End of life: Right-to-die advocates and palliative care providers in frontline opposition

to analyze. Start a debate “calm down” At the end of life: Emmanuel Macron has made a bet to achieve this through the Convention of Citizens, which starts on December 9. However, the goal is out of reach today, as many advocates of palliative medicine and those in favor of legalizing euthanasia are engaged in a fierce battle. for many reasons.

The first is historical. The palliative care movement was born in the early 1980s when a favorable trend toward euthanasia was observed. After being invited to the International Congress of the Association for the Right to Die with Dignity (ADMD) in Nice in 1984, Dr. Robert Zitoon, one of the pioneers of palliative medicine, decided to start a multidisciplinary forum. Ethical and social issues in supporting patients at the end of life. “ The intensity of the public debate to demand the legalization of euthanasia seemed completely out of place at a time when there was no palliative care service in France.– says Dr. Zitoun, former head of the hematology department at Hôtel-Dieu in Paris.

For caregivers who practice it, it is palliative medicine “ The Third Way Between Therapeutic Perseverance and Euthanasia”, explain Dr. Gilbert Desfosses, another founder of the movement in France. “By alleviating patients’ pain, our hope has always been to eliminate the request for death.”Former director of several palliative care groups in Paris continues.

Diametrically opposite positions

Another explanation for the difficult dialogue between euthanasia advocates and caregivers: palliative medicine has “Specialized from the beginning in pain management for patients at the end of life, especially with cancer”, notes Professor Didier Sicard. Among these patients who are dying, requests for assistance in dying are less frequent than with other serious pathologies, in particular neurodegenerative pathologies. “This initial specialization meant that euthanasia questions were only marginally addressed in palliative medicine.”The former president of the National Ethics Advisory Committee notes.

If the divorce ends, it is also due to the diametrically opposite positions of the two main characters. On the one hand, ADMD, which campaigns for the legalization of euthanasia and suicide. On the other hand, the French Society of Supportive and Palliative Care (SFAP), which is fiercely hostile to him. Its president, Dr. Claire Fourcade, confirms this “The hand that heals cannot be the hand that kills” and “Murder is not a cure”.