End of life: the College of Doctors opposes euthanasia and supports a “conscience clause”

City debates haven’t even started yet, but the topic is already making headlines. The question of the end of life and the possibility of a law regulate active death assistance emerged this week, thanks to an announcement by Emmanuel Macron, but above all thanks to the opinion expressed by the National Ethics Advisory Committee (CCNE).

An opinion nuanced and cautious, but which opens up prospects for reflection on the implementation of this law. A citizens’ convention is expected to start in October, with a view to drawing conclusions in the spring of 2023.

A conscience clause is required for the College of Doctors

Interviewed a The doctor’s newspaperDr. François Arnault, President of the National Council of the Order of Doctors (Cnom), recalled the ” delay “ of France on the question of the end of life and the need to do so “fight against these inequalities in access to palliative care”. He also expressed the position of Cnom on euthanasia and the involvement of doctors:

“The CCNE does not further detail the role that the physician might play if assisted suicide is accepted. We will be very careful: should it be a guide? Certainly. Effector? I do not believe. This is not his job. And the Order is not in favor of euthanasia ”.

Further on, he evokes the idea of ​​a conscience clause applicable to doctors who refuse to perform assisted dying:

“This must go through a conscience clause, such as the one that exists for voluntary termination of pregnancy (IVG), with the duty to redirect the patient to a doctor who agrees to take care of him. It must be specific, for safety, to avoid any misinterpretation. ”

An opposition which is in line with the opinion of the CCNE. The parallel with abortion, however, is perhaps not the most appropriate, when we know today that the specific conscience clause, which allows the doctor to legally refuse to have an abortionis regularly contested.

The specific conscience clause of abortion, maintained but contested

During the examination of the bill aimed at extending the abortion period to 14 weeks, the deputy Albane Gaillot, rapporteur for the text, had tried to add the deletion of this provision. However, during the final vote on the text in February 2022, the conscience clause was finally confirmed.

For family planning, its abolition would help “having abortion considered as it should be: treatments like any other in the course of one’s emotional and sexual life”.

Especially since this clause of conscience sometimes risks being maintained inequalities in access to abortionlike this survey of the World : “In 2018, the media coverage of the situation at the hospital in Bailleul (Sarthe) highlighted this type of difficulty. For much of the year, an abortion was not possible in this institution due to the retirement of a doctor and the choice of three of the four practitioners still in office to enforce their conscience clause. “

Although recommended by the CCNE in the context of active dying assistance, the conscience clause could therefore be subject to discussion during the city conference that will take place in the coming months, but no less than many aspects of this already very delicate issue.

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