Pharmacists and Experts Take a Stand Against Euthanasia

Currently, a pharmacist who prepares or dispenses a lethal substance for ingestion by a person would be prosecuted for complicity in poisoning. They would face 30 years of criminal imprisonment. The fact that the person consents to their poisoning does not lessen the severity of the sentence.

With the "end of life" bill, the Government intends to make mandatory the preparation and dispensing of lethal substances by pharmacists. Within the framework of "aid in dying," a pharmacist would thus be obliged to cooperate in euthanasia and assisted suicides. An act currently punishable by up to 30 years in prison would, by such a law, become an obligation for pharmacists.

The Government views pharmacists as mere executors of euthanasia and assisted suicide that it wants to legalize. The "end of life" bill explicitly deprives them of the conscience clause. In the explanatory statement, the Government provides no justification for this choice. It simply states: "Only pharmacists cannot benefit from such a clause." In other words, the pharmacists' freedom of conscience will be violated.

Therefore, about thirty pharmacists, two professors from pharmacy faculties, and around thirty jurists co-sign a collective op-ed in Le Figaro on May 13, initiated by the European Centre for Law and Justice (ECLJ):

The bill on " end of life care and support for patients " proposes the establishment of "aid in dying" for patients who have requested it. The legal definition of this provision includes both euthanasia and assisted suicide through the administration of a lethal substance. These practices face opposition from many healthcare providers, as they would be the first affected by the implementation of the law.

In fact, it would be a doctor who decides on a patient's request for "assisted dying," and a doctor or nurse who "assists" in administering the lethal substance. Between the decision-making and its implementation, pharmacists would also intervene, by preparing the "lethal magistral preparation" intended for the patient, and by dispensing this substance in a pharmacy or within a healthcare facility.

To reassure, the government has provided a conscience clause "for healthcare professionals who do not wish to participate in the assisted dying procedure." However, the bill explicitly excludes pharmacists from this provision. In the explanatory statement, the government provides no justification for this choice. It simply states: "Only pharmacists cannot benefit from such a clause." In other words, pharmacists will be required to prepare and dispense products intended to cause death, under threat of disciplinary action.

Currently, a pharmacist who prepares or dispenses a lethal substance for ingestion by a person would be prosecuted for complicity in poisoning. They would face thirty years of criminal imprisonment. The fact that the person consents to their poisoning does not lessen the severity of the sentence. With the "end of life" bill, the government intends to make mandatory the preparation and dispensing of lethal substances by pharmacists. An act currently punishable by up to thirty years in prison would thus become an obligation for pharmacists.

Pharmacists are thus ordered to reverse the very purpose of their chosen vocation. In addition to preparing medicines for the sick, they will also manufacture and provide poisons. However, according to the Public Health Code, "the pharmacist exercises his mission with respect for life and the human person" (Article R4235-2). This obligation is also expressed in the Galen's Oath, the equivalent of the Hippocratic Oath for pharmacists. It is logical that some pharmacists see an incompatibility between this code of ethics and the end-of-life bill.

In its legal opinion on the bill, the Council of State validates this differentiated regime regarding freedom of conscience. It acknowledges on the one hand that the tasks assigned to doctors and nurses "may offend their personal convictions in ways that infringe on their freedom of conscience." On the other hand, regarding pharmacists, the Council of State believes conversely that "the tasks of preparing the lethal magistral preparation and dispensing the lethal substance [...] do not contribute directly enough to assisted dying to risk infringing on freedom of conscience."

In other words, making and dispensing the substance used for euthanasia would not constitute close collaboration with this euthanasia and would not engage the pharmacists' conscience. This argument is intellectually unconvincing. The lethal substance being essential to euthanasia, the pharmacist who provides it is no less morally involved than the practitioner who prescribes or administers it. If the pharmacist in question opposes euthanasia, what is being ordered of them directly contradicts their personal convictions. Their right to conscientious objection should therefore be recognized and guaranteed, just like other healthcare professionals involved.

The legal regime applicable to the crime of poisoning is enlightening to attest to the moral responsibility incumbent upon pharmacists in this bill. As stated above, a person who provides a lethal substance for poisoning is prosecuted for complicity in poisoning. They face the same penalty as the person who administers the substance, which is thirty years of criminal detention. The Penal Code thus equally condemns the supplier of the substance and its administrator. Providing a substance for poisoning is therefore legally treated as close and direct collaboration in this poisoning.

To fully understand the responsibility incumbent upon the pharmacist, it is also useful to examine the legal treatment of prescription errors. In principle, both the prescribing doctor and the pharmacist are jointly responsible for the harm suffered by the patient. For example, the Court of Appeal of Aix-en-Provence considered in 2017 that a pharmacist should have detected the overdose of medication prescribed by the doctor, rather than executing the prescription. The pharmacist was judged as co-responsible, equally with the prescribing doctor, for the therapeutic accident suffered by the patient.

A pharmacist is recognized as a medication professional, following at least six years of higher education. They are not merely merchants. Moreover, they have a conscience, just like other healthcare professionals. In 2015, 85% of pharmacists consulted by their Order voted in favor of a conscience clause whereby "the pharmacist can refuse to perform a pharmaceutical act likely to endanger human life." They have not been heard and are once again treated as mere executors.

In Belgium and the Netherlands, where euthanasia has been authorized for over twenty years, pharmacists have never been obliged to take part. The same applies in Luxembourg for euthanasia and assisted suicide, as well as in Canada for "medical assistance in dying." In the United States, pharmacists preparing lethal substances are all volunteers, whether in the context of the death penalty or assisted suicide. Spain, which legalized euthanasia in 2021, also respects the freedom of conscience of pharmacists. By obliging pharmacists to actively participate in "assisted dying," France would be an exception.

List of signatories.

The ECLJ congratulates the deputies who have tabled amendments to the bill to introduce a conscience clause for pharmacists. This is particularly the case of Mr. Dharréville (Democratic and Republican Left - NUPES), Mr. Hetzel, Bazin, Juvin, Gosselin, Breton, Brigand, Di Filippo, Mrs. Serre and Blin, (The Republicans), Mrs. Ménard (Unregistered), Mr. Bentz, Odoul, Dessigny, de Lépinau, Frappé, Mrs. Hamelet, Loir, Pollet, Dogor-Such (National Rally).

Conversely, three socialist deputies Mr. Delautrette, Guedj and Mrs. Pires Beaune have proposed an amendment for the sanctions against objecting pharmacists to be not only disciplinary but also criminal, providing for one year of imprisonment and a 15,000 euro fine.

We invite you to sign the text below, addressed to three United Nations bodies following an official procedure, which will prompt these bodies to provide a formal response. For now, this text has only 7,000 signatures, which is insufficient to submit it.

When it reaches 10,000 signatures, the ECLJ will submit it, triggering concrete action at the United Nations. Your support and that of your loved ones is therefore essential: