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00:00So just to remind you, France's Lower House of Parliament adopted bills to allow adults with incurable illness to take lethal medication.
00:07It has to go, of course, before the French Senate, before it becomes law.
00:11Let's get a broader analysis and bring in Luc Delian, who is Professor Emeritus in Palliative Care Research at the VUB and Ghent University.
00:19Thank you, sir, for being with us.
00:21What's your reaction to this vote in France?
00:26I think it's a very logical vote.
00:28If you take the development all across the globe, very rapidly since 2000, after the Netherlands and Belgium legalized euthanasia, in the last 10 years, major countries like Canada and also the different states, almost all states in Australia, except the Northern Territories, have legalized euthanasia or assisted dying in their countries.
00:56And as it's been presented in the news in France, most of these laws are based on the same criteria, although they differ in many aspects on the details.
01:11We will all die.
01:13We will all die.
01:13That is one of the great facts of life.
01:16And sadly, we will see, probably witness, a loved one dying too.
01:20It is undoubtedly tough on the person who's losing their life.
01:23It is perhaps even more tough on those who are suffering the grief afterwards.
01:27So clearly, this subject is incredibly delicate.
01:31And of course, people's beliefs come into it, don't they?
01:33So what you've argued is a very reasonable, logical explanation and analysis, which we appreciate.
01:39You see also, I imagine, from your perspective, that there is a different interpretation.
01:44And some people will be dead set against this because for them, it's against their beliefs.
01:50That's absolutely no problem, because I do not know any law that obliges any of the patients to go for this law.
01:58So the basic fundamental issue of this law is person's autonomy.
02:04So it's an autonomous choice of a patient that is suffering endlessly, but also unbearably.
02:12And I think that is the crucial aspect of the law.
02:15So, of course, you might fantasize all kinds of pressures to that patient,
02:21but it's up to the clinicians to make sure that all safeguards of the legal framework have been met
02:28through different communications with the patients
02:32and following the due care criteria that are explained in these laws.
02:39It is a remarkable thing to have to discuss.
02:43At the end of life, of course, those who don't believe in this idea of being able to take your life in this way
02:48say it's about God deciding when this happens, whichever God they may believe in.
02:53But, of course, there's also an ethical dilemma, too, isn't there,
02:55which gives the medical profession something to really reflect about
02:59because some might see in some way, shape or form something that could be abused by a doctor
03:05or someone of that kind of influence, something that could be abused by a family member, for instance,
03:10those kind of things.
03:11You're obviously alive to those issues, aren't you?
03:13Well, I don't think that if the procedure is monitored by a doctor,
03:22I don't see that a family member can oppose euthanasia on their loved ones.
03:29So that is fully impossible, at least in the Belgium system.
03:33Of course, the doctors need to be educated.
03:35So those who get involved in this practice need to have training.
03:39And that's why, for example, in the law in Australia, they need to go for their training
03:44and they need to have their certificates before they can start doing these practices.
03:50Just like for palliative care, too few doctors have been trained in palliative care.
03:57So there's a lot of training needed to cope with very complex situations at the end of life.
04:03And I would not reduce that to the request for euthanasia.
04:08The whole end of life issues in medicine is a very complex issue.
04:13And so doctors need to be trained from medical school on and then in an advanced stage.
04:19And of course, you need specialists like specialists in palliative care
04:22and people who are also specialists in euthanasia or assisted dying.
04:27So it needs a lot of training.
04:30In Belgium, we have an infrastructure of training for what we call the life physicians
04:36who are really supporting the doctors when they are confronted with the request for euthanasia.
04:42And so they support their colleagues in these difficult moments in their practice.
04:48Because it must be an incredibly difficult thing for a doctor to be confronted by a patient
04:52who's saying, please, I want to die.
04:54Well, that differs from doctor to doctor.
05:00In my view, if you're a very good palliative care doctor, it's not a difficult thing.
05:05A palliative care doctor is used to talk about death and dying,
05:08about preferences of patients, about their death, etc.
05:12So I think the main challenge is the communication challenge.
05:18A doctor needs to be able to have a communication on all levels.
05:24Also, the existential level of a patient.
05:28And I must say, I must admit, in general, very few doctors are able to communicate on that level.
05:34But once you are able to communicate on an existential level with your patients,
05:40these conversations are not difficult.
05:42Luc Delian, thank you very much indeed for your time and for answering my questions,
05:48which I think at one point went off the track of which you wanted to take us.
05:52But you brought us back with your expertise and your knowledge of how things work in different countries
05:55to give us a real sense of how this is happening in other countries and how it could happen here in France.
06:01That's Luc Delian, Professor Emeritus in Palliative Care Research at the VUB and at Ghent University.
06:06Thank you, sir, for being with us here in France 24.
06:08We appreciate your time.