The bill on the right to medical aid in dying, adopted on May 27, 2025, must now be examined by senators. The ECLJ has identified 14 major problems with this text that Senators must correct. 14 issues in addition to the violation of the prohibition on killing.

1. The concept of “aid in dying” confuses assisted suicide and euthanasia and equates them with medical care

The text describes euthanasia and assisted suicide as “medical care,” creating an obligation for doctors. This terminology is a euphemism that masks the purpose of the act, which is to voluntarily cause death.

The proposed law defines the “right to assisted dying” as authorizing and accompanying a person in using a lethal substance (Art. 2). Either the person administers the lethal substance themselves, or they have it administered by a third party if they are physically incapable of doing so. The Conseil d'État clearly stated in its opinion of April 4, 2024, that the bill legalizes, under certain conditions, assisted suicide and euthanasia. The notion of “aid in dying” is therefore a euphemism, masking the real purpose of the text.

Assisted suicide and euthanasia are defined as "care." This new ”right to aid in dying" therefore creates an obligation that the physician must fulfill when a patient meets the eligibility requirements and requests assistance in dying.

By incorporating this new right into Article L. 1110-5 of the Public Health Code (Art. 3), which enshrines the right to receive the most appropriate care to alleviate suffering, the text equates assisted suicide and euthanasia with medical care. This approach marks a fundamental break with previous laws (known as the “Leonetti” and “Claeys-Leonetti”) which, while guaranteeing the right to pain relief until the natural end of life and the refusal of obstinate treatment (art. L.1110-5-1 of the Public Health Code), ruled out the possibility of actively causing death.

Thus, a person who has suffered from high blood pressure for several years could one day request assisted suicide. A decision in favor of the request would be legally considered as a new treatment protocol for high blood pressure, ensuring the continuity of care.

• See on this article: End of life: what is the difference between “killing” and “letting die”?

2. “Aid in dying” does not only concern people at the end of their lives

The proposed law does not only apply to people at the end of their lives. People who still have several years to live could also be eligible. The criteria for suffering are subjective.

The proposed law opens up assisted suicide and euthanasia to a much wider population than just those at the end of their lives. The cumulative conditions defined in Article 4 require:

To be at least eighteen years of age, to be a French national or to reside permanently in France, and to be suffering from a serious and incurable condition, regardless of the cause, that is life-threatening, in an advanced stage, characterized by the onset of an irreversible process marked by the deterioration of the patient's health, which affects their quality of life, or in a terminal stage.

The concept of ”advanced stage" does not apply only to people at the end of life. Indeed, an incurable disease does not mean that there are no appropriate treatments, but that the disease persists despite existing treatments. Thus, people who still have several years of life expectancy would be eligible. For example, an adult suffering from chronic renal failure or HIV, which are serious and incurable conditions that are life-threatening if treatment is stopped, could thus fall within the scope of the law. For example, approximately 50,000 patients in France are on dialysis due to kidney failure[1] and would be eligible for the procedure if treatment were to be discontinued.

The person must also be experiencing constant physical or psychological suffering that is resistant to treatment, or “unbearable” suffering, when the person chooses to stop or not receive treatment. These criteria are alternative and highly subjective. It is difficult to assert that psychological pain is constant, as it is very common for a person to experience “ups” and “downs.” There is no medical consensus on the degree at which suffering becomes “unbearable.” Thanks to the adoption of Amendment No. 1453, psychological suffering alone does not qualify a person for euthanasia. Despite this, the physician will have complete discretion to assess the medical situation and the “free and informed” will of the patient. The judge is excluded from the procedure, unlike in cases of legal guardianship or intra-family organ donation.

3. A person with a mental disorder may request assisted suicide

The proposed law allows a person suffering from a mental disorder to request euthanasia. The decision is based on the assessment of a physician who is not a specialist in the field of discernment.

Article 6 of the proposed law excludes people whose judgment is “seriously impaired” from the “right to assisted dying.” Conversely, a person with a disorder that “slightly” impairs their judgment may request and obtain euthanasia if the substantive conditions are met. The determination of discernment at the time of the initial request will be at the discretion of the referring physician.

