Alliance VITA’s audition at the French National Assembly
Alliance VITA was auditioned at the French National Assembly on the Falorni bill for assistance in dying (assisted suicide and euthanasia)
On Tuesday 1st April 2025 at 21:30, Alliance VITA was auditioned at the French National Assembly by the commission for social affairs, on the subject of two bills, one on the end of life (aimed at legalising assisted dying and euthanasia under the term assisted dying), the other on palliative care. The hearing was conducted as a round table of four associations, two who support euthanasia (ADMD association for the right to die with dignity – and Choice) and two opposing it (Fondation Jérôme Lejeune and Alliance VITA).
Each association was given a few minutes to explain its position before facing questions from the MPs. We report below the introductory statements by our two representatives, Dr. Olivier Trédan, medical advisor to Alliance VITA and Tugdual Derville, its spokesman, who based their case on the bill being put forward by Olivier Falorni.
Tugdual Derville
Mr President,
Mr. General Reporter
MPs…
Thank-you for inviting us to speak. In the view of Alliance VITA this text which you are asking us to comment on is dangerous in its very principle and even more so in its methods. I call upon our medical advisor, Dr. Olivier Trédan, an oncologist, then I shall add to his statement.
Dr Olivier Trédan, medical advisor
Like many of my colleagues, and as an oncologist, I cannot accept, the very notion of “assistance in dying”, which attempts to legitimise assisted suicide or euthanasia. Our mission, through our choice is to accompany on a daily basis patients suffering from a disease as difficult as cancer. It means caring for life and our patients and not administering death.
As head of a medical oncology department, I am astounded by the radical changes which you are proposing because the criteria adopted by your text would result in a serious impediment to our work and the devotion of healthcare staff. The fragile trusting relationship established between healthcare staff and patients would in many cases be diminished or even lost.
First of all, you propose that a patient who asks for a prescription for a lethal product should “be suffering from a serious and incurable disease, threatening his/her life expectancy, in an advanced phase”. I can confirm that the announcement of an advanced phase cancer (typically with evolving metastases) brings with it the announcement of a risk of death. However, I wish to stress that, thanks to progress in medicine and in oncology in particular, most of metastatic cancers can be controlled for several years.
It is a paradox of these serious diseases, whose outcome is often known, that their rate of development is unpredictable. The time left to live with metastases is often measured in years. How then, under such circumstances, can one give a hasty response to a request to die whereas, in particular, the time left to live for most patients is so uncertain?
This is the very heart of the carer/patient relationship, based on a pact of trust: the patients know that they have an incurable disease but hope to receive from us the treatments and care best suited to their circumstances throughout its development. You are well aware that our hospital facilities are currently suffering from a cruel lack of means, particularly human means; many wards are operating in degraded mode due to a lack of healthcare staff or doctors.
Many professionals have expressed their distress at work. A breakaway law allowing any doctor, at any moment during the development of the disease, to suggest and then to implement a procedure aimed at causing death, would inevitably introduce distrust in patients weakened by a chronic disease, and a doubt on their right to live.
Also, in order to procure the lethal product your text refers to “suffering which is resistant to treatments or unbearable according to the person, when he/she chooses not to receive or to stop receiving a treatment”. The overall treatment for chronic incurable diseases such as metastatic cancer must be early, multidisciplinary and multimodal. Early in the patient’s development path, we implement many medicinal or non-medicinal treatments.
Everything possible is done, through support care, in order to relieve physical suffering and moral distress. In that context, the term “unbearable” is understood as a signal inciting the use of objective indicators and scales to enable repeatable and reiterated evaluations. The carers dealing with chronic and serious diseases know that suffering is eminently variable with time and requires regular re-evaluation. So-called unbearable suffering is anything but an objective and tangible criterion. Its use as a decision criterion is therefore not acceptable and would prevent any pertinent evaluation of practices.
Finally, according to your text, the validation process for assisted suicide or euthanasia is based in fact on a single deciding doctor. It may be accelerated, with no possible appeal by family members or carers.
With such a law, a new risk is generated for fragile patients: when during periods of distress, they ask to die, a rapid and implacable process could be initiated, which would lead in a few days to the lethal injection. There is a risk of a breach of trust by certain willing doctors who would administer death as they administer any common medicines.
That is exactly the situation of medical omnipotence reported by our colleagues in Holland whose patients are suddenly snatched up by the euthanasia specialist organisations. I should point out that my position is shared by hundreds of committed carers within our association.
