At its last reading, the bill to legalise assisted suicide and euthanasia was adopted by a relatively narrow margin. The National Assembly voted by 291 votes "for" versus 241 votes "against". There were 29 abstentions.
As it is a bill, i.e. on the initiative of MPs, the reading process between the two chambers (National Assembly and Senate) ended with this vote because the Government so decided. They chose to give the last word to the National Assembly following the failure of the Joint Representation Commission (Commission Mixte Paritaire) last May. But it could also have allowed the parliamentary ‘to and fro' process to continue, remove the text or submit a new one.
The vote was marked by the absence of consensus in Parliament
Other than the pressures applied by the euthanasia militants, the evolution of the voting by the National Assembly partly explains the choice to call for a final decision.
- At the first reading, on 27th May 2025, the bill was supported by 305 votes "for" versus 199 "against", with 57 abstentions.
- At the second reading, on 25th February, the text achieved 299 votes "for", 226 votes "against" and 37 abstentions.
- At the third reading, on 30th June, there were 295 votes "for", 232 votes "against", and 35 abstentions.
The trend is clear: diminishing support and less abstentions. Simply more opposition.
The Senate being largely opposed or hostile to such a permissive text, it is possible to conclude that a majority of parliamentarians were opposed to the law.
In 2005, the Leonetti law on the end of life was adopted by 548 votes out of 551 MPs. That law prohibited unreasonable therapeutic obstinacy whilst seeking to encourage the development of palliative care. It is one of the rare French laws to have been adopted unanimously by the votes cast.
The attempts by numerous MPs to regulate and attenuate the effects of the text legalising assisted suicide and euthanasia were rejected. Thus, of the 1800 amendments submitted, a mere 23 were accepted by the relatively close majority – in favour of the text.
The contrast is striking. Emmanuel Macron, who supported the entire process, and the Government, chose to break away from several decades of legislative consensus on the end of life. On such profound issues as the end of life and death, this breach is all the more irresponsible in that our health system is confronting a serious crisis.
The major principles of the text adopted
The text adopted finally includes few changes compared with its first version put to the vote on 27thMay 2025.
The principle of the execution of the lethal act in the form of assisted suicide is maintained, with an exception of euthanasia for those "who are physically unable to do so " (article 2). In such case, the act is then performed by a doctor or a nurse.
Article 2 also establishes penal irresponsibility for all those who take part in the procedure chain leading to the administration of death to the patient.
A claimed "exception" which establishes a broad rule
Several parliamentarians picked up in the debates on the use of the term "exception". It relates to exceptional situations, in specific cases of pain which is refractory to any treatments. The media willingly use the expression "strict framework" to indicate the criteria listed in article 4. However, the notion of "a serious and incurable condition which threatens life expectancy", in an advanced or terminal phase, provides the scope for a broadened interpretation.
The high authority for health (HAS) has stated that "there is no medical consensus on the definition of threatened life expectancy in the "medium term", nor on the notion of "advanced phase" when it is considered within an individual approach to a temporal prognosis." In that statement, it defines advanced phase as "the entry into an irreversible process marked by the aggravation of the state of health of the sick person, affecting his/her quality of life." That definition therefore refers to a subjective criterion on the quality of life of a patient, but which lacks any scientific or medical foundation.
A study of these ill-defined criteria has led to a plausible estimate of 1 million "eligible" candidates. The French Society for Accompaniment and Palliative Care (SFAP) has corroborated that estimate. During the plenary session debates, several MPs underlined this point. The euthanasia supporters systematically stated that one has to trust the carers who will be in charge of responding to the requests for assisted death. Such trust, according to them, means that carers will never be tempted to adopt a broad interpretation of the criteria. Surprisingly, those euthanasia supporters did not grant their trust in the carers when the latter, in large numbers, expressed their disagreement with the text.
A procedure which sanctions medical omnipotence over the patient
Articles 5 to 10 detail the different stages in the procedure. Elise Rojas, the lawyer for the JABS collective (solidarity to the end), recently published a book against assisted suicide, under the evocative title "To die, type 1". It is indeed an administrative medical procedure being established by the text.
Of all the points detailed in the text, it should be noted that:
- The initial request by a patient is not necessarily made in writing. A remote consultation is nevertheless excluded for the initial request.
- Only a person whose discernment is "severely diminished" is excluded from the procedure. That leaves some scope for evaluating the degree of diminished discernment.
- Those under legal protection are not excluded from the procedure. The obligation for the doctor to consult a register of protected people has to confront a reality which is recognised in the text itself: the existence of the register will be effective "at a date to be determined by decree, and no later than 31st December 2028'.
- A collegial meeting is to be held with at least three carers. But the final decision is not collegial, it is taken by the only doctor contacted by the patient. In this collegial procedure, a specialist in the patient's pathology examines the person "except if he/she does not consider it necessary"! In other words, the law does not demand such an examination. Neither is the patient's family doctor necessarily consulted.
- The doctor must come to a decision within a maximum of 15 days following the patient's request. In practice, the doctor can decide sooner.
- The patient is obliged to comply with a 48-hour cooling-off period before confirming his/her request. That period is extremely short, compared with foreign legislations and compared with the cooling off periods applicable in many cases in everyday life (buying a car, plastic surgery, etc).
- Only doctors and nurses, who may directly prepare and administer the lethal substance, have the benefit of a conscience clause, nevertheless, they are under obligation to send their patient to "health professionals who agree to participate in the implementation of the procedure". Pharmacists, nursing auxiliaries and health establishments or old people's homes do not enjoy any such protection.
- A commission is to be established to "monitor" the procedure after the event. Its composition does not exclude the presence of pro-euthanasia associations within it. Such "monitoring" will probably be more likely administrative and statistical rather than a true audit.
The next stage for the Constitutional Council
The law has been adopted, but the debate is far from over.
The president of the Senate and the Prime Minister prior to the final vote, announced their intention to appeal to the Constitutional Council, which they did indeed on 16th July for the first, 17th July for the second. Groups of MPs and senators have also submitted appeals. The Constitutional Council must check whether the text is compliant with the major principles of the Constitution. Nevertheless, several voices have expressed doubt on the impartiality of several "advisors". Of the 9 members of the Constitutional Council, 4 have already expressed an opinion in support of euthanasia in the past. A reply is expected within a month, a time limit established in the Constitution. In the event of censure of certain articles by the Constitutional Council, the President may call on the Parliament for a further deliberation or promulgate the text without the incriminated articles.