On June 25, 2025, a Court of Appeal (Cour d’assises d’appel de l’Ain) ruled that a woman who learned of her husband's adultery had her discernment “impaired.” This impairment of discernment, which lasted several hours, enabled her to obtain a reduced sentence for the crime she committed in a fit of rage following this news. Consequently, it is reasonable to assume that a request for assisted suicide made after announcement of a spouse's adultery could be analyzed as an impairment, rather than an abolition, of judgment, which would not prevent the request for assisted suicide.

It should also be noted that an amendment (No. 45) aimed at explicitly excluding people with psychiatric illnesses from the scope of the law was rejected during parliamentary debates. However, the Brain Research Foundation states that: “depression, addictions and disorders related to drug or alcohol use, anxiety and phobias, eating disorders, schizophrenic, bipolar or borderline disorders are examples of mental disorders”[2]. If the law were adopted as it stands, it would follow from the “spirit of the law” that the law did not intend to exclude people suffering from psychiatric illnesses.

4. The proposed law discriminates against people with disabilities

The text does not protect people with disabilities and risks reducing their visibility and the resources allocated to the measures dedicated to them in society.

The proposed law discriminates against people with disabilities, as the eligibility criteria for “assisted dying” coincide with the very definition of disability. People with disabilities are eligible precisely because of their health condition. It thus violates the United Nations Convention on the Rights of Persons with Disabilities and Article 14 of the European Convention on Human Rights, which prohibits discrimination in the enjoyment of fundamental rights.

On August 26, 2025, the United Nations Committee on the Rights of Persons with Disabilities issued several reservations about this proposed law, because persons with disabilities are objectively in a vulnerable situation and should be better protected from the risk of suicide. It also asked the government not to claim that this Committee and the Convention it is responsible for enforcing recognize a “right to die,” because this is obviously false.

This creates a legal paradox: the law presumes that a person under legal protection is capable of consenting to their own death, while the same presumption is denied to them for acts of property disposal, suggesting that less value is placed on their life than on their property.

Procedural safeguards are specifically weakened for persons with disabilities, where they should be strengthened. For example, the requirement for a written request is relaxed, and the law does not protect against the undue simplification of information provided to a person with impaired judgment. The National Assembly has even removed the provision that required doctors to inform people with disabilities of “all the measures and rights aimed at guaranteeing that their medical, material, psychological, and social needs are met,” to include it in the more general scope of the obligation to provide information in Article 5.

Finally, the text risks creating a vicious circle: by encouraging the use of euthanasia among people with disabilities, their visibility in the public sphere will diminish. This reduced presence could then limit public spending on inclusion measures, making life in society more difficult for people with disabilities and increasing the temptation to resort to euthanasia.

• Assisted dying: France's international obligations.

5. The assisted suicide procedure is expedited

The decision and reflection periods are very short. Euthanasia could be performed within a week, without the patient having received complete information before confirming their request.

The proposed law sets very short decision and reflection periods (Art. 6). The doctor must decide on the request within a maximum of fifteen days, and no minimum time limit is set. A decision could therefore be made in less than three days if the multi-professional team meets quickly.

Once the doctor's decision has been notified, the person has a reflection period of at least two days before confirming their wish (Art. 6). Euthanasia can therefore be granted and carried out in a very short time, potentially within a week. These time limits are expeditious compared to foreign legislation. In Belgium, the cooling-off period is one month, and in Austria, the period is in principle twelve weeks, and, exceptionally, two weeks if the person is in the terminal phase.

Then, the person requesting assisted suicide only receives information on the methods of administering the lethal substance and its specific effects after the short reflection period following the decision (Art. 6), which fundamentally undermines the informed nature of the final consent. An amendment (No. 51) proposed requiring truly comprehensive information, including “the risks involved,” before the patient gives their consent. These include risks related to the body's potential rejection of the substance, such as myoclonus (spasms), variability in the duration of the process, risks of regurgitation, and difficulty in accessing the vein[3]. This amendment was rejected, which suggests that the information provided by some doctors will be incomplete.

