“The less we are able to talk about death, the more we want it to happen quickly”
On September 13, CCNE issued an opinion opening the door to assisted suicide at the end of life. You are one of the eight members of the authority who have signed a reservation. Why ?
This opinion has been a long working process, and I believe that we have gone as far as possible from the discussions. We sought to speak with one voice and tried to integrate the reservations brought by each other. The majority text envisages simultaneous measures to be taken so that this legislative development can take place within an ethical framework: legalization of active assistance in dying and, at the same time, access for all to palliative care, among other things. What distinguishes the signatories from the reservation is that we believe that a certain number of conditions must first be met so that, in a second step, possibly, we can change the law.
Among the eight signatories, there would certainly be two options in the face of this second time. Some might continue to oppose, and others might consider this development. I am one of those who think that such a law is only possible in an irreproachable health system. However, it is the hospital, at the moment, which is in palliative care. One of the foundations of bioethics is consent. From the moment there is not 100% access to palliative care, no systematic alternative offered to the distress expressed, no way for the people concerned to tell themselves that the suffering and pain they feel could be appeased by different care, how could consent to assisted death be free? My position is: first 100% accessibility to palliative care, and then we discuss.
But why would this simultaneity not be possible?
Imagine a big day when we both open up the possibility of active assistance in dying and when we begin to think about territorial inequalities in terms of palliative care… The time we compensate for them and reaches 100% access, how many requests for active assistance in dying will there have been by default of access to care?
Suicide is freedom. What would it change to make it a right?
I am sensitive to the question of a death that is not violent, which is often a suicide practiced in full autonomy. But then we are in a paradox of autonomy, since we claim full autonomy of the subject but which requires solidarity. The paradox of this type of autonomy comes, in my opinion, from a denial of belonging to a social body. I hear this desire for autonomy, but can we really think that everyone, at the end of life, can set their own criterion as a tolerance threshold without thinking that they are, even unwittingly, prescribers for others about what is a life that is or is not worth living?
Saying that assisted dying is a freedom that takes nothing away from others, is that debatable?
It takes nothing away from others, it does not take away their freedom, at least I hope, but shifts its terms and discernment. As a hospital chaplain, I don’t know how many times I heard: “I am a burden on my family. » If you start to hear all your girlfriends, at 80, say that they are going to Switzerland so as not to weigh on their children, while you say: “No, I would like to stay here and still live, even if it means needing help”, there is a moment when the pressure is likely to take effect. I concede that I have a form of fear vis-à-vis a normalization of what could be “well-dying” for oneself and for others. Because, from the moment there is a law, it is a common injunction. Even if the number of people who take the plunge remains small and it must be recognized that this panic fear that euthanasia will take on a huge proportion has not taken place in neighboring countries…
Is choosing to legalize euthanasia a choice between autonomy and solidarity?
No, because no one abandons one or the other. A person who is against a change in the law will never tell you that he does not care about autonomy. No more than a person who is in favor of it makes fun of solidarity. On the contrary, the same principles are thought out, but with different definitions. In active assistance in dying, solidarity is called upon and, rightly so, in the sense that it makes it possible to accompany a chosen death under conditions considered to be milder.
Does this mean that helping to die can be a gesture of compassion?
I have no doubt about it. Let’s get out of politics, let’s move to Verdun with a trench mate who is in agony after being hit by a shell. I imagine that we can convene the fraternity and say to ourselves: “I’ll finish him off if he asks me to. » Would I? Why would I? And why wouldn’t I? For once, as a Christian, I have no religious thoughts about it. I don’t receive any prescription believing that it would be more fraternal to watch this man die. We must avoid appropriating key concepts to turn them into militant coats of arms. In all our hearings at CCNE, we heard, in each camp, the values of liberty, fraternity and equality. We all agree on the values that are important to us. It is the hierarchies between these values and their proper definitions that are not the same. The question is how to maintain the ethical tension between the different values so that none is left behind.
Among these key concepts, dignity often comes up in the debate. Why is it so attached to autonomy?
I do not know. The problem of dignity, compared to the other values mobilized in the debate, is that it is the most vague, the one whose contours will be the most subjective. What seems to you or me to be a worthy life may not be the same thing. And it’s a bit the limit of the debate, the definition of what is worthy or not. Especially since the end of life is also preempted by a lot of imagination. I’ve had the experience a thousand times of telling myself that such and such a thing would be beyond my strength and then, finally, by living it… But the human imagination gallops off towards horror with disconcerting ease. It is very difficult to imagine that there is anything else to live in death. I don’t want to seem to minimize the horror, but it’s much more difficult to imagine the possibility that we can still experience something that makes sense there. And yet it sometimes happens, unexpectedly.
Basically, does our death belong to us? Does it belong to medicine, to society?
I have the impression that the less we are able to talk about death, the more we want it to happen quickly. What strikes me is that we are a society that will put everything in place not to die, but which, when it fails to do so, asks to die as soon as possible. It seems surreal to me that friends my age (44 years old, Editor’s note) have never seen dead people, for example. For my part, I would like 2023, before being the year of a possible legislative change, to be the year when death becomes a subject.
The Citizens’ Convention begins on December 9. How do you fight, in yourself, to tell yourself that the case is not folded?
What is not folded is to speak. Now is not the time to sulk.