France's National Assembly will give final approval to assisted-dying bill after years of debate

PARIS — France's National Assembly is set to give final approval Wednesday (July 15) to a bill allowing adults with incurable illnesses to receive lethal medication, the culmination of years of debate over end-of-life care.

The lower house of parliament is widely expected to approve the measure after backing it in three previous readings, completing parliament's work on the legislation announced by French President Emmanuel Macron over three years ago.

The proposed measure primarily provides for medically assisted suicide, by allowing patients to receive and self-administer lethal medication under strict conditions. 

Only people whose physical condition prevents them from doing so would be allowed to receive assistance from a doctor or a nurse.

The Senate, the upper house where conservatives hold a majority, rejected the bill. 

Under France's legislative process, however, the National Assembly has the final say when the two houses of parliament disagree.

Senate President Gerard Larcher has said he will refer the bill, once adopted, to the Constitutional Council, which will have up to a month to determine whether it complies with the Constitution. 

The law would only enter into force once that review has been completed.

The bill sets strict conditions

Patients seeking to end their lives would have to be at least 18 years old and either French citizens or legal residents of France.

A doctor would first have to consult a team of health care professionals and then confirm that the patient has a serious and incurable illness that is life-threatening. 

The patient must be in an advanced or terminal stage, experiencing pain that cannot be relieved or is unbearable, and seeking lethal medication of their own free will.

Lawmakers specified that psychological suffering alone would not qualify a person for medically assisted dying.

People with severe psychiatric disorders or neurodegenerative diseases such as Alzheimer's would not be eligible.

Patients would initiate the request, to be reviewed by health professionals within 15 days, and then confirm it after a period of reflection lasting at least two days.

If approved, they could take the lethal medication at the time and in the place of their choice, including at home or in a health care facility, in the presence of their loved ones if they wish.

On the chosen date, the doctor or nurse would have to verify that the person still wishes to proceed and remain nearby to intervene if complications arise.

France's national health insurance system would cover all associated costs.

Many French people support the changes

A 2023 report found that most French people are in favour of legalizing end-of-life options, and opinion polls have shown support increasing over the past two decades.

The Association for the Right to Die With Dignity said the law would allow people "to choose to end unbearable suffering, freely and with full awareness." 

Its president, Jonathan Denis, said in a statement that "a law that creates a new right never forces anyone to exercise it. It does, however, ensure that every person … can remain at the heart of medical decisions that concern them and have their wishes respected."

Opponents argue the measure could put pressure on older people and those living with illness or disabilities.

In an open letter to Macron, the anti-euthanasia group Alliance Vita said "every effort must be made to ensure that people who are suffering have immediate access to palliative care and support. Presenting death as a desirable solution can never be an acceptable response to suffering and is contrary to human dignity".

In the past years, many French people have travelled to neighbouring countries where medically assisted suicide or euthanasia is legal.

Medically assisted suicide generally involves a patient voluntarily taking lethal medication prescribed by a doctor. Euthanasia involves a doctor or other health care professional administering a lethal injection at the patient's request.

Euthanasia is legal under certain conditions in the Netherlands, Belgium, Luxembourg, Spain, Portugal, Canada, Colombia, Australia and New Zealand. 

Some of those countries also allow assisted suicide, which is legal in Switzerland, Austria and several US states.

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