Tugdual Derville, Alliance VITA spokesman
As you will have understood through Dr. Trédan’s presentation, removing the prohibition on killing a patient, a key element in any medical code of ethics, would be all the more unjust at a time when our health system is experiencing a multiform crisis which exposes us all.
This text in our view contradicts the very national slogan which it claims:
A/ A freedom is authentic only when expressed in full knowledge
Which is not the case here, because the patients concerned are subject to three types of pressures which distort their freedom:
- Firstly, what is the meaning of a freedom, under the pressure of poorly treated suffering, due to a lack of accompaniment or care, in particular palliative care?
- Secondly, what is the meaning of a freedom under the pressure of a fear of what may happen but which is never totally predictable?
- Finally, what is the meaning of a freedom under the pressure of a society which considers you to be useless, burdensome or costly? It suggests that the lives of the sick have no sense or value, the right to a so-called “assistance in dying” ends up becoming a “duty to die”.
It must be stated that the administered death would be forced on families, with no possible right of appeal, on chemists and health establishments, with no conscience clause. And on all the healthcare team, restrained from accompanying the patient. For all of them, “freedom” becomes liberticidal.
B/ Equality also is scorned
Indeed, for all those living in conditions of isolation, social precariousness, medical deserts, without access to palliative care, assisted suicide or euthanasia would appear as the obvious solution through a lack of solidarity. One must be conscious of these discriminations bearing in mind the Canadian example: people suffering from degenerative diseases call for euthanasia due to a lack of suitable support. Again in Canada, most of those who choose euthanasia have low income.[1]
C/ Therefore fraternity is suffering
The universality of suicide prevention, a key element in our social pact is a stake for fraternity. To deprive patients of such prevention is to break the solidarity pact.
Dr. Trédan is quite right to raise the subject of cancer – which is the reason for the vast majority of euthanasia in those nations which have legalised it. Those patients who are psychologically fragile, isolated, destitute, aged are those who most frequently call for euthanasia.
We are particularly concerned for the aged: the over 75s experience the highest suicide rate. The President of the MGEN health insurance, who supports administered death, shocked us by stating: “The suicide rate of the aged in France shows that there is already a demand”.
But it is the very availability of assisted suicide which generates the demand. Instead of saying “We shall be here to care for you right until the end, because your life is valuable!” such availability poses a question which reverses fraternity: “Surely it is time to go? You have had your time.” We have already noted, through this debate, a Werther effect on the contagion of suicide: our end-of-life help line, is receiving ever more suicide requests for people merely suffering psychologically. The debate has led them to believe that a dedicated public service could suicide them.
We are also shocked by the designation of categories of patients eligible for suicide or euthanasia (starting with those suffering from motor neuron disease, as understood by several political leaders). The head of health insurance which I quoted above is campaigning to delete any threatened life expectancy condition, referring to those suffering from neuro-degenerative diseases.
Several members of our association who are suffering from Parkinson’s, ALS or other degenerative diseases say they are horrified at being so stigmatised. It is a violence for such patients as well as for their families and carers who are fighting alongside them in confronting the ordeal of the sickness. Those most deeply suffering and their families have the greatest need for protection against despair. Instead of pushing them towards their death, fraternity would consist in helping them to live, by providing relief, without aggressive therapy, nor euthanasia, nor encouragement to suicide.
Finally, we are concerned for palliative care, as was the State Council, who in 2018 wrote: “The expression of a request for an anticipated death should never be the result of a lack of access to palliative care. Access to high quality palliative care (…) is a necessary prerequisite to any proper ethical debate on the question of the end of life[1].”
That is why we consider that there should be a consensus on a programming law to implement a ten-year plan for palliative care, prior to any modification to the law on the end of life. At a time when governments are having difficulty in meeting their commitments, we do not understand your impatience to legalise euthanasia. Your bill if it is adopted, could come into effect by the end of 2025 whereas the “ten-year strategy on accompaniment care” will be spread over ten years. The urgency therefore demands the adoption of a programming law which is the only way to guarantee universal access to palliative care.
I should like to conclude by stating that Alliance VITA can provide you with this document which summarises the return of experience reported from five nations which have already legalised assisted suicide or euthanasia. These expert statements and witness reports corroborate all our warnings.
Thank-you for your attention.
[1] 58% cf. https://theconversation.com/projet-de-loi-sur-laide-a-mourir-peut-on-ignorer-la-question-economique-248612
[1] Conseil d’Etat « Révision de la loi bioéthique : quelles options pour demain ? » Juin 2018.
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