The provision of palliative care — care that seeks to maximize the quality of life for people living with serious or terminal illnesses, without hastening death — remains markedly underfunded and undersupported in France. The concept was first discussed in legislative settings in the mid-1980s, but it was not until 1999 that palliative care became a right for every French citizen. In 2005, the so-called Léonetti Law expanded these end-of-life rights to allow patients with severely life-limited prognoses the option to forego treatment — or to stop treatments that were already underway. In 2016, France introduced the Claeys-Léonetti Law, which remains the governing principle for contemporary palliative care in France. This law, presented as a specifically “French response” to a rising demand to legalize assistance in dying, permits physicians, at the request of the patient, to administer palliative sedation to people who are in the final stages of a terminal illness, or who have decided to cease treatment and face the prospect of “unbearable suffering.” With the law, France became one of the first countries in the world to make terminal sedation legal.
The rising public support for assisted dying reflects our deeper failure, as a society, to adequately care for the living.
However, palliative sedation — currently the final recourse for French palliative care physicians — is distinct from assisted dying. It is administered to alleviate suffering, not to hasten death, whereas assisted dying is an active decision, on the part of the patient and their physicians, to bring life to an end. The French terminology, “aide active à mourir,” or “active assistance in dying,” captures this well. (By contrast, francophone Canada has opted for “aide médicale à mourir ,” or “medical assistance in dying” — although the anglophone acronym, MAID, undoubtedly played a role in that choice.)
Some argue that palliative sedation does not go far enough and that current eligibility requirements for the procedure are too strict. But a more fundamental question is whether existing palliative care services receive adequate support. (...)
Some argue that palliative sedation does not go far enough and that current eligibility requirements for the procedure are too strict. But a more fundamental question is whether existing palliative care services receive adequate support. (...)
Proponents of legalizing assisted dying argue that that issue is philosophically and politically distinct from the matter of improving palliative care. But the two ideas are connected: The reasons that many French people give for wanting a change in the law are intimately related to the distressing ways in which they are seeing people die today. (...)
As sociologist Nicolas Menet recently argued, “We mustn’t reduce the question of end of life to a debate around whether or not to legalize euthanasia.” Rather, he said, “we need to discuss the financing of palliative care and value that care provision. We also need to discuss what palliative sedation really means.”
As sociologist Nicolas Menet recently argued, “We mustn’t reduce the question of end of life to a debate around whether or not to legalize euthanasia.” Rather, he said, “we need to discuss the financing of palliative care and value that care provision. We also need to discuss what palliative sedation really means.”
The reasons that many French people give for wanting a change in the law are intimately related to the distressing ways in which they are seeing people die today.In other words, improving end-of-life care in France, or anywhere for that matter, will require us to think holistically about the issues at hand, rather than look to assisted suicide and euthanasia as panaceas. (Writer and journalist Abnousse Shalmani also makes this point in a recent column for L’Express.)
by Anna Magdalena Elsner & Jordan McCullough, Undark | Read more:
[ed. Glad to see this (and as an adjunct, see this prior post: Fake Consensualism). As Woody Allen said: "I'm not afraid of death. I just don't want to be there when it happens." Denying a person's autonomy and forcing them to suffer needless, and frequently horrible deaths is, in my view, torture. At present, even states that allow assisted dying have made the process so convoluted as to be prohibitive. Perhaps this might account for part of it (from the comments section at NC:)
Props to the French for having what sounds like a very sober societal conversation on these issues. (...)
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Every day a person’s existence persists equates to more billable hours, receivables… whether from The State, or in America, the Insurors. ...It’s been said that the last six months of ‘life’ dissipate the average persons life savings and wealth. And, after all, that is what we aspire to… more money, more wealth…. what’s yours is now mine.
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As others have noted, the religious fundamentalists and the insurance/BigPharma extortion racket want to maintain the status-quo in the US. Health extortion is big business: 18-19% of GDP. No incentive to kill the golden goose.The dysfunctional health extortion in the US is just getting more dysfunctional. Medicare does not cover skilled nursing or other long-term care. The conditions in these places, while obscenely expensive, are appalling – I have seen quite a few. I can look forward to bankruptcy, debt and a horrific end of life unless I am blessed with a quick death.