When assisted suicide is initiated, the patient's family is not systematically notified. According to Article 7, the doctor's decision and the date of administration of the lethal substance are communicated only to the persons personally designated by the patient. The “victim[4]” determines the date of administration of the substance with the doctor, with no minimum period between confirmation and the occurrence of euthanasia (Art. 8). When the person requests a postponement of the initially agreed date of administration (Art. 9), this request is analyzed as a simple request that suspends the procedure, and not as a doubt that calls into question the constent.

6. The referring physician has too much power

The physician is not a mere executor. The entire procedure and interpretation of the legal criteria are based on a single referring physician, without the intervention of a judge.

The physician assesses whether the patient must submit their request in writing or by another appropriate means (Art. 5), whether the prognosis is terminal or not (Art. 4), whether the patient's judgment is seriously impaired (Art. 6), and whether the patient's decision is free and informed (Art. 4). The physician to whom the request for euthanasia was addressed personally makes the final decision (Art. 6) after consulting a multidisciplinary panel that he or she calls upon (Art. 6).

The decision is not subject to appeal except by the patient; and, under strict conditions, by the representative of an adult who is subject to legal protection measures (Art. 12). The physician also assesses the existence of “pressure” from relatives who may influence the patient's will at the time of administration of the lethal substance (Art. 9). If the patient takes more than three months to confirm their wishes after being notified of the favorable decision to “aid in dying,” the physician may optionally have the patient's judgment and free and informed consent reassessed by the multidisciplinary team.

The presence of specialists in discernment is also optional (Art. 6). In fact, the physician in question may be any practicing physician.

The physician must take into account the fact that for a neurodegenerative disease (Art. 6), the assessment of discernment “cannot be based exclusively on cognitive tests.” However, they retain considerable leeway to interpret nonverbal communication and assess moments of lucidity.

This concentration of discretionary power in a single person, even a physician, and the non-intervention of a judge in the procedure, are serious matters, as a final decision of life or death depends on it.

7. The multi-professional panel only gives an advisory opinion

The panel of professionals consulted by the referring physician only gives a non-binding opinion. Its composition is minimal and it can even meet remotely.

The decision-making process is collective and involves consultation with the "multi-professional panel," but the final decision is made individually by the referring physician (Art. 6), who has discretionary power over the procedure. The role of this panel is limited to an exchange of non-binding opinions, which reinforces the sovereign power of judgment of the referring physician alone.

The physician must convene a “multidisciplinary team” composed of at least one specialist in the pathology (of the patitent asking for assisted suicide); a nursing assistant or, failing that, a medical assistant involved in the treatment, and the referring physician. The participation of other professionals, such as psychologists, is optional. The opinion of the trusted person is only sought if the patient expressly requests it, and the representative of an adult who is subject to legal protection measures only communicates observations, without participating in the panel (Art. 6).

“Medical assistant” refers to various professions (nurse, massage therapist, podiatrist, occupational therapist, psychomotor therapist, speech therapist), and the panel meeting may be held remotely if it is impossible to meet in person. The specialist doctor could thus give their opinion without ever having physically examined the patient or even consulted their medical file (Art. 6).

For example, a dermatologist is involved in the care of a patient with diabetes who lives in a nursing home. During the visit, the patient declares that they want to die. The dermatologist then calls in a diabetologist and a nursing assistant from the nursing home. As the diabetologist is unable to attend in person, the meeting could be held remotely and the dermatologist could make a decision within three days, after determining that the patient's judgment is not seriously impaired and that the basic conditions are met.

Ultimately, the procedure is designed so that the college cannot act as a countervailing power or a supervisory body.

8. Assisted suicide is presented as an alternative to palliative care

The text presents assisted suicide and euthanasia as an alternative to palliative care, rather than as a last resort after all other resources have been exhausted.

The doctor must inform the person about support and palliative care options and ensure that they have access to them if they so wish, but this information is given the same weight as information about “aid in dying.”

A recent report by the Cour des comptes ("Court of Auditors") reveals unequal access to palliative care in France, where only 48% of needs are met[5]. According to the 2012 Sicard report, requests for death fall dramatically as soon as effective pain management is put in place. The proposed law does not prioritize access to palliative care and does not specify how the doctor will “effectively” ensure that the person has access to palliative care if they so wish (Art. 5).

