A-Infos (en) France, UCL AL #370 - Politics - Debates: Living Your Life, Choosing Your Death (ca, de, fr, it, pt, tr)[machine translation]

As the bill on euthanasia and assisted suicide continues its 
parliamentary journey, comrades revisit the debate surrounding this 
text, which is stirring up libertarian discussions, between demands for 
individual freedom and anti-ableist critiques. ---- It is likely that 
the tortuous legislative path of the bill on assisted dying will lead to 
its final adoption this year. In this context, it seemed necessary to 
revisit a debate already discussed several times within Alternative 
libertaire[1], offering a contrasting perspective to those already 
expressed in these pages.

We are clear-sighted about the political context in which this law is 
being proposed, the announcement of which by a president nearing the end 
of his term does not conceal the dismantling of public health services 
endorsed by the 2026 Social Security budget bill[2].

The state of the public hospital system threatens the conditions for 
receiving care. Access to palliative care is very unevenly distributed 
across the country, and specialized facilities are lacking[3]. These are 
some objective observations echoed by those who oppose the law on 
assisted suicide. We share them.

Caption: Advocating for the right to euthanasia and assisted suicide 
necessarily involves demands concerning health and palliative care.

Credit: The Death of Géricault, by Ary Scheffer   Louvre Museum
A different rhetoric is added to these observations; our capitalist 
society is said to be concealing, under this law, a desire to drive 
people with disabilities, the elderly, etc., to suicide. We reject this 
dystopia; the structural neglect linked to the lack of resources in the 
healthcare system must be distinguished from any malicious intent driven 
by a eugenic objective. Access to assisted suicide, on the contrary, 
seems to us a vehicle for emancipation and autonomy.

Deconstructing the myths surrounding the bill on assisted dying
First, let us remember that this bill concerns society as a whole: all 
of us, living, will die. As this law currently stands, it is strictly 
intended for people suffering from incurable illnesses who do not want a 
painful end of life; it does not only concern people currently living 
with a visible or invisible, physical or mental disability: everyone is 
or will be ill, everyone will be faced with choices regarding their own 
mortality. While we acknowledge the reasons for the fears expressed by 
some anti-ableist groups, an interpretation solely through this lens 
would be limiting.

The Clayes-Leonetti Law of February 2, 2016, currently the only 
reference text for end-of-life care, proposes three ways to support a 
patient in death, provided they are suffering unbearably and their death 
is recognized as inevitable and imminent: withholding treatment (not 
resuscitating, not hydrating, not feeding), analgesia (deep sedation), 
and limiting or stopping treatment "when it appears futile, 
disproportionate, or has no other effect than the artificial maintenance 
of life." Apart from sedation, which aims to relieve physical pain, the 
current legal framework therefore only addresses withholding treatment.

The bill on assisted dying proposes adding two options to this range: 
assisted suicide (the patient self-administers the lethal substance), 
intended to cover the majority of cases, and euthanasia (an authorized 
person administers the lethal substance), an exceptional measure when 
the patient is physically unable to perform this act. It is worth noting 
that these two scenarios are already part of the reality of the French 
medical landscape: the aim here is to guarantee equal access to assisted 
suicide and to legalize the actions of patients, families, and doctors 
who decide to resort to it in the privacy and trust of their mutual 
relationship.

Every year, French citizens cross borders to access assisted suicide in 
neighboring countries: more than one hundred in Belgium in 2023, and at 
least 600 people in Switzerland between 1998 and 2024[4]. Knowledge of 
this system, the financial investment, the logistical capabilities 
required, the need to benefit from a supportive environment to organize 
this project are unfair and discriminatory conditions: it seems 
desirable to us that the entire population potentially wishing to resort 
to assisted suicide should have access to it and that it should be taken 
care of by the public health system[5].

The figures available in countries where this practice is legal show 
that only a few thousand people resort to it each year, representing 3 
to 5.8% of annual deaths[6]. Their average age is over 70, and the 
requests are mostly due to incurable cancers and severe, recalcitrant 
neurodegenerative diseases. The legalization of assisted suicide has not 
been accompanied by a surge in applications but responds to a societal 
demand concerning a minority of individuals.

A Libertarian Communist Position on Death
We approve of the law on end-of-life care, and our thinking goes 
further. In the libertarian communist conception, there is neither a 
sacred law nor a universal moral law whose scope transcends eras and 
cultures. Do we recognize that our life, and its counterpart, our death, 
belong to us? Do we recognize the individual freedom to determine the 
time and conditions of our death? This goes beyond the question of the 
quality of care; loss of autonomy is a subjective and evolving concept, 
and one may not even want to be cared for at all. The issues of physical 
suffering and individual freedom, beyond the healthcare system and those 
close to the person, are profoundly personal.

Supporting this bill commits us to promoting the maintenance and 
improvement of public health services, and more broadly, the public and 
shared management of basic needs (health, housing, education, old age, 
etc.). Giving people access to death does not take anything away from 
the living; giving everyone the possibility of choosing the conditions 
of their death does not imply abandoning the care of life. The 
libertarian movement has, and must maintain, a unique place in the 
debate on this issue; we cannot forget the core of our movement, which 
is to choose free will in the face of determinism, whether religious, 
ideological, or governmental. We will not wait for the hypothetical 
framework of an ideal society to make our own choices; the revolutionary 
project, a long-term vision, must not prevent us from pursuing an 
achievable short-term goal: giving everyone the choice of how they die.

Léda, Léa, Michael, and Santo (UCL Montreuil)

Submit

[1]See "Bill on Euthanasia: A Dignified Death After an Undignified 
Life?", Alternative libertaire no. 344, December 2023, and "Odile Maurin 
(Handi-social): 'Will the Choice to Die Truly Be Free?'", Alternative 
libertaire no. 362, Summer 2025.

[2]The 2027 social security budget aims for savings of EUR7.1 billion 
through measures requiring efforts from both healthcare professionals 
and insured individuals.

[3]Data on palliative care makes it difficult to establish reliable 
statistics. It should be noted that in 2024, 21 French departments still 
did not have a palliative care unit. The Court of Auditors estimated in 
2023 that only half of those eligible for palliative care actually 
received it.

[4]The costs incurred for assisted suicide abroad are estimated at 
between EUR1,500 and EUR2,500 in Belgium, and between EUR7,000 and 
EUR11,000 in Switzerland.

[5]Citizen groups have been raising this voice for a long time: Ultime 
Liberté, ADMD, Le Choix... We should also recall the thought-provoking 
episode of Pieds sur terre, "Barbiturates and Old Lace," France Culture, 
November 2022.

[6]See the document "Euthanasia, Assisted Suicide... Data on the 
Different Forms of Assistance in Dying Worldwide," published by the 
National Center for End-of-Life and Palliative Care on its website.

https://www.unioncommunistelibertaire.org/?Debats-Vivre-sa-vie-choisir-sa-mort
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