Skewing the Statistics on Clandestine Assisted Deaths in France

On April 8th, the French National Assembly debated a bill tabled by MP Olivier Falorni to legalize euthanasia and assisted suicide. The promoters of euthanasia regularly argue about the hypocrisy of the French position. They claim that the annual number of clandestine assisted deaths is between 2,000 to 4,000 and call for ending this outrageous situation. However, as pointed out in the newspaper “La Croix” on April 26, 2021, this argument is based on a distorted extrapolation of statistics published in a 2012 study.

The “INED” (National Institute for Demographic Studies) study evaluated the end-of-life medical decisions made by doctors for nearly 5,000 cases of death (or 0.01% of the total number of deaths in France at the time). Essentially the INED reported that: “Acts of euthanasia (‘ending a patient’s life at his own request’) accounted for 0.6% of total deaths; and 0.2% (11 cases) resulted from deliberately administering a substance to end the patient’s life. In these latter cases, less than 4 were defined as euthanasia by the doctor; the others were generally considered as administering sedation to relieve suffering for end-of-life distress. »

Proponents for euthanasia took advantage of INED’s rather ambiguous wording to retain the highest figure of 0.6%, and then applied it to the annual total number of deaths in France to publicize a figure claiming that there are nearly 4000 so-called “deaths by euthanasia”.

One of the study’s chief scientists has repeatedly warned about this biased analysis. On the one hand, the study does report that some patients were sedated for unspecified reasons, but if the lower number of 0.2% is used, the hypothetical number would be a little over 1000 presumed deaths by euthanasia. On the other hand, it is not scientifically sound to use such a percentage from one single study and then apply it as a representative index for the national population.

The recent article in “La Croix” reasserts what other media and organizations have already pointed out over the last years. As early as 2012, the National Consultative Committee on Ethics (CCNE) insisted on restoring the real facts in an article entitled “End of life, personal autonomy, desire to die”. Nonetheless, at the beginning of the General Bioethics Conferences during the first semester of 2018, this argument of clandestine euthanasia was again widely used in France by several politicians and journalists. Adding fuel to the fire, “fact checkers” from the Libération newspaper arrived at the same conclusion, and published an article entitled “Are there really 4,000 acts of euthanasia per year in France? Shortly after, the French Society for Counselling and Palliative Care (“SFAP”) retorted with a well-documented article entitled: “4,000 cases of clandestine euthanasia a year in France? That is not true. »

The way the promoters of euthanasia continually persist in misinterpreting the INED study finally shocked many observers and experts on these issues. For example, in a January 2019 interview with Tanguy Chatel, a specialist in end-of-life and palliative care spoke of the misinformation: “We had the opportunity, on many occasions, to politely and calmly tell those who spread these errors, that they were misinterpreting the study. The authors of the study also publicly denounced the use that is made of their work. This repeated and abusive misrepresentation shows that it is not just an accidental and excusable error, but a deliberate misinterpretation for ideological and political reasons. This figure, along with other erroneous information, is being purposefully used to push for the legalization of euthanasia by making it appear that there are more cases of clandestine euthanasia in France compared to other countries where it has been legalized. In fact, it is seems to be exactly the opposite. »

Indeed, in the countries that have legalized euthanasia, the issue of clandestine euthanasia or assisted suicide persists. For example, several studies demonstrate that in Belgium, a country presented as a model to be imitated, there is still a great number of unreported assisted deaths. Not only has decriminalizing the practice not eliminated clandestine euthanasia, but nowadays authorities just shrug it off as an inevitable fatality.

Thus, the Chairman of the Federal Commission for Controlling and Evaluating  Euthanasia (CFCEE), Professor Wim Distelmans, commented on the report published in 2015  with the following remark: “Let us not forget that the number of times euthanasia has been practiced without being declared, prevents us from having a real view on the magnitude of the question.” Even more formally, the Control Commission mentions in its 2018-2019 official report (page 47): “As already stated in previous reports, the Commission does not have the means to assess the cases of euthanasia officially reported, compared to the actual number of acts performed.”

In July 2012, a study conducted by researchers from the Free University of Brussels and Ghent was published in Social Science and Medicine. Based on a representative sample from 480 doctors in Flanders and 305 in Wallonia, this in-depth survey revealed that 27% of all euthanasia practices in Flanders and 42% in Wallonia were never reported to the Control Commission.

In Belgium this alarming practice of undeclared, and therefore illegal, euthanasia was corroborated by a second study. Published in 2018 in the Journal of Pain and Symptom Management in 2018, it was found that at least 31% of euthanasia practices carried out in Flanders in 2013 were not reported to the Control Commission. In a significant number of these unreported cases, the patients were sedated (with or without consent) in order to hasten death. The study indicates that many doctors do not even consider these acts as euthanasia and find it therefore unnecessary to file official declarations for the Commission. Nonetheless in the medical and legal sense of the term, if a doctor injects a patient with a product to hasten his death, whether it is inherently lethal or not, this act is indeed qualified as euthanasia, due to the doctor’s intention.

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