The disappearance of two Comtoise personalities, Paulette Guinchard then Jean-Loup Coly, a few months apart, revives the debate around assisted death. Both have benefited from this device, which has been legal in Switzerland since 1942. In France, the debate is still lively and it is difficult to be resolved as the ethical questions raised are so complex. “The Claeys-Leonetti law, which since 2016 has authorized sedation to put an end to refractory suffering, remains a law that is difficult to manipulate, and above all it causes confusion”, explains Aline Chassagne, research engineer at the CHU de Besançon.
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18 requests analyzed
A former nurse and now a socio-anthropologist, the young woman is part of a team from the Clinical Investigation Center working under the authority of Professor Régis Aubry, on ethical issues in a situation of medical progress. “This is a research program on requests for assistance in dying, by euthanasia or assisted suicide (DESA), in Bourgogne Franche-Comté and in collaboration with a Parisian team from the Jeanne Garnier medical center. “
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Arrived in palliative care, “people imagine that it will be possible”, underlines Mme Chassagne, who recalls that “this is not the case” even if the sedation, which consists of “an accompaniment by a deep and continuous falling asleep”, can give the appearance of a workaround. Moreover, a bill “giving the right to a free and chosen end of life”, last April was hampered by a deluge of amendments and led to a very reluctant reaction from the French palliative care company.
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We still have to ask ourselves the question of what is covered by this request for assistance in dying on the part of patients. Conducted since 2014, the study made it possible to meet patients, but also relatives and caregivers and analyze 18 of these requests in palliative care units. “It is difficult to stay on a binary position, for or against, on this issue. We have tried to provide empirical data to encourage debate. And the first remark made by the synthesis of this DESA study is that patients challenge palliative care providers and encourage them to change clinical practices. “These requests, mainly oral, express above all” a call for the recognition of suffering and the fear of being overwhelmed by it. “
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A need “to be able to allow yourself to discuss it freely”
The continuation of the interviews also demonstrated the “vagueness” around these notions of assisted suicide (the person triggers the device) and euthanasia (it is a third party who acts) and of the difference in perception of what “a person” is. acceptable suffering “and the lack of response to be provided by caregivers to patients at the end of their life, sometimes expressing an ambivalent request situated” in a middle ground where the patient is torn between the desire for death and life . “
What emerges from the analysis of these interviews “is perhaps the need to be able to allow oneself to discuss it freely, which has an important psychic function and makes it possible to dispel confusion, and to define a somewhat future. desirable, ”concludes Aline Chassagne. “This approach leads to questioning palliative care practices. “
