- The Washington Times - Sunday, October 26, 2003

The “mercy killing” of Vincent Humbert, 22, last month after his mother put an overdose of sedatives in his intravenous drip on the third anniversary of the car crash that had left him in a semivegetative state has reactivated the right-to-die debate in France, a recurring issue in many postmodern societies.

“Some people will certainly be sad to learn that I am not here anymore. But they are wrong, I am so happy to leave,” young Mr. Humbert declared in a book published last month, titled in English “I Ask the Right to Die,” which he dictated letter-by-letter by pressing his thumb against his mother’s hand.

It reached French bookstores on Sept. 25, the day after his mother, Marie Humbert, administered the overdose through the intravenous drip that was keeping him alive. Mr. Humbert’s father and two brothers also endorsed ending the life of the young man who was deaf, mute, paralyzed and nearly blind.

“Death is beautiful when it is wished for and comes after months of waiting,” Mr. Humbert said in the book asserting his right to die.

The life of Vincent Humbert changed on Sept. 24, 2000, when the 19-year-old volunteer fireman ran off the road as he drove home. Since the crash, he had lived motionless in a bed at a medical center at Berck-sur-Mer, a fishing village in northern France.

His story first became public in November, when he wrote, also through the mediation of his mother, to President Jacques Chirac, pleading for an exception from France’s ban on assisted suicide. Mr. Chirac and his wife then received Mrs. Humbert and contacted the young man by telephone at Christmas and his birthday.

Since his devastating accident, Mr. Humbert always had claimed a right to end his “non-life,” as he called it. His mother promised to help him do it.

“I wanted this book as a testament … because I will die. I will leave the day that only my mother and I know and have chosen,” says the book published under his name.

On the third anniversary last month of his car accident, his mother put an overdose of sedatives into his intravenous line.

Only Mr. Humbert didn’t die — he fell into a coma and became a “human vegetable” who might have remained technically alive for decades.

So on Sept. 26, Dr. Frederic Chaussoy — chief of the resuscitation unit at the hospital in Berck-sur-Mer — turned off the life-support machine on his own authority to “limit active therapeutics” on the patient, which made Mr. Humbert die.

After his death, one of the deceased’s two brothers told LCI, a French TV station, “I am happy my brother is finally free. It’s a huge relief.”

Belgium, the Netherlands and Switzerland are the only places in Europe where euthanasia and assisted suicide are allowed.

In the case of Mr. Humbert, a criminal investigation is under way, but French Justice Minister Dominique Perben already has told local authorities to consider this case with “the highest humanity.”

The young man’s death has reignited the debate in France about “mercy killing.” Although the law considers euthanasia to be willful homicide or murder and assisted suicide to be “a failure of the duty to rescue” people in danger of death or grave harm, the French National Consultative Ethics Committee notes that “such cases are rarely brought to trial, and when they are and a verdict is pronounced, they are judged with great leniency.”

According to a 2002 poll by the Institut Ifop, 88 percent of French people consider themselves in favor or tolerant of euthanasia.

However, politicians are far more divided on whether there is a need to adopt a law dealing with this issue.

Jean-Pierre Raffarin, the French prime minister, is said to oppose modifying the current law. He told Le Figaro newspaper that one “cannot govern or legislate for such specific situations.”

On the other hand, many politicians call for “deep reflection” about this social issue.

At the beginning of this month, a special commission was created by the French parliament to investigate the issue of assisted suicide and is expected to make recommendations to lawmakers, without excluding “an evolution” of the law.

A debate also has been opened on the Web site of Mr. Perben, the justice minister.

The president of France’s Catholic bishops conference, Archbishop Jean-Pierre Ricard of Bordeaux, declared after the death of Mr. Humbert: “The acceptance, and even more the legitimation, of euthanasia would not be progress, but a great regression for our society.”

For defenders of the right-to-life position, who oppose the legalization of euthanasia, the difficult problem remains confusion between a deliberately provoked death and a legitimate interruption of treatment for serious disease or refusal of aggressive and futile therapies.

“The Catholic Church has always declared itself in favor of reasonable and humane care, which does not imply an obligation to maintain life at any cost,” said Archbishop Ricard.

In public discourse, the word “euthanasia” can have several meanings, such as the deliberate administration of lethal substances to provoke the death of a willing person, a so-called “mercy killing,” and “passive euthanasia,” which consists of refusing or stopping a treatment necessary to sustain life.

Assisted suicide occurs when the dying person performs the final act, even if a doctor intervened to prescribe the lethal medicine.

According to a study for the French Senate, the stoppage or withholding of care and overdoses of strong painkillers frequently are used to shorten the life of terminal-phase patients, even though these generally are not permitted by law.

Since April 2002, euthanasia and assisted suicide have carried no penalties in the Netherlands, legalizing medical lethal intervention on patients with terminal diseases after their formal request.

The doctor must make sure that the request is voluntary and well-considered and that the suffering is unbearable, with no possible amelioration. People 12 to 18 years old also are allowed to be euthanized, on condition that their parents are associated to the decision; if the patient is younger than 16, the parents must agree.

In Belgium, where a similar law came into force in September 2002, the same kinds of conditions have to be followed to protect, before the courts, doctors who practice euthanasia.

In the United States, Oregon has been the only state to allow such practices since the Death with Dignity Act legalized assisted suicide in 1997 for people with a life expectancy of less than 6 months who express their wish to die. According to the Oregon health department, 38 assisted-suicide deaths were reported last year, compared with 16 in 1998.

The fear of losing autonomy and decreasing ability to do enjoyable activities were the most reported reasons for Oregonians who requested assisted suicide in 2002.

As in Denmark, several cantons of Switzerland, half of Australia and other states in the United States allow people to express in advance their refusal of aggressive and futile therapies by writing a legal document or designating a person charged with making all medical decisions in case of incapacity.

But for the people who have not made advance declarations, medical treatment also can be stopped on condition that the wish of the patient can be clearly established without ambiguity.

Because of the growing tension between medical advances on one hand and the priority given to respect for an individual’s will on the other, euthanasia is becoming a growing social issue today, according to the French National Consultative Ethics Committee.

While “right-to-die” activists speak about choosing one’s death as a matter of individual liberty, “right-to-live” defenders worry about the risks of abuse, exploitation and a possible erosion of care for the most vulnerable people. The latter are also haunted by the widespread euthanasia six decades ago in Nazi Germany, which routinely ordered the killing of sick or disabled people.

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