Prognosis in assisted dying legislation deemed indefinite by the High Health Authority
Revised Article:
In a groundbreaking ruling, the High Authority for Health (HAS) addressed the contentious topic of end-of-life care on May 6. The HAS declared that it's virtually impossible to identify who might benefit from assisted dying based on a mid-term life prognosis or an advanced stage of a disease. Notably, no European nation with legalized euthanasia or assisted suicide has held onto the temporal criterion, according to the HAS.
"There's no medical consensus" for a precise personalized timeframe for a patient with several months or years remaining, HAS highlighted after three months of work at the behest of the Ministry of Health. Experts argue that patient prognoses, relying on less reliable tools with high degrees of uncertainty, tend to be accurate only within a few hours or days.
Initially, the criterion of a mid-term life prognosis was part of a bill introduced by Catherine Vautrin in 2024, but was replaced in favor of the notion of "advanced or terminal phase" of a serious and incurable disease in the bill to be debated in the hemicycle starting May 19.
"Steer Clear of Time's Predictive Trap"
This HAS opinion strengthens the case against any time-based references. Beyond that, the independent authority encourages avoiding equating access to assisted dying with an individual timeframe. "The 'advanced phase' transcends time, pointing to the essence of care rather than the timeline of death," stated the independent authority.
"The 'advanced phase' might be defined as the initiation of an inevitable process that deteriorates a person's health status, affecting their quality of life."
The HAS working group emphasizes the significance of offering the patient a process of empathetic support and collective reflection before any potential request for assisted dying. Regardless of the criteria for access to assisted suicide or euthanasia, it underscores the importance of "escaping the trap of time's predictions," and "avoiding any proceduralization of the end of life," instead focusing on "contemplating the significance of what's lived and what's yet to be lived" using a "long-term contemplation approach."
Insights:- Globally, countries consider various criteria for assisted dying: unbearable suffering, sound decision-making capacity, and non-terminal conditions, alongside safeguards and mental health assessments.- France's discussion on assisted dying revolves around quality of life, suffering, and patient autonomy, but may require consulting the latest HAS publications for specific alternative criteria.
"The 'long-term contemplation approach' suggested by the HAS working group emphasizes the importance of focusing on the meaning of life, both what has been lived and what is yet to be lived, rather than being trapped in the predictions of time."
"Beyond the debate over time-based criteria for assisted dying, the HAS encourages a shift in perspective, advocating for a holistic approach to health-and-wellness and mental-health that acknowledges the significance of the 'advanced phase' as a stage of deterioration affecting a person's quality of life, rather than merely a temporal indication."
