France debates ‘deep sleep’ option at end of life, no euthanasia

Some say it’s euthanasia, others say it’s not enough, French legislators are to start examining a draft law which would give the right to “deep and ongoing sedation” until death for terminally ill patients.

VILLEJUIF, FRANCE (MARCH 4, 2015) (REUTERS) – French legislators are to start debating a draft law which would move a step closer to euthanasia by allowing a right to “deep and ongoing sedation” until death for terminally ill patients who request it, a move that some critics say amounts to euthanasia in disguise.

If passed, the legislation would give dying patients in the predominantly Catholic country considerably more power over their own treatment.

It would also bolster President Francois Hollande’s legacy as a social reformer after a hotly contested move to legalise gay marriage in 2012 as he promised to introduce a new right-to-die legislation in France, which left grey areas in a 2005 law on patient rights and care for the terminally ill.

Jean Leonetti, a centre-right lawmaker and doctor who authored the law, told Reuters the bill would let patients with just hours or days to live decide when sedation would begin and allow them to die.

“First of all, patients need to have reached the end of their life. We prepared a bill which goes slightly further than that as we wrote “when the prognosis is at risk in the short term.” We are talking about the coming days or hours. In the coming days or hours, this man or this woman will die. She continues to suffer despite the treatments she has been given, she feels pain which we describe as resistant to the usual treatments. When these two elements are present, I (the doctor) am obliged to start sedation that is deep and continued until death which means that I send off the patient to sleep,” Leonetti said.

According to Leonetti, the current legislation based on a 2005 law is mainly focused on the doctors’ analysis and leaves aside the patient’s wishes.

Leonetti said the new bill is aimed at meeting “strong demand” by patients in terminal stages of illness.

“It’s a bill about the rights of patients. The 2005 law was focused on the duties of the doctors. It said “I won’t let you suffer, I won’t abandon you, I am not going to keep you alive more than is reasonable”. This time, instead of saying that it’s society’s duty through the medical profession, it’s now an enforceable right of the patients who say “I have the right not to suffer.” It’s a right and a duty for not suffering at the end of a life,” Leonetti added.

The bill would let patients decide to be placed under general anaesthetic if doctors agree they are near death.

While stopping short of assisted suicide, it lets patients begin the process of dying, as the state of deep sleep is irreversible, but is different from euthanasia because the time of death cannot be determined.

Doctor Stephane Mercier, head of the palliative care unit at Paul-Brousse hospital in Paris said the current legislation allows doctors to do their job as their goal is above all to to lower pain but not to send to sleep with sedation.

“I think that the current legislation allows us in palliative care units to properly do our job. Today I question myself on the confusion there is between “sedation” and “pain” and I think that sedation is just a medical tool which allows to calm people down but it’s not a universal answer to the pain of those who are at the end of their life. It’s on this issue that we need to focus our message, because going further would mean opening doors to issues that are meaningful for our society –euthanasia or assisted suicide– but this isn’t the medical profession’s role,” Mercier said.

Currently, doctors in France can suspend treatment under some circumstances for patients who ask for it, if they provide palliative care to reduce suffering, similar to other European countries.

In Europe, only Belgium, the Netherlands and Switzerland allow ‘voluntary euthanasia’, when doctors assist patients seeking death.

Pro-euthanasia groups have criticised the latest bill to be debated at Parliament as too timid, and hypocritical.

“Of course it’s a form of euthanasia but an indirect euthanasia which for me can be seen as extremely violent and extremely hypocrite. What I mean by that is that they do everything they can to make you die but they don’t know when you are going to die. And this can last for weeks. They stop giving you food and water, everyone says that no one is suffering but who knows as no one has been in this situation. This is extremely violent. When you are in very good shape, if you are young, it ‘s going to take you days or weeks to die and this is why this is so hypocrite. Why can’t we listen to people who wish to die within a few minutes, surrounded by their family and without any suffering,” Jean-Luc Romero, head of the Right to Die in Dignity association said.

French law has little evolved since a 2005 reform establishing when doctors could decide to suspend treatment, despite Hollande voicing support for authorising voluntary euthanasia during his presidential campaign.

The debate over end-of-life legislation resurfaced last year over the case of paraplegic Frenchman Vincent Lambert whose family members clashed in French and European courts over whether or not treatment should be pursued while he remains in a deep coma.

His wife wants doctors to stop life support but his parents disagree and the case is pending at the European Court of Human Rights.

The new French bill is expected to be voted at French Parliament on March 17th.