2024-03-25 09:00:13
On March 10, the President of the Republic presented the bill in favor of “assisted dying”, which is part of real progress for the care of the end of life of our patients.
We, active caregivers signatories of the collective forum of September 7, 2023, demanding and assuming unfailing medical support for people eligible for such “active assistance in dying”, take note of this first step. Here we would like to highlight the positive elements of the project, and its room for progress.
The project presented allows societal and medical advances for end-of-life situations which were not previously taken into account by previous laws, in particular pathologies with a medium-term prognosis. It is progress for patients’ rights and a formula which attempts to bring together the various actors through its nuance, even if they are initially reluctant. Whatever the term chosen, it will be possible for us tomorrow to respond to the requests made to us by patients and thus to support them throughout the process: from the evaluation of the request until their end of life and the monitoring of their relatives. We also welcome the decision to have integrated into the scope of refractory pain the psychological character of this, often a central component of what a patient describes as the dignity of his life.
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However, we would like to point out several areas of significant improvement to be made.
The notion of “short and medium term” will pose an inevitable problem, insofar as, basically, it excludes fatal pathologies in the longer term than a few months (authentic sources of refractory suffering, notably neurodegenerative); and, in terms of form, by the very imprecision of the notion which, as with the Claeys-Leonetti law of 2016, risks being decided a posteriori by the medical profession or a health authority, hypertrophying medical power at the expense of the right of the patient. No neighboring European country has introduced this notion of “term”, focusing on refractory suffering. We therefore propose an identical approach, which will avoid the paradox of a law effectively excluding the most emblematic applicants, those with fatal neurological damage in the medium to long term.
The examination of a request for assistance in dying by a broader body, professional and non-professional, raises the question of its application on a practical level, and the risk of “perpetuating”, or even blocking, this examination by a multiplication of reservations. Here again, our European neighbors have not opted for this complexity, except in Spain. For an approach that is both impartial and as precise as possible, we offer an examination carried out by the doctor in charge of the patient, assisted, if necessary, by a nurse also familiar with the person, and completed by an (independent) specialist. of the disease in question.
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