France passes "right to die" law
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《英国医生杂志》
A year and two months after a celebrated case of euthanasia incited a parliamentary commission on the subject, France has passed a law allowing terminally ill or gravely injured patients the right to die.
The law, which was passed by the National Assembly on 30 November but has to be ratified by the Senate, stops short of legalising active euthanasia. But it nevertheless clarifies a common, yet illegal, situation, according to health minister Philippe Douste-Blazy, who called it "a third way, a French way."
The compromise follows the widely reported case of active euthanasia in which Vincent Humbert, aged 22, was seriously injured in a road accident and helped to death by his mother and a doctor on 26 September 2003 (BMJ 2003;327:1068).
Dr Douste-Blazy said that 100 000 patients a year in France have their life support machines turned off, although the law previously had no system for dealing with it.
Under the new law, terminally ill but conscious patients may refuse treatment to prolong their lives. Seriously disabled patients who are not terminally ill may also request an end to treatment. Palliative treatment must continue, however, and the doctor may give increasingly strong doses of painkillers, even if it risks shortening the patient抯 life.
If the patient is unconscious, the doctor must consult with other doctors and the patient抯 family or the person closest to them. People may also stipulate in writing in advance how to be treated in such circumstances.
Patients who are conscious but in a vegetative state may also have their life support stopped. If they have an infection or a life threatening complication, they will not be treated as it will be considered "out of proportion" to the benefit, according to the law.
Under no circumstances may doctors cease treatment on their own initiative, nor, once a decision has been made to end treatment, may they inject patients with drugs to kill them quickly.
The law reinforces palliative care, however, for which Dr Douste-Blazy announced 1990 more beds in the next two years, 35 mobile units in 2005, and the training of personnel.
The law has been criticised by pro-euthanasia associations and Marie Humbert, the mother of Vincent, who has been charged, along with Dr Fr閐閞ic Chaussoy, for premeditated poisoning and giving a toxic substance. She allegedly gave her son a deadly dose of a sedative, and Dr Chaussoy turned off his life support. Ms Humbert told French television that the new law would not have prevented her son from suffering.
Another mother, Mich鑜e de Somer, wrote to President Jacques Chirac in October asking that her son be allowed to die humanely. Eddy de Somer, aged 26, had head and brain stem injuries in a motor scooter accident on 21 August 2001 that left him quadriplegic, blind in one eye, and incapable of speech.
The new law allows his treatment to be stopped by, for example, removal of his intravenous feeding, which would kill him through starvation.
"This new law maintains the current hypocrisy and does not respect the right of people suffering from an incurable and grave handicap to autonomy and liberty," Dr Jean Cohen, president of the Association for the Right to Die in Dignity, told newspaper Le Figaro.(Paris Brad Spurgeon)
The law, which was passed by the National Assembly on 30 November but has to be ratified by the Senate, stops short of legalising active euthanasia. But it nevertheless clarifies a common, yet illegal, situation, according to health minister Philippe Douste-Blazy, who called it "a third way, a French way."
The compromise follows the widely reported case of active euthanasia in which Vincent Humbert, aged 22, was seriously injured in a road accident and helped to death by his mother and a doctor on 26 September 2003 (BMJ 2003;327:1068).
Dr Douste-Blazy said that 100 000 patients a year in France have their life support machines turned off, although the law previously had no system for dealing with it.
Under the new law, terminally ill but conscious patients may refuse treatment to prolong their lives. Seriously disabled patients who are not terminally ill may also request an end to treatment. Palliative treatment must continue, however, and the doctor may give increasingly strong doses of painkillers, even if it risks shortening the patient抯 life.
If the patient is unconscious, the doctor must consult with other doctors and the patient抯 family or the person closest to them. People may also stipulate in writing in advance how to be treated in such circumstances.
Patients who are conscious but in a vegetative state may also have their life support stopped. If they have an infection or a life threatening complication, they will not be treated as it will be considered "out of proportion" to the benefit, according to the law.
Under no circumstances may doctors cease treatment on their own initiative, nor, once a decision has been made to end treatment, may they inject patients with drugs to kill them quickly.
The law reinforces palliative care, however, for which Dr Douste-Blazy announced 1990 more beds in the next two years, 35 mobile units in 2005, and the training of personnel.
The law has been criticised by pro-euthanasia associations and Marie Humbert, the mother of Vincent, who has been charged, along with Dr Fr閐閞ic Chaussoy, for premeditated poisoning and giving a toxic substance. She allegedly gave her son a deadly dose of a sedative, and Dr Chaussoy turned off his life support. Ms Humbert told French television that the new law would not have prevented her son from suffering.
Another mother, Mich鑜e de Somer, wrote to President Jacques Chirac in October asking that her son be allowed to die humanely. Eddy de Somer, aged 26, had head and brain stem injuries in a motor scooter accident on 21 August 2001 that left him quadriplegic, blind in one eye, and incapable of speech.
The new law allows his treatment to be stopped by, for example, removal of his intravenous feeding, which would kill him through starvation.
"This new law maintains the current hypocrisy and does not respect the right of people suffering from an incurable and grave handicap to autonomy and liberty," Dr Jean Cohen, president of the Association for the Right to Die in Dignity, told newspaper Le Figaro.(Paris Brad Spurgeon)