During its penultimate session prior to submission of its final document, the Citizens’ Convention on the morning of Sunday 19th March, took part in numerous votes on the procedures and conditions for active assistance in dying. Although a majority voted in favour of its authorisation, the votes did not however reveal any clear trend by the Convention on the application methods and access criteria. This shows the difficulties which would be encountered to control such practices, once the prohibition to kill is lifted.
A majority of the members of the Citizens’ Convention are favourable to euthanasia.
After the voting during the 7th session to improve “the current arrangements for the accompaniment during the end of life”, the participants of the Citizens’ Convention on the end of life gathered for a plenary session during the final morning of the 8th session to define their position on the possibility of active assistance in dying, its procedures, the routes and to evaluate alternative “end of life models”.
In answer to the question “Should active assistance in dying be made available?”, 75.6% answered yes, 23.2% answered no, and 1.2% abstained. The distribution showed little change compared with the votes which took place a month earlier. A few abstainers moved towards opposition.
The majority of citizens are favourable to active assistance in dying, subject to conditions (70.6%). Nevertheless, when questioned on the different procedures for active assistance in dying, they are far more divided, since no absolute majority was achieved: 9.8% are favourable to assisted suicide alone, 3.1% to euthanasia alone, 28.2% for assisted suicide with an exception of euthanasia, and 39.9% for assisted suicide or euthanasia by choice.
Impossible consensus on the control of “active assistance in dying”
Some hundred votes were then taken in an attempt to define all the details of the route to active assistance in dying, whether for assisted suicide or euthanasia: submission of the request, medical and psychological accompaniment, evaluation of discernment, validation of the request, execution of the procedure, supervision and control. All the proposals which were adopted can be viewed on the CESE (Economic Social & Environmental Council) web-site. Certain proposals are quite flabbergasting, such as assisted suicide for those who are unconscious or incapable of expressing themselves, which achieved 57.8% of favourable votes.
The final stage of voting concerned the criteria for eligibility for euthanasia and assisted suicide : voting age, physical or mental disease, incurability, short or medium term life-threatening condition, discernment…Rather than submitting each of these criteria to the vote, the Convention organisers chose to ask the participants to allocate a mark of between 1 and 5 to 19 competing models each proposing a combination of criteria which would provide access to active assistance in dying.
Following all these votes, it is quite difficult to understand which model would be preferred by the Convention. The one with the most 5 scores or the one with the highest average? That question has still to be resolved. Especially, no model in particular appeared to achieve a true consensus. The models which achieved the best average marks were those authorising assisted suicide for persons of voting age, with an exception of euthanasia accessible also to minors. Nevertheless, they were divided on the access conditions: how many criteria should be considered? Could mental suffering provide a right to active assistance in dying? Should life expectancy be threatened in the short or medium term? Should there be a requirement of a pathology or a “serious situation, which is irreversible and considered unbearable” could that be a sufficient condition on its own? It is clear to see the impossibility of reaching a consensus on these criteria, and how any control of “active assistance in dying” could easily be jeopardised.
The citizens opposed to the opening of active assistance in dying could have felt marginalized by these votes, in particular on the models where some of them felt that their vote served no purpose. They, in fact, had only one option each time, by voting “6” to show their opposition.
Finally, due to a technical problem, the votes on the models were cancelled and will have to be repeated during the next session on 31st March, 1st and 2nd April. It is during that session that the final document will be officially adopted. There however remains some doubt on the ability of the Convention to provide any clear guidelines for the Government.