Although the government has put in place a ten-year strategy with €1.1 billion in funding over ten years, with plans to define the “Republic's palliative care policy” to guarantee equal access to palliative care throughout the country, there are no provisions for patients who are waiting for this strategy to be implemented and who currently face unequal access to palliative care. The immediate effectiveness of the assisted suicide or euthanasia procedure thus undermines the positive obligation of States to protect life, enshrined in Article 6 of the International Covenant on Civil and Political Rights and Article 2 of the European Convention on Human Rights.

We are clearly facing the risk of assisted suicide becoming the default option. In practice, it will be quicker to obtain assistance in dying than to access palliative care.

9. No legal recourse against the doctor's decision

Only the patient can challenge a doctor's decision to refuse treatment; virtually no third party (relatives, caregivers) can challenge a decision to die.

The proposed law almost completely rules out the intervention of a judge. Article 12 provides that the doctor's decision can only be challenged by the person who made the request. In practice, this means that only a refusal of euthanasia could be appealed by the patient. Only the person determined to die has the right to refer the matter to a judge in order to pursue their request, even though no third party, whether a relative, designated trusted person, or caregiver, is authorized to challenge the referring doctor's favorable or unfavorable decision. The only and very restrictive exception concerns the representative of a protected adult, who has two days (Art. 12) to refer the matter to a judge, and only in cases of doubt as to the free and informed nature of the protected adult's wishes.

This lack of right of appeal is unique compared to the practice in Belgium, Spain, or the Netherlands, for example, and disregards the principle of the right of appeal enshrined in Article 13 of the ECHR, which aims to remedy the situation criticized by the complainant.

It is also contrary to the case law of the Conseil constitutionnel[6], which guarantees the right to an effective judicial remedy for “interested parties” in the context of the collegial procedure prior to the decision to limit or discontinue treatment in the context of deep sedation. This right requires that the decision be notified to the persons from whom the physician has inquired about the patient's wishes, under conditions that allow them to seek redress in a timely manner. This appeal must be examined as soon as possible by the competent court.

Undoubtedly, such a procedure allows doctors to commit fraud and euthanize people without following the procedure and without anyone being able to take legal action.

A parent of an 18-year-old boy who is eligible and asking for the procedure will therefore not be able to challenge the doctor's decision to euthanasie the young man before a judge.

10. A priori and a posteriori controls are insufficient to prevent abuses

A priori control is a form of “self-control” exercised by doctors, without judicial intervention, while a posteriori control by a commission created for this purpose (Art. 15) only takes place after the patient's death.

A priori control relies entirely on verifying the person's eligibility for assisted dying through the multi-professional college procedure. Several factors weaken this medical check: the initial request may be made in writing or by “any other appropriate means of expression,” with the assessment once again being made by the referring physician (Art. 5). The opinions issued by the various members of the multidisciplinary team are not subject to written formalities or to being recorded in the patient's file, unlike the collegial procedure relating to deep sedation (L1110-5-2 and R4127-37-2 of the CSP). These opinions are not binding on the referring physician, who makes the final decision.

A “control and evaluation commission” is responsible for a posteriori control. This commission is responsible for verifying, after the person's death, the legality and compliance with the procedure, both in substance and in form. Thus, the review takes place after the act has been committed and therefore cannot prevent any potential abuses beforehand.

This commission may report any criminal offenses it finds to the public prosecutor with a view to bringing public proceedings, or refer cases to the disciplinary chambers of the relevant professional associations in the event of breaches of ethical rules. Its action remains entirely retrospective and it has no other powers. In addition, the main association campaigning for the legalization of euthanasia in France, may also be included under the heading of “approved associations representing users of the health system in hospital or public health bodies” (Art. 15).

• See this article on the consequences of such a control procedure in Belgium: Euthanasia: the counter-example of Belgian and Dutch laws

11. Violation of doctors' conscience

Professionals who refuse to perform assisted suicide or euthanasia must “without delay” provide the applicant with the names of other professionals willing to perform assisted suicide and euthanasia.

