the weekly meeting of the Renaissance group, several executives were moved. Stéphanie Rist, general rapporteur of the Social Affairs Committee, was particularly very offensive, regretting a text become very unbalanced » compared to the government’s copy.

In committee, our deputies did anything. They got LFIsed ! I do not vote for this text and I am not the only one. Many of us find this to go way too far. Even the government is uncomfortable », rails an influential member of the majority. Renaissance MP Benjamin Haddad tries to explain the many changes made: The first version of the government was very cautious, but the deputies present in committee were very liberal on these questions. » Her colleague Caroline Janvier goes more frankly: There has been a significant shift in the text. What people who, like me, are unfavorable to the text feared, happened much faster than expected… » Before adding: The systematic radicalism of certain groups, on a subject as sensitive as this one, has led them once again to shoot themselves in the foot. »

Caution in the Hemicycle?

Many are reassured, believing that, if the most active deputies on the subject were present in the special committee, all parliamentarians will probably be much more cautious and will not validate the text as it arrives in public session. My feeling is that there will be a rebalancing », wants to believe Maud Bregeon (Renaissance). Whatever their beliefs on the subject, everyone plans for respectful and peaceful debates. “ I don’t like the idea of ​​death becoming public policy, but I want to remain very humble because I have never been faced with this choice »justifies Benjamin Haddad. It’s complicated to legislate on a permit to die, to feel truly legitimate in voting on this law which touches so deeply the innermost part of every French person. »adds Maud Bregeon.

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Will the enlargement of the text, in committee, allow the government to unite around its initial text, more “balanced” by contrast? “ The initial text already contained the seeds of what happened in the special commission. In a few days, the limits were blown. This reinforces the idea that what we are presented with as strict conditions are only provisional conditions. “, believes Claire Fourcade, president of Sfap (French support and palliative care society). In its wake, more and more learned societies and professional organizations of caregivers are mobilizing against the text.

Heavyweights like the French Pediatric Society, the National Professional Council of Nursing Aides, the French Union for Free Medicine (general practitioners) have joined the ranks of the protesters. In a forum at Figarothey address a petition to the deputies: Save the values ​​of care ! » « The caregivers who didn’t want to believe it are beginning to understand that something serious is happening. These are not a few so-called palliative care “extremists.” Caregivers are in a state of pre-traumatic stress and the government remains deaf to our warnings “, said Claire Fourcade. On the Atlantico website, psychiatrist Raphaël Gourevitch also warns: “ Asking for the improbable to obtain the unacceptable is a tactic as old as time. »

On the side of the Association for the Right to Die with Dignity, we welcome the arrival in the National Assembly of a text on assisted dying. But criticism also falls on its writing confused »according to its president Jonathan Denis, and his multiple contradictions ». Finally, he regrets that the government does not accept this development clearly enough ».

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