NOTShould our society accept that, in certain situations, health professionals can prescribe, or even administer, a lethal product to a person who requests it? The end-of-life debate cannot be reduced to this question. However, this cannot be avoided. In France, it has long been approached through the prism of the notion of dignity. Today, it is the notion of care that crystallizes the debates. It is not certain that this angle of analysis is the most relevant.
Many caregivers believe that to lend their assistance to “aid in dying” would constitute a diversion of their mission and a transgression of their vocation. And, in fact, taking care of others is in principle protecting them against anything that threatens their integrity and existence. Care, says political scientist Joan Tronto, is a life support network that aims to perpetuate and fix our world. Emmanuel Levinas, for his part, emphasizes the fundamental nature of the ban on murder.
Some caregivers, however, see things differently. They admit that as a general rule their mission is to preserve life. But they also believe that alleviating suffering is an unconditional duty. However, as the philosopher Frédéric Worms notes, certain situations cause such suffering that they seem worse than death. In these extreme cases, does the ethics of care condemn any form of assisted dying? Doesn’t Levinas himself write that we are summoned to respond to the appeal of the face of the other and to his suffering?
The question posed is not primarily philosophical but practical: what role could or should medicine play if assisted dying were authorized? For some, caregivers should not participate in any way. For others, they should limit themselves to prescribing the lethal product, and it is associations (rather than the medical institution) that should be involved. For still others, caregivers could be led to administer a lethal product within the framework of healthcare institutions.
The confession of a finitude
The underlying question is what arguments could legitimize these positions. Assistance in dying is often based on the values of freedom and solidarity. It would be a question, for society, of showing solidarity with people who, in conscience, consider that what they are experiencing is not acceptable.
This argument poses several difficulties. First, asking to be assisted in dying is not often a matter of choice. When one is suffering from a serious illness and one finds oneself in a situation of therapeutic impasse, this request is more the recognition of a failure, the confession of a finitude, than the affirmation of a freedom. Then, making the possibility of requesting assistance in dying a new right does not seem very appropriate. Because, if patients claimed this possibility as a right, caregivers would be entitled to systematically invoke their conscience clause. Finally, basing assisted dying solely on the values of freedom and solidarity points towards a model similar to that of Switzerland, where individuals can come to the aid of other individuals who wish to end their lives. In this model, the medical institution could indeed remain in the background. But it is not clear on the basis of what arguments one could then restrict access to assisted dying only to people suffering from a serious and incurable disease.
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