This obligation (Art. 14) transforms a refusal into an act of indirect cooperation, effectively forcing doctors who oppose euthanasia to lead a person to obtain assisted suicide. It infringes on the physician's freedom of conscience, guaranteed in Article 18 of the International Covenant on Civil and Political Rights and Article 9 of the European Convention on Human Rights, in the name of the patient's “individual freedom” to choose the time of his or her death. Indeed, there is no reference to an obligation to refer to an institution or simply to a colleague, but directly to professionals willing to perform euthanasia.

While the law provides for a conscience clause for healthcare professionals who do not wish to participate in euthanasia, it accompanies this with a constraint by excluding medical students, pharmacists, and institutions (see below).

This approach is contrary to the recommendations of the World Medical Association, which states that: “No physician should be forced to participate in euthanasia or to assist a person in ending their life, nor should they be required to refer a patient for this purpose[7].”

There is no escape for doctors who are fundamentally opposed to euthanasia. Either they do not declare themselves conscientious objectors in order to make decisions unfavorable to the requests made to them, and they may be sued by the rejected patient; or they declare themselves conscientious objectors and must refer the person to a colleague whom they are certain will perform euthanasia.

12. All medical-social establishments must allow euthanasia on their premises

The manager of any medical-social establishment is required to allow assisted suicide and euthanasia to be carried out on their premises. This obligation will apply to private establishments with a specific ethic opposed to euthanasia.

The scope of application (Art. 14) is very broad, also covering medical-social establishments that temporarily accommodate people with disabilities or people in situations of social exclusion, nursing homes, young workers' hostels, etc.

All amendments aimed at allowing a conscience clause for institutions were rejected, despite multiple references during the debates to a European directive[8] stating that "a difference in treatment based on a person's religion or beliefs does not constitute discrimination when, by the nature of these activities or the context in which they are carried out, religion or belief constitutes a genuine, legitimate, and justified occupational requirement in view of the organization's ethics."

While “walls have no conscience clause,” the proposed law differs in this respect from the law on abortion, which, although no longer allowing institutional clauses in public establishments[9], allows a private establishment to refuse to perform abortions on its premises (Art. L2212-8 of the CSP) , a possibility not included in this text on euthanasia.

This will include future care homes, even those dedicated to palliative care, as well as religious and non-religious institutions whose organizational ethics are fundamentally opposed to the practice of assisted suicide or euthanasia.

13. Pharmacists are obliged to dispense the lethal substance

Pharmacists do not have a conscience clause and are obliged to provide the lethal substance. France stands out in this respect from other countries' legislation.

Pharmacists are excluded from the benefit of the conscience clause (Art. 14), thereby crystallizing a contradiction between the pharmacist's ethical obligation to carry out their mission "with respect for life and the human person " (Art. R4235-2 of the CSP) and the new obligation to prepare and dispense a prescribed substance designed to kill (Art. 6).

Under current law, such an act would constitute complicity in poisoning, with a penalty of 30 years' imprisonment[10]. The intention to cause death is characterized by the production of the substance, a poison whose purpose is to cause death. The fact that the pharmacist does not administer the poison himself does not mean that he is not involved in the subsequent death in the eyes of the law. The link between the death and the administration of the substance is certain, albeit indirect, through the simple dispensing of the product by the pharmacist.

In its opinion of April 4, 2024, on the draft law, the Conseil d'État considered that the dispensing of the lethal substance was not “sufficiently direct” to the death of the patient to infringe on the freedom of conscience of pharmacists (§ 38). Pharmacists, who previously had to refuse to dispense such a product in the interests of the patient's health, under penalty of criminal prosecution (Art. R4235-61 of the CSP), would now be obliged to do so.

Here again, France differs from foreign legislation in its exclusion of pharmacists. Indeed, Belgian, Swiss, Austrian, and Canadian legislation allow pharmacists to object on grounds of conscience under certain conditions.

14. The offense of obstruction limits the possibility of preventing euthanasia and assisted suicide

A person seeking to dissuade a loved one from committing suicide could be prosecuted for “moral pressure,” which constitutes the offense of obstruction.

Article 17 of the law creates an offense of obstruction of “assisted dying,” punishable by two years' imprisonment and a fine of €30,000. The penalties have been aligned with those for the offense of obstruction of abortion (Article L.2223-2), and are therefore doubled those in the initial proposal.

