On 25th January 2012, the Parliamentary Assembly of the Council of Europe (PACE), adopted the Resolution 1859 (2012) “Protecting human rights and dignity by taking into account previously expressed wishes of patients”. This Resolution defines the applicable principles, in Europe, to the “testaments de vie”, also called “advance directives”. Although it does not aim at treating euthanasia, the resolution condemns it strongly.
In the course of a resolution on end of life, the APCE condemns euthanasia
Because they deal with the delicate subject of the end of life, the advance directives can be subject to abuses and be diverted to practice euthanasia. Thus the APCE judged necessary to establish the principles which have to govern the practice of advance directives in the member states of the Council of Europe.
As a reminder, as defined by the European Recommendation CM/Rec (2009)11, the advance directives are “the whishes emitted by a capable adult on questions which can be raised by his future disability”. The APCE judges that quick progresses are to be made in the field of advance directives so that the human rights and the dignity of people are warranted”. To do so, it encourages the member states:
– to apply the CM/Rec(2009)11 Recommendation which unifies and supervises the mechanisms of the advance directives in their country.
– to ratify the Oviedo Convention on Human rights and biomedicine. This sanctions the free and informed consent of a person on whom a surgical intervention is made. It sets that “an intervention cannot be performed on a person who does not have the capacity to consent, only for his/her direct benefit”. It specifies that the whishes previously expressed by this person will be taken into account.
– to follow the 1418 (1999) Recommendation on the “Protection of human rights and the dignity of incurably ill and dying patient” which advocates an “equitable access to palliative care appropriate to all incurably ill patients and dying patients”.
This Recommendation reminds that decisions based on value judgments have to be banned. Also it insists on the right to life as it is set out in the article 2 of the European Convention of human rights which states that “No one shall be deprived of his life intentionally”. It specifies the fact that “the desire to die expressed by a patient (…) can never constitute any legal claim to die at the hand of another person”.
– to respect the following principles, aligned with the Rec. 1418 (1999):
- Recognizing as invaluable the instructions of the advance directives when they are “contrary to the law or good practices”. This way, if the national law prohibits euthanasia, an advance directive cannot imply it.
- Prohibiting the decision by a subrogated person based on “general value judgments” concerning the situation of the person: “if in doubt, the decision should always aim at preserving the life of the concerned person and to extend the life”.
Thus the APCE encourages he States not to yield to relative judgments to make the decisions concerning end-of-life unconscious patients.
Building on this principles the Resolution comes to reject euthanasia, stating that “euthanasia, in the meaning and the use of processes by action or by omission enabling to provoke intentionally the death of a depending person in the alleged interest of him/her, must always be prohibited” (§5).
Impact of this resolution
This Resolution has been praised by the European Center for Law and Justice, ECLJ (1) as a “major victory for the protection of the human life and the dignity”.
It is indeed “the first time from decades that euthanasia is so clearly rejected by a political European institution”. For the chairman of the ECLJ Grégor Puppinck, this resolution shows the explicit opposition of the majority of the European countries to euthanasia. Even if it has not binding force on member states, it sets apart the European countries which legalized euthanasia (3 to date). This way the strong lobbies which exist in favor of a legalization of euthanasia, contrary to what we can think, has no support. Moreover, this Resolution reminds once more that dignity and euthanasia are not equal, but quite the opposite. We cannot pretend to the respect of the private life, the protection of human rights and the dignity by proposing to put an end to the life of a person.
France will not have support to legalize euthanasia
The question of euthanasia comes back within the framework of the French presidential campaign.
François Hollande, the French socialist candidate, agrees to legalize euthanasia in the proposal 21 of his program. Mixing up deliberately euthanasia and dignity, this new proposal contradicts the European text which sees euthanasia as a serious transgression to the respect of dignity and human rights of people. For Europe, such legalization does not respect the dignity of dying people.
For the APCE, the protection of this dignity cannot avoid palliative care, which allows accompanying a patient to the end of his/her life by alleviating his/her pains. In France, Leonetti law advocates to develop these cares and prohibit therapeutic obstinacy (2). A report issued mid-February by the national Observatoire of the end of life shows that this law is unknown from health professionals for whom a real palliative culture must progress.
Like the European texts, it advocates the reinforcement of palliative cares, still very insufficient in the country. Finally, it reviews
the situation of the countries which legalized euthanasia: we observe a constant increase of the number of euthanasia practiced on patients who did not ask for it. The legalization can only be dangerous, and may cause France to miss out the necessity of development of palliative cares.
1. International NGO, specialized in the legal defense of human rights. ECLJ plays an important role, particularly to the European court of human rights, Council of Europe, European Parliament and the Organization for safety and cooperation in Europe (OSCE);
2. Practice by which an end of life patient is maintained alive artificially (by mean of respirator, drugs…) whereas there is no more hope to improve or stabilize his/her state.