France’s ‘aid in dying’ law comes into effect after constitutional approval

Right to assisted dying established for patients with conditions assessed as incurable and causing unbearable pain

Legislation granting incurably ill adults the right to assisted dying has been formally adopted in France after the text was approved by the country’s highest constitutional authority and published in the official journal.

The law, known as a law on “end of life” or “aid in dying” rather than “assisted dying” or “euthanasia”, means France joins the small group of countries including the Netherlands, Belgium, Switzerland and Canada to have legalised the practice.

Published on Wednesday after years of debate, it establishes a right to assisted dying for patients of legal age who are French nationals or long-term residents and suffering from conditions that are assessed as incurable and are causing unbearable pain.

A doctor must verify the patient’s eligibility before a panel assesses whether the criteria have been met. Once approval has been granted, patients must wait at least two days before the procedure can take place and confirm their decision on the day.

The patient may withdraw consent at any time and must administer the lethal substance themselves unless they are physically unable to do so, in which case a healthcare worker can help.

Until now France has allowed passive euthanasia – such as withholding artificial life support – and deep sedation before death, but people seeking active end-of-life options have been forced to travel to other countries where assisted dying is legal.

Emmanuel Macron, who promised a right-to-die law in his 2022 re-election campaign, welcomed the news, which he said “concludes an exemplary democratic debate”, while the text’s author, a centrist MP, called it “a major step forward”.

Macron’s office added that the law provided “an essential guarantee for our fellow citizens” and could now be implemented “in the certainty that it rests on fully established democratic, ethical and constitutional foundations”.

However, the Jérôme Lejeune Foundation, which provides lifetime care to people with genetic intellectual disabilities such as Down’s syndrome, expressed “outrage” and other campaigners said the law posed “an absolute danger to the most vulnerable”.

All parliamentarians were given a free vote to express their personal convictions during the debate. Euthanasia is a controversial subject in France, which has a longstanding Catholic tradition, while the bill was also opposed by some health workers.

The publication in the official journal follows several legal challenges, with critics arguing that the minimum two-day reflection period was too short and that entire healthcare institutions should be able to refuse on grounds of conscience.

France’s constitutional council upheld the law in its entirety last Friday but ruled that certain provisions needed clarification, including the “conscience clause”, which will allow healthcare professionals to refuse to take part in the procedure.

The council refused to strike down any part of the law, but ruled that doctors must take into account patients’ legal guardians when assessing requests, and that pharmacists as well as doctors and nurses could exercise the “conscience clause”.

That clause must also apply to private, typically faith-based healthcare facilities where assisted dying is “manifestly contrary” to their mission, it said, providing they were not the only establishments able to meet “local needs”.