Already too many cases of euthanasia in France encouraged by the reduction in spending on health

Publié le : 6 February 2013

 Nicole Delepine, head of the paediatric oncology unit of Raymond university hospital, has published a report in Economie matin on the subject of "‘euthanasia, or the radical reduction of spending on health." Denouncing what she says are too many cases of euthanasia in France, she explains the drift of the country towards euthanasia and why it should not be legalised because the motivation behind the project is more economic that compassionate.

She begins by pointing out that euthanasia, although illegal, is already practised in France: "3.1% of deaths occur following an act deliberately aimed at cutting life short, by stopping the treatment or intensifying the sedation. In 0.8% of deaths, medications were administered to provoke death (only 0.2% of them at the request of the patient)." Although it is illegal, euthanasia is practised, according to the National Institute of Demographic Studies (INED), "in a significant number of cases without the request of the patient […] and it concerns in particular patients suffering from cancer." These too numerous "precipitated deaths” shock Nicole Delepine. She explains the reasons: "the government and, reflecting it, the health care workers and even the families, have got used to deciding what is good for the patient. In the hospital meetings […] we regularly hear it said at meetings between carers and families: ‘this life is not worth living’ or ‘why revive this disabled child?’" She denounces the use of the suffering of families to get them to make the decision to put an end to the life of their relative which in reality has been decided by the doctors themselves. She says that people are being conditioned to legalise euthanasia.

Nicole Delepine goes on to explain that if the partisans of the legalisation of euthanasia do not put forward a real argument for palliative care and by their actions reduce the possibilities of potentially curative treatment, it is because there is another explanation rather than compassion, the patient’s dignity and the freedom of choice put forward to obtain a "pro-euthanasia" consensus. The real argument for legalising euthanasia, she claims, is the same one that encouraged the campaigns in 1990 highlighting palliative care and placing it in competition with treatment for cancer, for example. "It was quickly understood at the time that morphine costs a few euros while chemotherapy costs hundreds." So that is the true reason: "The hospitals are ‘overloaded’ with patients who are old, tired and perhaps incurably ill […] and the hospitals are in deficit. The costs have to be cut, hence the number of hospitalisations […] So by accelerating the end of life while presenting it as a humane and compassionate choice, the managers can put across this unmentionableidea to the population". She reminds readers that the big media coverage for reducing the health costs began not recently but back in 1995, when mergers of hospitals began, the closing down of small maternity units and local clinics… "These closures radically changed the health care scene."

The last six months of life are the easiest to curtail, she points out: palliative care first, then stopping the costly chemotherapy treatments on the pretext that they constitute unreasonable obstinacy, then passive or active euthanasia, "but always discreet, not admitted or named."            

She explains it as "one of the perverse effects of a law that is well formulated but whose application already has overtaken its goals" (she is referring to the Leonetti law), but also due to the introduction of basing the charges on health care “acts”, the famous T2A clause applied to hospitals which progressively revealed that only these "acts" could be paid for. "With the establishment of quantitative thinking, this a priori logical attempt to pay the hospitals according to the work really provided very quickly had perverted effects and was derailed from its objectives." With the T2A clause, the human activities provided for the patient (toilette, listening, consolation, etc.) were no longer regarded as “acts”. The emphasis is now put on economic viability. Short stays are now an obligation. "It was necessary to curtail the duration of hospitalisations in palliative care also." So those likely to take the longest to leave "would be conditioned to feel too much of a burden, a trial for society and their family because they added to the health funding deficit."
"So the request for euthanasia, if it exists at all, boils down to a feeling of being a burden for society or one’s family?" asks Nicole Delepine. According to Lucien Israël, the request for euthanasia is rare and exceptional among patients correctly looked after.
She concludes by saying that the legalisation of euthanasia is very dangerous, as there is "no possible safeguard against abuse."  "Patients have to be made aware of the dangers of giving permission to all those who will carry out euthanasia on request." Euthanasia can become a "business" as in Switzerland where "assisted suicide costs at least €10,000 for the fatal 3-day stay”, shedenounces. The Sicard report of 2012 cites the INED which points out that the Leonetti law has already led to the multiplication of cases of euthanasia in France without the voluntary agreement of the patient. "Do we need to go further?" she asks.

Nicole Delepine calls on her readers to reflect collectively on the value and the meaning of human life so that we can always guarantee respect for the most vulnerable people.

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