Dyears his review 139 widely commented on since its release, the National Consultative Ethics Committee (CCNE) “considers that there is a way for an ethical application of active assistance in dying, under certain strict conditions”based on “the reconciliation of two fundamental principles: the duty of solidarity with the most vulnerable people and respect for the autonomy of the person”. In this perspective, CCNE demands the strengthening of public health measures in the field of palliative care – a sine qua non condition for the eight members of CCNE who expressed a reservation to the opinion voted by the majority – and proposes ethical benchmarks in the event of decriminalization of active assistance in dying: access toassisted suicide “to adults with serious and incurable illnesses, causing refractory physical and psychological suffering, whose vital prognosis is committed in the medium term” ; access toeuthanasia for patients physically unable to commit suicide, an act subject or not to the appreciation of the judge to help doctors make a decision that they consider contrary to the founding principle of not killing.
One of the arguments put forward by supporters of active assistance in dying is based on the observation that in France, people die badly. In other words, we still die in the greatest suffering, as evidenced by the numerous testimonies of families and militant associations, reporting the cases of these cancer patients whose unbearable pain cannot be relieved, of these patients suffering from neurodegenerative patients unable to move and simply wanting to end a life that is no longer worth living, of these patients in a chronic vegetative state wandering from service to service, etc.
The only possible outcome would then be, for these patients, to stop living, here and now, with the help of medicine, the deleterious technicalization of which is nevertheless criticized. These patients, whose short-term vital prognosis is not engaged, in extreme suffering despite all the means implemented, call us, us caregivers, us citizens, and challenge political decision-makers. The heart of CCNE’s argument lies precisely in this moral dilemma: let this patient, who has a name, die or die?
Inequality in the face of death
But what about these anonymous patients, who sometimes die in general indifference: old people in nursing homes, where the lack of resources, especially staff, can lead to inhuman end-of-life support; old people in emergency departments still open, found dead after many hours of waiting on a stretcher; schizophrenic patient found hanged in the psychiatric hospital; homeless, poor among the poor, dead in the street, etc.
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