World Day for the Right to Die with Dignity

November 2 is the World Day for the Right to Die with Dignity.

In reality, circumlocution refers to euthanasia or assisted suicide. The illiberal political climate in which France is immersed makes it difficult to assert that one chooses one’s death. However, classical philosophy proposed a hermeneutics of existence articulated around death.

For Socrates, knowing how to live implied knowing how to die, and philosophy is nothing but a “practice of death” (melete thanathou) : to die in the body to be born in the mind. Ancient Greece, which was not afraid to clearly designate reality, saw in the kallos thanatosthe noble death, an ideal of life, just like the Romans: Bene autem mori est effugere male vivendi periculum (to die well is to escape the danger of living badly), affirmed Seneca: “I choose my boat myself when I embark and the house where I will live; I have the same right to choose the kind of death, by which I will come out of life” (Letters to Lucillus).

What does liberal thinking say about the right to die with dignity?

Liberal thought takes up this tradition by leaving the individual free to choose his death. The state is conceived as a protection of the individual against others. John Stuart Mill said that ” in this time of progress in human affairs, the individual must challenge the rules coming from outside, decide for himself, to the point that no one is entitled to prescribe standards for him, including for the to prevent self-harm “. Each in front of pursue one’s own good in one’s own way”, refraining from injuring others, it follows that “every restriction as such is an evil » (On Liberty1859).

The Judeo-Christian tradition refuses to see a distinction between euthanasia and homicide. According to the Catechism of the Catholic Church:

“ Voluntary euthanasia, whatever its forms and motives, constitutes murder. It is gravely contrary to the dignity of the human person and to respect for the living God, his Creator. “.

However, since Pius XII the acceptance, even the encouragement of palliative care by the Church has come to qualify the theological condemnation and give a compassionate dimension to the question of the end of life. It is in this tradition of commiseration that the main texts were adopted in France since the circular of August 26, 1986 relating to “the organization of care and support for terminally ill patients” and later the law of June 9 1999 “aiming to guarantee the right of access to palliative care” until the law of February 2, 2016 via the Kouchner law of 2002 and the Leonetti law of 2005.

Respect life or respect the will to die

The spirit of all these texts could be summed up as follows: it is better to respect the life of the patient rather than his will to die.

However, these are two separate issues. As medical acts aimed at relieving pain, alleviating suffering and supporting the patient and those around him, palliative care is a necessary but not sufficient right. Reality shows that the development of palliative care, including deep sedation, does not put an end to the social demand for active assistance in dying. One does not exclude the other and only euthanasia and above all assisted suicide (without external pressures or influences) guarantee individual self-determination and sovereignty provided that the patient can also choose palliative care in complete freedom.

The legal history of the end of life in France shows that the question has never been treated as that of a freedom protected by the State but as a medical act of compassion.

It is indeed in this climate of popular emotion caused by certain high-profile cases (Chantal Sébire, Vincent Humbert, or Vincent Lambert) that the politician reacted by mobilizing his magisterium of approved experts: Commission for reflection on the end of lifeunder the direction of Pr Didier Sicard, opinion of the National Consultative Ethics Committee (CCNE) on the End of life, personal autonomy, will to die (opinions no. 63 and no. 121), Citizens’ Conference, Regional spaces for ethical reflection, Report on the public debate on the end of life of CCNE, General states of bioethicsetc.

François Hollande had even made “medical assistance in death” an electoral promise never kept. While 94% of French people approve of the use of euthanasia and 89% are in favor of assisted suicide, while President Macron has said he is personally in favor of euthanasia and the CCNE is paving the way for active assistance in dying , while our Belgian, Swiss, Italian, Luxembourg, Spanish, English and Austrian neighbors already have the right to medical assistance in dying, France is struggling to propose a new legal framework, despite the fact that several parliamentarians had tabled the January 19, 2021 a bill n ° 3755 “ aiming to affirm the free choice of the end of life and to ensure universal access to palliative care in France », widely supported in a cross-partisan manner.

Good political and expert intentions are more paternalism and pain than the search for an emancipatory solution that respects the patient’s autonomy. The liberal State is one that allows the individual to choose freely and in an informed manner (according to his personal convictions, his health situation, his tolerance to suffering, his loss of autonomy, etc.) by guaranteeing his right to die naturally, to have access to palliative care in hospital or at home and to deep sedation, to leave advance directives to organize the end of life, but also to have active assistance in dying in all its forms or to refuse. Only the individual knows what is worthy for him and no authority, apart from that of his conscience, can impose on him to undergo a suffering considered unbearable.