End of life: details on the operation of the future Citizens’ Convention revealed



“Is the end-of-life support framework adapted to the different individual situations encountered or should any changes be introduced? » This is the question that the members of the Citizens’ Convention on the end of life, whose work will begin on December 9, will have to answer.

The modalities of the democratic exercise desired by Emmanuel Macron on the subject were unveiled, Thursday, September 29, by the Economic, Social and Environmental Committee (Cese), which will pilot and host the debates. It is on the basis of the conclusions of this convention that the government will decide – or not – to change the current law, known as Claeys-Leonetti, by legalizing – or not – a “active assistance in dying”.

150 citizens drawn at random and pitfalls to avoid

Within the Cese, a governance committee made up of 14 members will be responsible for organizing and ensuring the smooth running of the system. Among them, the president of the National Advisory Council on Ethics, Jean-François Delfraissy, the philosopher Cynthia Fleury or the president of the national center on end of life and palliative care (CNFVSP), Giovanna Marsico.

Above all, 150 citizens will be drawn “in a fortnight”, specifies Claire Thaury, member of the Cese and president of this governance committee. The mix will be made according to criteria of gender, geography, socio-professional category, level of diploma. The panel thus constituted, whose members will receive compensation, will meet on Fridays, Saturdays and Sundays, until the end of the work set for March 12, 2023.

But what legitimacy will these citizens have to deal with such a sensitive subject? What do they know about the issue? “The increase in skills of citizens will go through elements of training and information”, details Giovanna Marsico.

In what form ? “Documentation, hearings. The appropriation of things will be the essential first phase of the debates. By December, we have time to specify the method,” continues the lawyer, convinced that the debates can be plural and not acquired in advance.

A question that annoys some

During the Citizens’ Climate Convention in 2019, “we had already witnessed this increase in the skills of the citizen panel between the start and the end of the work”, assures Kenza Occansey, member of the Cese and of the governance committee. To avoid, however, repeating the pitfalls encountered during the Climate Convention (a lack of clarity on the future of the proposals had notably created frustrations), two former participants of this convention joined the governance committee to play lookouts.

“If the debate on the end of life is delicate, it is because it concerns the intimate, therefore cannot be treated in a completely rational way. But it also affects our vision of society, so it cannot be approached in a purely affective way either. It is this balance that we will have to find”describes Claire Thoury, aware of the precautions to be taken.

The intimate against the collective. It is this confrontation that particularly embarrasses the opponents of assisted dying, in the formulation of the question that will be put to the members of the convention. Ask if the current frame is “adapted to the different individual situations encountered” is a “purely individual approach, while reflection has a crucial collective dimension”, annoys the lawyer Erwan Le Morhedec, author of the book End of life in the Republic (1). If the law evolves to respond to these individual cases, what impact, what risks on other patients, caregivers? »

“Me, she reassures me, this question, comments Jonathan Denis, the president of the Association for the right to die with dignity (ADMD). First, because it is not binary, for or against euthanasia; then because it is broad and will therefore make it possible to draw up an inventory of palliative care and of these patients who, indeed, are caught in a legal vacuum with the current law, because they are not condemned in the short term . »

All the more reason to see a ” trick question “, replies the philosopher Agata Zielinski. “No law can ever respond to exceptional situations. » Pending the effective launch of the work, the next meeting of the governance committee is scheduled for next week.

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A citizens’ convention, but not only…

Along with the randomly drawn sample, other think tanks have been or will be set up in the coming weeks:

Agnès Firmin Le Bodo, Minister Delegate in charge of Territorial Organization and Health Professions orchestrates consultations with “stakeholders”: caregivers, user and patient associations or activist associations. She also received religious leaders, including bishops of France, on September 26.

The National Ethics Advisory Committee plans to organize debates, round tables, public meetings, in the regions, in schools or nursing homes.

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