Only twenty-seven days to soothe – if not settle – a debate that has been tormenting the French for years. The 170 people called upon to take part in a citizen's convention dedicated to the divisive issue of assisted dying, are to meet nine times for three-day sessions until March 19, 2023, to answer a question formulated by Prime Minister Elisabeth Borne: "Is the end-of-life framework well-suited to the different situations encountered (by patients and families) or should possible changes be introduced?" In other words, participants, whose work started on December 9 are asked to give their opinion on assisted dying, whether through euthanasia or assisted suicide.
The citizen's assembly, inspired by a 2019-2020 citizen's climate convention, is "a fantastic democratic innovation," French president Emmanuel Macron said on September 12. "I would defend it to death...no pun intended." The president warned, however, that like with the climate, he would not necessarily retain all the convention's proposals. The government has only committed itself to justifying future decisions before the people.
The convention's role will be to offer advice to the government, should it decide – depending on the answers it will come up with – to modify the legal framework and "support a bill [...] by the end of 2023," Mr. Macron said in September, although he later added that this deadline could be pushed to 2024.
When opening the convention on Friday, Ms. Borne encouraged participants to undertake their work with the greatest "freedom" and open up about their doubts and disagreements.
'Irish method'
The government's stated objective with this convention is to prepare the country for possible changes. "The citizens' convention is inspired by the Irish method, which led to the legalization of same sex marriage and abortion in Ireland," Olivier Véran, France's delegate minister in charge of democratic renewal, said. "Its aim is to ease concerns prior to a parliamentary debate, ensure that everyone is properly consulted and that the debate is serene."
The government's stated objective with this convention is prepare the country for possible changes. "The to a citizens' convention because it touches to intimacy, and appeals to the values and beliefs of everyone," Marc Ferracci, a Renaissance (the president's party) MP and a long-time friend of Mr. Macron, said. "It does not require technical expertise, unlike topics such as climate, for which the (convention) format was not ideal."
The issue of assisted dying "requires nuance and taking the time for an in-depth debate," Claire Thoury, who chairs the governance committee of the citizens' assembly, said. Ms. Thoury, a specialist in participant democracy, added the challenge for citizens would be to "spell out the agreements and disagreements, as well as to identify which hurdles can be overcome."
There is a possibility that the convention will not produce anything new, philosopher and psychologist Cynthia Fleury, a member of the governance committee of the citizens' assembly said. "We can imagine that it will give an opinion somewhat very similar to that of the National Consultative Ethics Committee (CCNE)."
In a recommendation issued on September 13, the CCNE opened the way for active medicaly assisted dying for the first time, on the condition that it be accompanied by better access to palliative care. In 2013 and 2018, smaller citizen consultations had taken place and also expressed support for the legalization of active medicaly assisted dying.
Bring medics on board
On the same issue, Mr. Véran and Agnès Firmin Le Bodo, delegate minister of territorial organization and health professions, are sitting on a cross-party panel made up of MPs and senators. The Parti Socialiste in the Sénat and Les Républicains (right wing) in both chambers have refused to participate. In the Assemblée Nationale, a committee to evaluate the Claeys-Leonetti law on end-of-life practices was created, chaired by MP Olivier Falorni (centrist), a fervent supporter of active medicaly assisted dying. The work of the committee will begin in January 2023 and end in March.
In a recommendation issued on September 13, the legalization of euthanasia and the government is seeking to avoid a clash with the medical community should it decide to change the current legislation. "The method chosen is also to ensure that health professionals have their say," Mr. Véran said. "If we were to ignore their opinion, considering it's an issue regarding people and not medical practitioners, we would risk failure and finding ourselves in the same situation as Spain, which is having great difficulty in implementing its reform on assisted dying."
On the cornerstone of the national debate on assisted dying, the work of the citizens' convention must not end up creating "a conflict of legitimacy." Parliament will indeed have the last say on a possible reform. While Mr. Macron indicated, in September, that he had "the conviction necessary to move because there are inhuman situations that exist and it is necessary to bring a response to them," the debate is not pure form for him. "He will only back a bill if he feels that he can rely on public opinion to decide," added François Patriat, head of the Macronist senators.