Can the debate on euthanasia be revived in Norway?

After Emmanuel Macron’s re-election in 2022, the end of life (“la fin de vie») became one of his most important political projects. In May, the National Assembly will consider a bill to allow euthanasia for incurable and dying patients. Can a French yes revive the Norwegian debate?

A citizens’ panel for active euthanasia

The proposal to allow euthanasia is the result of a, for Norwegians, democratic innovation. 185 French people were selected by lottery to sit on a citizens’ panel to decide whether there was a need to change the legal framework around the end of life.

In its final report from April 2023, the panel advocated allowing euthanasia. The decision is in line with the will of the people: Opinion polls show that a large majority are supporters of some form of active help to end life.

Euthanasia is prohibited in Norway. If the French bill is passed, it could help to revive the Norwegian debate again.

In Norway, too, a majority is in favor of euthanasia: 70 percent of Norwegians want to legalize active euthanasia. It is a democratic paradox: an overwhelming majority of Norwegians are in favor of euthanasia, but the position is not represented by any parties in the Storting.

The paradox can be explained by the fact that the interests of an intense minority trump the interests of a passive majority. It may also be because it is unpopular for politicians to remind voters of their mortality.

The fact that the majority opinion is not represented in the Storting is a reason to try a citizens’ panel in Norway as well. A citizens’ panel will take the political initiative away from parties that do not want to be seen as messengers of death. A citizens’ panel is also a good fit since euthanasia raises deep ethical questions and cuts across political divides.

The French bill

The bill on the table in France would allow euthanasia for adults who are capable of making the decision themselves. In order to receive euthanasia, one must suffer from an incurable disease that is life-threatening in the short or medium term, and where pain relief is not a good option.

If healthcare personnel decide that the criteria are met, the patient will receive a lethal dose of medication which the person takes himself. If your health does not make it possible to take the dose yourself, you can get help to take the medicine from a doctor or nurse or a “voluntary third person” pointed out by the sick person.

Although the word “suicide” is not mentioned in the bill, the French solution is a form of “physician-assisted suicide”. The name indicates that the primary way in which euthanasia is given is for the doctor to prescribe a lethal dose of medication with the intention of assisting the patient’s suicide, rather than for the doctor to take the patient’s own life.

The fact that a doctor and nurse can still give the patient the poison cup means that the arrangement can also be considered “euthanasia”. In Oregon, which has had physician-assisted suicide since 1997, it is not legal for a doctor or nurse to administer euthanasia. However, it is the norm in Belgium, the Netherlands, Luxemburg and a number of other jurisdictions. There, the patient can request that the doctor take their life.

However, the French terms are more similar to the Oregon model. In Oregon, there is a requirement that the patient must have a terminal illness that gives them less than six months to live. In the French proposal, one must have a fatal disease that is expected to take the patient’s life in the short and medium term, where the medium term is understood as having months left.

In the Benelux countries, the patient does not have to be close to death to be granted euthanasia. However, they must suffer excruciatingly, have no realistic prospect of recovery and have a consistent desire to die.

Plenty of time has been set aside to discuss the bill, first in a separate commission and then in open plenary debates in the French National Assembly, before the text is scheduled to be voted on on 11 June. Most likely, there will be several amendments, but it is still expected that the law will eventually be adopted, as there is a majority in favor of active euthanasia both on the French left and in the president’s own party.

The right, on the other hand, is divided. Leader of the Gaullist party Les Républicains Éric Ciotti is himself in doubt about what he will vote for, while Marine Le Pen, who is the parliamentary leader of the right-wing populist Rassemblement national, wants to prioritize better pain relief over “helping people die”. Both parties have exempted their elected representatives, so that they can vote according to their conscience.

Arguments for and against active euthanasia

Taking a position on active euthanasia requires one to go into a number of ethical questions. There should be no doubt that sometimes life is worse than death. When life is dominated by suffering, one has no realistic prospects for recovery and urgently wants to let go, it is often a relief for the patient when death occurs.

There is greater disagreement about whether we should hasten death. Many believe it is wrong to kill, even when the killing is ordered by the patient and death is desired.

Another point of appeal is the doctor’s role. Many doctors see their job as helping and not harming and are therefore against euthanasia. On the other hand, if doctors’ primary obligation is to heal when they can, and otherwise to prevent suffering and respect the patient’s autonomy, it argues in favor of allowing euthanasia.

Another consideration is the social effects a change in the law will have. If euthanasia is a possibility, it may be that more people will feel that they should end their lives in order not to be a burden. On the other hand, should we deny people who suffer excruciatingly and desperately want to die a dignified way out of life, because of speculation about possible societal effects? Euthanasia raises many questions.

Active euthanasia in Norway – a matter of time?

In Norway, euthanasia is prohibited. If the French bill is passed, it could help revive the Norwegian debate again. We need that, and especially the part of the Norwegian people who lack politicians who lead their cause and the many who would like a more dignified end to life than is possible today.

This week’s episode of France explained is about active euthanasia. Listen to the episode here.