End of life: patients resorting to assisted dying will not be deemed to have “died of natural causes”

On Friday, May 23, MPs removed a provision from the text relating to the right to assisted dying, according to which patients who resort to it would then be "deemed to have died of natural causes" on their death certificates.

Amendments to delete the paragraph in question were approved by a narrow majority, with an unfavorable opinion from the rapporteur (Socialist Party, Socialist Party, Haute-Vienne) Stéphane Delautrette, and a sensible opinion from the government, that is, not directing the deputies in one direction or the other. The article was approved immediately.

The MP (Renaissance) for Maine-et-Loire, Nicole Dubré-Chirat, who initiated one of the amendments that led to the introduction of this provision in committee, explained that she wanted to "spare the families of the deceased from possible difficulties linked to contractual commitments entered into during their lifetime."

But MPs from various groups have castigated an "Orwellian" provision (the Socialist Party representative from Meurthe-et-Moselle, Dominique Potier), which "completely manipulates the meaning of words" (the Renaissance representative from Bas-Rhin, Charles Sitzenstuhl), and "distorts reality" (the Republicans, LR, representative from Bas-Rhin, Patrick Hetzel).

"You are changing the meaning of words to impose an ideology, even if it means destroying reality," said the MP (National Rally) for the Pyrénées-Orientales, Sandrine Dogor-Such, linking this statement with the refusal of the promoters of the text to include the terms "euthanasia" or "assisted suicide" in the law.

Mr. Delautrette, for his part, argued that patients who died following deep and continuous sedation, as authorized by the Claeys-Leonetti law of 2016, were deemed to have died of natural causes.

But Mr. Sitzenstuhl recalled the difference between the two procedures, highlighted by the High Authority of Health, particularly with regard to the "result criterion." Deep and continuous sedation is "continued until death due to the natural progression of the disease. Whereas euthanasia (...) causes the immediate death of the patient," he quoted.

Health Minister Catherine Vautrin, for her part, pointed out that it was specified later in the text that "assisted dying was not an obstacle to the conditions of life insurance contracts ." She suggested "taking advantage of the parliamentary shuttle" of the text, which must then be examined in the Senate, to improve this point. One possibility would be to add "two boxes" to the list of apparent circumstances of death, one for deep and continuous sedation and one for assisted dying.

In the evening, the deputies largely validated (by 126 votes to 10) the framework of the "conscience clause" allowing any doctor to refuse to perform assisted dying, on the model of the existing rules for abortion. This decision will remain individual, despite attempts by the right to authorize a collective clause at the level of an establishment or a service, Patrick Hetzel evoking "palliative care services hostile" to assisted dying and his colleague (LR) from Hauts-de-Seine Philippe Juvin, the case of retirement homes "run by religious congregations" .