Interview with Tugdual Derville Remarks summerized by Frédéric Aimard
Q. How do you react to the judgment of the European Court of Human Rights (ECHR), which validates Dr Kariger’s decision to stop feeding and hydration for Vincent Lambert?
Tugdual: With great sadness, I must admit. A sad and complicated affair, which runs the risk of ending in a dramatic manner, breaking a prohibition that is as vital for medical ethics as it is for the protection of the most vulnerable. This judgment is unjust first of all for Vincent and his family whose situation is already difficult (locked room, no more physiotherapy for over 1000 days, etc.).
But it also has other serious consequences, since it opens an insidious breach in the wall against killing, and does this even in the name of human rights! It’s just this sort of inversion between right and wrong, just and unjust, between good and evil that leads to the fall of civilisations! Should we recall that in 1950 it was largely through concern to protect handicapped people that the ECHR was created? I have read the voluminous text of their judgment in this case: all the energy put in to argue against the injustice of the law: written with precision and intelligence- perhaps in all good conscience – which is as seductive as it is terrifying. As with any technique, in and of itself neutral, the law can be used to reap good fruits or to reap poisonous fruits… Here, the result is fatal.
Q. Isn’t your objection to this judgment exaggerated, and moreover typical on the part of those who lose out, their loved ones and helpers?
Tugdual: The text published by five protesting judges supports our indignation. One has to read these lines that they signed together to separate themselves from their twelve colleagues, an exceptional deed: inversing certain bioethics, which too often consists in the art of complicating simple things to thereby legitimise transgressions. The Judges go directly to the heart of the matter:
“After mature reflection, we think that, now that everything has been said and written in this judgment, that the most subtle juridical distinctions have been established, and the thinnest hairs have been split into four, what is proposed comes down to neither more nor less than that a seriously handicapped person, who cannot communicate his wishes about his actual state, can, on the basis of several contestable affirmations, be deprived of the two components essential to the maintenance of life, namely, food and water.”
These five magistrates go so far as to conclude that the Court of Human Rights has lost the right to claim the title of “Conscience of Europe”, which it boasted for its 50th anniversary. These five people, coming from modest countries, make me think of the young Daniel, who bravely confronted in public the unjust death sentence of the beautiful Suzanna, ordered by two lecherous but frustrated old counsellors. We need perhaps to learn a lesson from societies whose culture is not quite yet gangrenous with such an eugenic ideology.
Q. In your view, does the ECHR validate euthanasia?
Tugdual: Absolutely. To define euthanasia there are two criteria: the intention to provoke death, and the result, whatever means is utilized. Hydration and feeding by a tube is a simple procedure which is in no way intended to “artificially maintain life” but is simply a means to take care of the patient by giving him life’s necessities. Let’s remember that Vincent, although very dependent, doesn’t need any medical treatment, no intravenous drip, no machines; he breathes autonomously. No different than for a baby who is bottle-fed, the food and water is not intended to either heal him or stop him from dying as if he were mortally ill. Whereas by stopping feeding and hydration cannot have the object of improving his life, but can only to provoke his death. So why do we have to play word games?
Here again the five dissident judges bring light to the subject by denouncing what is hidden behind the convoluted text of the long judgment, while continuing to assume their insinuating rebellious tone: “This case, is a case of euthanasia but without wanting to pronounce the name. In principle, it isn’t advisable to use emotional adjectives nor strong adverbs in judiciary documents, but in the end, it’s most certainly a contradiction for the defending government to underline that French law forbids euthanasia, and that therefore euthanasia does not come into the question in this case.”
Q. Do you think that following this case, other instances of euthanasia will be approved?
Tugdual: Even if the French State Counsel has tried to prevent this contaminating effect, if only to reassure the carers and loved ones of some 1700 patients living in poorly-relating or neuro-vegetative states, the management of Vincent Lambert’s specific case has clearly opened a breach…
Already the promoters of the lethal injection, all the while rejoicing at the judgment, continue to argue against this mode of euthanasia as being too long and painful… A new medical team has taken over Vincent Lambert’s care, since Dr Kariger is no longer on the case, and they have already called in the family for consultation. If they follow the judgment of the ECHR and begin a new protocol for ending Vincent’s life, then we will see a wave of protest rise in the media in the time that it will take for him to die…
Moreover, the ECHR has refused to examine a request by Vincent Lambert’s parents who contest the lack of physical therapy treatment for their son. Reading their judgment, to take such a request into consideration, either it needed to have come from Vincent himself, or else he’d have to be dead!
In other words, the Court renounces its role of receiving requests from those close to unconscious persons whom they consider to be victims of maltreatment.
Q. How can you explain such an evolution in Europe?
Tugdual: Like the events which mark our history, there are some deep roots, and others that are a matter of conjecture/ happenstance. Our society which is based on performance, individualism and autonomy feels uneasy / intimidated by the extremity of this kind of situation : handicapped people suffering severe apparently irremediable brain lesions. Personnel performing medical reanimation can feel guilty for having allowed these people to survive. Loved ones can be very committed to caring for them, but it is normal for them to pass through ambivalent phases. Some who are extremely devoted over months can become discouraged and can distance themselves. It’s not a question of judging them. Others may rediscover a balance in their life that might appear senseless, almost morally questionable to the majority.
I see Vincent Lambert as society’s archetypical scapegoat where he who seems useless no longer has any value and thus generates anxiety for healthy persons. However, for human beings, it is largely this free disinterested giving of one person to another which gives defines the value of a civilisation. And beware of the economic [/utilitarian] argument that certain people are beginning to exhibit, such as that internaut who wrote to Alliance VITA, “Are you the people who’ll pay for Vincent Lambert’s hospital bill? Get a little realistic»! At times when resources are stretched, humanity has a choice of how to behave towards the weakest of its members: either by solidarity or by exclusion.