This offense punishes the act of preventing or attempting to prevent the practice of or information about assisted dying, in particular by disrupting access to establishments required to allow the practice of assisted dying, or by exerting moral or psychological pressure on persons seeking information. It is contrary to the positive obligation of States to prevent suicide resulting from the right to respect for life (Article 2 of the European Convention on Human Rights), as interpreted by the European Court.

In light of case law on obstruction of abortion, the moral and psychological pressure is characterized when it is subjectively observed by women who have come to family planning clinics to obtain information about abortion[11].

In the case of euthanasia and assisted suicide, it is the doctor who exercises control over “pressure” (Article 9) and who ensures, at the time of administering the substance, that no relative, accompanying volunteer, or trusted person expresses convictions intended to dissuade the patient. The doctor could easily consider the comments of a relative or companion as moral and psychological pressure and report the commission of an obstruction offense to the public prosecutor.

This provision is a serious violation of freedom of expression and opinion, enshrined in Article 19 of the International Covenant on Civil and Political Rights and Article 10 of the European Convention on Human Rights. This offense of obstruction would criminalize the activities of certain caregivers, companions, volunteers, and relatives who disagree with the “aid in dying procedure."

The same article creates a right for any association that has been legally registered for at least five years and whose statutory purpose includes the right to access assistance in dying to bring civil action in the event of obstruction. Thus, the main association campaigning for the legalization of assisted suicide and euthanasia in France, will be entitled to bring civil action on behalf of persons who have declared that they have been obstructed in their will of dying. This same association will be able to keep records of doctors who “assist in dying,” while identifying institutions whose work ethic is opposed to the practice of euthanasia and which are likely to refuse to allow it to be carried out on their premises.

Conclusion

Analysis of the proposed law reveals a mechanism that, by its very design, facilitates access to suicide. The procedure is notable for its expeditious nature, with particularly short decision-making and reflection periods; final decision-making power concentrated in the hands of a single physician; and a multi-professional panel reduced to a purely advisory role. The almost total absence of legal recourse for third parties and the inadequacy of a priori control mechanisms eliminate potential safeguards, creating a boulevard to administered death, which risks becoming a highway due to difficulties in accessing palliative care.

This French legalization of assisted suicide and euthanasia is all the more worrying as it is significantly more liberal than that of its neighbors. The time limits are shorter than in Belgium or Austria, the right of appeal for third parties is more restricted than in Belgium, Spain, or the Netherlands, and the absence of a conscience clause for pharmacists is an exception to Canadian, Belgian, Swiss, or Austrian practices.

This particularly permissive bill of law raises fears of a “slippery slope” effect already observed abroad, which systematically manifests itself in a gradual broadening of the conditions for access and a steady increase in the number of euthanasia cases. Starting from an initially ultra-liberal legislative framework, France risks not only following the example of other countries, but even accelerating the downward spiral.

Jean-Louis Wurtz.

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[1] Réseau Épidémiologie et Information en Néphrologie (Epidemiology and Information Network in Nephrology), Annual Report, 2022.

[2] Brain Research Foundation, Psychiatric diseases and behavioral disorders, last accessed on July 22, 2025.

[3] Oregon Health Authority Public Health Division, Oregon Death with Dignity Act: 2023 Data Summary, p. 14.

[4] Catherine Vautrin, End of life: Minister Vautrin's surprising slip of the tongue, RTL Le grand jury, March 21, 2024.

[5] Cour des comptes, Communication to the Social Affairs Committee of the National Assembly, “Palliative care: a service to be strengthened,” July 2023.

[6] Constitutional Council, Decision No. 2017-632, QPC of June 2, 2017.

[7] World Medical Association, General Assembly of October 2019.

[8] Council of the European Union, Directive 2000/78/EC, November 27, 2000, Article 4(2).

[9] Conseil constitutionnel, Decision No. 2001-446 DC, June 27, 2001.

[10] Art. 221-5 Penal Code; Court of Cassation, Criminal Chamber, September 6, 2017, No. 17-84.446, Unpublished.

[11] Cour de Cassation, Criminal Chamber, No. 14-87.441, September 1, 2015, Unpublished.