French Senate rejects assisted dying (for now), adopts palliative care

After more than a year of debates, multiple consultations, and delays due to political uncertainties, the French Senate rejected the proposed law on assisted dying. The bill will ultimately be sent back to the National Assembly. Senators rejected the text by 181 votes to 122. Immediately afterwards, the Senate voted 307 to 17 in favor of the bill on palliative care.

The bill on the “right to assisted dying,” as drafted by the National Assembly, would have allowed adults of "sound mind" to resort to medical assistance in dying under certain circumstances: they would have to be suffering from a serious and incurable condition that is life-threatening in the short or medium term, and experiencing physical or psychological pain that is considered very resistant to treatment.

This assistance would have taken two forms: self-administration of a lethal substance by the patient (assisted suicide) or, where this was impossible, administration by a healthcare professional (euthanasia).

Adopted at first reading in the National Assembly, the bill marked a major break with the current framework established by the Claeys-Leonetti law.

The Senate thoroughly revised the text. Mostly opposed to the introduction of a "right to die," the Upper House first replaced the term “aide à mourir” (help to die) with “assistance médicale à mourir” (medical assistance to die). It then removed the central provisions of the law, notably by opposing Article 4, which set the conditions for access to assisted suicide. Proponents of the bill lamented the changes, which effectively doomed the bill until further revision.

The text aimed at improving access to palliative care was the subject of a much broader consensus. While the deputies had opted to introduce an enforceable right to palliative care, the Senate removed this provision, which was deemed unenforceable in practice due to a lack of resources.

However, the law provides for the creation of “palliative care and support centers”: this category of social or medico-social establishment (ESMS) — the equivalent of hospice centers, familiar in the US but new for France — is designed to serve as an intermediary between the home and the hospital, and is intended to accommodate people in palliative care and their families. 

Around 10 departments in France still do not have palliative care units, raising the question of the financial resources allocated to this highly important issue.

Although the proposed law on assisted dying was rejected by the upper house, marking the end of the first parliamentary cycle, the debate is not over. It’s now up to the National Assembly to write the next chapter, which is likely to be just as heated, given the political and ideological divide with the Senate. 

A compromise among deputies, most of whom are in favor of the bill, seems unlikely. It will come before the Assembly for a second reading on February 16.

"This rejection has an immediate consequence: the bill initially adopted in the spring of 2025 by the National Assembly—the most permissive in the world in terms of euthanasia—will return for a second reading. The threat therefore remains, and it is a major one," said the Lejeune Foundation in the wake of the bill's rejection. It is already calling for "citizen mobilization" for the rest of the debates.