France: Palliative Care and Euthanasia

The 2016 Claeys-Leonetti Act, which authorizes deep and continuous sedation without going as far as euthanasia, was not enough for progressive groups. Thus, in 2023, the Citizens' Convention on the End of Life, convened by Emmanuel Macron, declared itself in favor of a conditional opening to active assistance in dying. A bill had been drafted under Gabriel Attal's government in 2024, but the dissolution of the National Assembly in June interrupted its consideration.

It was in this context that Prime Minister François Bayrou decided to split the issue into two separate texts. This strategy, announced on February 26 by the Minister of Relations with Parliament, aims to separate the issues of palliative care, which enjoys broad consensus, from those of euthanasia, which still faces considerable opposition in the country. This approach was seen as a "delaying tactic" and even "hypocrisy" by advocates of white-coat death.

The government seemed to be at a point leading to a form retreat: the two bills were submitted simultaneously on March 8, 2025, so as not to suggest that the Prime Minister might prioritize his ethical and religious convictions—François Bayrou is a Catholic opposed to euthanasia—over the "values ​​of the Republic," a requirement of secularism.

The proposed law on palliative care aims to strengthen access to palliative care, which is often considered insufficient: less than one in two patients requiring palliative care would actually have access to it, and more than 20 departments lack dedicated services. The text provides a ten-year strategy to develop this care, with quantified targets and increased budgetary resources. The aim is to guarantee dignified care for all, regardless of the issue of euthanasia.

The second bill is openly transgressive. It proposes legalizing euthanasia under conditions presented as "strict": first, it would be necessary to be an adult, reside in France on a permanent basis, suffer from an incurable illness in its advanced or terminal stages, and demonstrate free and informed consent.

Suffering, whether physical or psychological, must be deemed unbearable by the patient themselves. This text, which is careful not to use the terms "euthanasia" or "assisted suicide," is inspired by the 2024 bill, amended before the dissolution.

Furthermore, it also institutes the crime of obstructing assisted dying, similar to the one that exists for abortion. Thus it is difficult to dismiss as "excessive" the remarks of U.S. Vice President J.D. Vance, who expressed concern about the decline of the "rights of conscience" in Europe, during his speech in Munich on February 14.

A palliative care physician, Claire Fourcade, president of the French Society for Palliative Care and Support, is concerned about the way the debate on the end of life is being presented in France: "We give the impression that in France everyone dies in extreme suffering after a long, painful agony. This is not the reality.”

"In the vast majority of cases, death occurs peacefully, calmly, or, conversely, suddenly, unexpectedly. And rare are the patients who ask to die, today as in the past; in twenty-five years, our team has had to follow nearly 15,000 patients, and I have only encountered three cases of persistent requests,” the caregiver explained to the newspaper La Croix on March 8.

For this Catholic, “euthanasia is the law of the strongest. A law for those who are capable of standing up to death and deciding on it. However, the vast majority of patients at the end of their lives are experiencing a loss of control and fragility. That's why I want a law for the weakest. The law is a collective response that must first take care of the most vulnerable.”

Supporters of the culture of death are delighted to see their fears that vote on the legalization of euthanasia would be postponed indefinitely recede. Those who fear assisted legalization will console themselves with the thought that the bill on palliative care could achieve a degree of unanimity in the House, which would send a strong message to patients and the public.