Is it morally justifiable to allow individuals the freedom to decide when and how they die, or does society bear a collective responsibility to protect life at all costs?

Few topics evoke as much controversy and ethical deliberation as euthanasia and assisted suicide.

Debate surrounding euthanasia and assisted suicide has emerged as a contentious issue, an issue more moral than it is political.

The difference between euthanasia and assisted suicide is the degree of the doctor’s involvement.

Euthanasia involves the physician playing an active role in the patient’s request to die, usually by supplying an intravenous lethal substance.

Assisted suicide implies that the medical personnel provides the patient with the lethal means to kill themselves, meaning it’s the patient who employs them.

Some countries have also allowed passive euthanasia, which is the withdrawal or withholding of life-preserving treatments, at the request of the patient or a family member.

French President, Emmanuel Macron has announced new legislation to legalise “aid in dying” that will allow adults facing terminal illness to take lethal medication.

Few European countries allow euthanasia and assisted suicide. France’s neighbours, including Belgium and Germany, allow either assisted suicide or euthanasia under strict conditions.

According to Belgium’s Federal Commission for Control and Evaluation of Euthanasia, about 53 French patients travelled to neighbouring Belgium for euthanasia procedures in 2022, out of a total 61 abroad-based patients.

Macron said the new bill will refer to “aid in dying… because it’s simple and humane,” rather than terms like euthanasia or medically assisted suicide.

For the time being in France, it is the Claeys-Léonetti law, adopted in 2016, that regulates end-of-life procedures for incurable patients. It allows deep and continuous sedation until death for terminally ill patients in great suffering who are not predicted to live past the short term.

Advocates of euthanasia argue that it represents the ultimate expression of personal autonomy — the right to choose the timing and manner of one’s death.

They contend that individuals suffering from debilitating, incurable illnesses should have the option to end their lives with dignity, sparing themselves and their loved ones prolonged suffering.

In their view, it is a compassionate act that respects the individual’s right to control the narrative of their own existence.

To deny them this choice, they contend, is to perpetuate unnecessary suffering and deny them the basic human right to self-determination.

However, opponents of euthanasia raise valid concerns about the potential for abuse and the slippery slope that may lead society down a path where the value of life becomes increasingly diminished.

They argue that legalizing assisted suicide might inadvertently compromise the sanctity of life, eroding the very foundations upon which our moral and ethical principles rest.

Furthermore, they question the implications for vulnerable populations, such as those with mental illnesses or individuals who might feel pressured to end their lives prematurely, either by explicit coercion or the subtle weight of societal expectations.

Moreover, they argue that the normalization of euthanasia and assisted suicide could undermine the foundational principles of medical care, eroding trust between patients and healthcare providers and fostering a culture of death over life.

What Happens To Palliative Care?

The associations for palliative care, cancer support and specialist nurses said in a joint statement, Macron “has with great violence announced a system far removed from patients’ needs and health workers’ daily reality, which could have grave consequences on the care relationship.”

Accusing the government of aiming to save money with the plan, they said that greater resources for palliative care, rather than assisted dying, would fulfil patients’ demands to “die with dignity.”

Dr Claire Fourcade, President of the French society for palliative support and care, said Macron was proposing a bill for “medically assisted suicide”.

“For us, the carers, this bill is a source of immense concern. Today in France, 500 people die every day without having had access to palliative care when they needed to be alleviated [of pain]. It seems to us that the urgent thing is to support all these people,” Fourcade told a news agency.