Lessons from the French end-of-life system: what to avoid

In light of certain statements read or heard in recent days regarding the Veneto regional law on assisted dying, we must not overlook a detail that risks misleading even those who are not in favour of assisted dying: namely, the role of palliative care in the patient’s course of treatment – and, in some cases, in their dying process. Firstly, let us not forget that Law 38, passed way back in 2010, made palliative care ‘a right’ for all patients – a provision that has so far been largely disregarded in many parts of the country. It is therefore not to the credit of the Veneto law that it has highlighted the fact that the public health service must commit to providing palliative care to all patients: this should already have been the case since 2010, save for the fact that it merely adds to the list of rights that, in practice, vanish into thin air.

Secondly, and this is the most sensitive issue, one must not assume, as many Catholics do, that the initiation of palliative care automatically safeguards against the various deadly excesses. For some time now, we have been witnessing a drift in palliative care itself, or at least in part of it. The ‘palliative care movement’ has always embodied the spirit of the middle way between euthanasia and unreasonable obstinacy – that form of support which should never have meant ‘pushing towards death’. This is no longer the case, and it is now common to encounter fellow doctors and palliative care nurses who, in defiance of the original ethos, regard death on demand as a possible option in the patient’s care pathway. It is therefore clear that no one can claim to be ‘reassured’ by the frequent references to palliative care made by those who legalise assisted dying, and it is equally clear that continuing to present palliative care as an antidote to assisted dying means overlooking a development that is plain for all to see. The pure milk of our origins has now become a coffee with a dash of milk: when we ask for something, we must be certain of what we will be served.