Vincent Lambert and Euthanasia: Reactions of the Political Class

May 28, 2019

The last twist and turn of this painful story provoked reactions in the political milieu. The manner in which the question is approached and the vocabulary employed are symptomatic and deserve an analysis.

Benoît Hamon (Génération.s): “When there is a determination to maintain a life that is no longer, it is something hard, terrible to imagine persevering, to persevere like that; and the decision of the Council of State seems to me to be heading in the right direction.” He adds: “I understand that today, French men and French women do not want to live in a form of prison, which is that of a body that no longer responds to the brain.” Let's emphasize the terms of tenacity and prison. We would like to know in what way giving food and drink is a kind of tenacity. And for a body that no longer responds to the brain, it is medically false.

Raphael Glucksmann (Socialist Party and Public Place) awkwardly avoids the question: “If the medical profession is unanimous, if justice decides that the medical profession is right, well it must follow justice!” But precisely, there is no unanimity of the medical profession, since several services have proposed to receive Vincent Lambert so as to continue his nursing care and nourishment. As for justice, it has exceeded its rights, because the Leonetti law—which, moreover, is unjust and thus not a law, but that is another question—does not apply in this case.

Manon Aubry (La France Insoumise) says: “From a legal point of view, there have been various decisions by the Council of State, the European Court of Human Rights, which say the same thing: he does not need intensive medication.” We are seeing one more time how the proponents of euthanasia use this term. In order for there to be intensive medication, there needs to be a treatment, because drink and food do not constitute treatment.

Yannick Jadot (Europe Ecology): “In Belgium, it is first the companion who decides, it should be the same in France. If Vincent Lambert’s wife asks that her husband be no longer fed, it is her right.” It is always the same confusion between nutrition and treatment. The Belgian example speaks: it is the country with the most radical legislation concerning euthanasia; it is even ahead of the Netherlands in this matter.

Euthanasia, Intensive Medication and Unreasonable Tenacity

François-Xavier Bellamy (The Republicans) believes that “behind Vincent Lambert, it is the question of our connection to the extreme dependence that is in play.” “We live in a world that worships performance,” he adds, “where being human is being fit, agile, fast. And here we have the heart of a figure of humanity who looks at us and tells us that he is absolutely dependent. And sometimes we have the temptation to consider that the absolutely dependent life is a life that is no longer worthy of living. There is no life not worthy of being lived. This reflection of the ethical order—“is an affair that supposes that we have reason to intervene”—has  a certain value. But to add that “it is not a matter on which one should express oneself using religious convictions” is a very clear rejection of the sovereignty of God over all things.

Marine Le Pen (National Rally) accurately points out that: “Beyond Vincent Lambert, the question is about euthanasia.”

Marion Maréchal also seized the subject, considering the cessation of care to be “euthanasia.” “I see in the manipulation of Vincent Lambert’s case the desire to broaden the application of the current law or even prepare people for a new law on euthanasia,” she said.

Emmanuel Macron, when asked to comment, replied on Twitter: “On this issue, which touches each one intimately, there is no simple or unequivocal answer. Only uncertainties and heartbreak…and the desire to respect the dignity of all human life. As President of the Republic, it is not for me to suspend a decision that dismisses the assessment of his doctors and that is in accordance with our laws. All the medical experts have decided on the irreversible nature of his condition. The decision to stop treatment was made after a continuous dialogue between his doctors and his wife, who is his legal guardian. It has been, in accordance with our legislation which allows for the suspension of care in cases of unreasonable tenacity—which, according to the various medical teams, is the case with Vincent Lambert.”

The Leonetti Law had Already Opened the Door to Excesses

Unreasonable tenacity obstinacy has replaced intensive medication in this discourse. This is also the term used by the Leonetti law: “The acts mentioned in Article L. 1110-5 [prevention, investigation, or treatment] should not be implemented or prosecuted when they result from unreasonable obstinacy.” It may be less aggressive, but the expression is no less formidable.

The remainder of the article makes it possible to understand the venom contained in this law: “When they appear useless, disproportionate, or when they have no other option than only the artificial support of life, they can be suspended or not be undertaken, in accordance with the will of the patient and, if the latter is unable to express his will, at the end of a collegial procedure defined by regulation. —Artificial nutrition and hydration constitute treatments which may be stopped in accordance with the first paragraph of this article” (Article L1110-5-1 of the Public Health Code).

By introducing “only the artificial support of life” without any circumstance, we open the door to frankly euthanistic interpretations. Similarly, the terms “artificial nutrition and hydration” are not defined, and one can blithely identify a drip or parenteral nutrition (sophisticated intravenous nutrition system) with a simple gastric tube under these terms. It is an open door to euthanasia that still threatens Vincent Lambert, and all those who are in his condition.

Voluntarily Vague and Ambiguous Texts

It is interesting to note the triple interpretation given to this text:

1) That of Dr. Vincent Morel, a palliative care physician who believes that the cacophony in the Vincent Lambert affair “is not linked to the texts’ lack of clarity.” “The 2016 end-of-life law gives clear criteria: the uselessness of treatments, their disproportion and only the artificial maintenance of life.” This is not the opinion of the two following interpretations:

2) That of Marie de Hennezel, clinical psychologist and also palliative care specialist: “Vincent Lambert is a disabled person...Moreover, he is very important to his parents. We cannot ignore that...At the Berck Maritime Hospital, they take care of people in comparable situations. He is not in a situation of intensive medication. If we consider that this is the case, we enter into another debate, which has not yet taken place, on the care to be given to people in a chronic or pauci-relational vegetative state.”

3) That of professor of medicine Jean-Louis Touraine, also deputy LREM (The Republic in progress). Like other advocates of a “right to die with dignity,” he acknowledges that “the texts are very imprecise. If unreasonable obstinacy was clearly defined in the law, this frightening spectacle of a clash of two camps around Vincent Lambert would not exist.” Deputy Jean-Louis Touraine, fervent supporter of a law on euthanasia, advocates a new regulation: “It would be possible to specify that extremely deep vegetative states represent an unreasonable obstinacy, he believes. The sense of human dignity is nevertheless a minimum of brain activity.”

But professor of medicine Touraine cannot ignore that the electroencephalography of Vincent Lambert shows clear brain activity, and the expression “extremely deep vegetative state” is anything but clear. He can no longer ignore recent advances in the classification and explanation of so-called “minimal” states of consciousness.

Notably, the publication of the results of scientific work—disconcerting—accomplished using new techniques of cerebral functional imagery which tend to establish the existence of a certain degree of consciousness in patients diagnosed as being in a persistent vegetative state (PVS) or in a minimally conscious state (MCS). These results have shaken up the certitudes professed until now.

They are providing new evidence: beyond the diagnostic approximations, “the absence of proof of consciousness does not signify the absence of consciousness.”