Rasool Mogooei

PhD Candidate in International Relations, University of Isfahan

Introduction

In recent decades, end-of-life issues have become one of the most contentious subjects at the intersection of law, medicine, ethics, and human rights. Advances in medical science have, on the one hand, made it possible to sustain life in circumstances where this was previously impossible and, on the other, raised new questions concerning the limits of medical intervention, patient autonomy, and the right to decide how one’s life should end. Within this context, concepts such as euthanasia, assisted suicide, and medical assistance in dying, although legally and procedurally distinct, are all in some way connected to an individual’s decision concerning the end of life. Euthanasia generally refers to the intentional ending of a person’s life at their request through the direct intervention of a third party, usually a physician, whereas certain forms of assisted dying are based on the individual personally administering the lethal medication. These conceptual distinctions have led different legal systems to adopt different approaches to the issue.

The adoption of the new law in France should also be understood within this broader context. The legislation marks France’s entry into a new stage in the legal regulation of end-of-life matters and in defining the permissible scope of medical intervention in this field. The significance of this development extends beyond French domestic law, as it is also closely connected to comparable experiences in other countries and to broader debates concerning the right to life, human dignity, free and informed consent, and social responsibility. Examining the French law can therefore provide a clearer picture of contemporary developments in the legal regulation of end-of-life decisions and the challenges arising from them.

Assisted Dying Law in France

The adoption of the “Right to Assistance in Dying” (Droit à l’aide à mourir) law in France represents an important yet highly controversial development in the country’s medical and healthcare landscape. France, traditionally regarded as a Catholic country, had long grappled with legal, medical, ethical, and religious questions concerning end-of-life options. Existing legislation allowed physicians to keep terminally ill patients under deep sedation before death but did not permit assisted suicide or euthanasia (Australian National Review, 2026). The new law, however, establishes a specific legal framework through which individuals may request and receive medical assistance to end their lives under particular circumstances. The final reading of the legislation, under Vote No. 8280, took place on 15 July 2026, when it was adopted by the French National Assembly by 291 votes to 241 (French National Assembly, 2026a). The Constitutional Council of France subsequently approved the law on 14 August 2026, and it was published in the Official Journal of the French Republic five days later (French National Assembly, 2026b).

The legislation was designed to establish a right to assistance in dying for individuals suffering from a serious and incurable illness that threatens their life. It primarily provides for medically assisted suicide, allowing eligible patients, subject to strict conditions, to obtain lethal medication and administer it themselves. Only individuals who are physically unable to do so may receive assistance from a physician or nurse. Patients seeking to end their lives must be at least 18 years old and either French citizens or lawful residents of France (Ruffino, 2026). Under the legally prescribed procedure, the physician must inform the individual of their state of health, the likely progression of that condition, and the treatments and support mechanisms available. The physician must also inform the person that they may benefit from accompanying support and palliative care provided for under the relevant statutory provision and, if the individual so wishes, ensure that such services are accessible to them. In addition, the individual and their relatives must be offered referral to a psychologist or psychiatrist for support, with access facilitated if they wish to use these services. The person must also be informed that they may withdraw their request at any time (Dufour, 2026).

In general, access to “assistance in dying” is subject to five cumulative conditions: the person must be at least 18 years old; hold French nationality or reside legally and on a stable basis in France; suffer from a serious and incurable illness that threatens their life and has reached an advanced or terminal stage; experience suffering caused by that illness which is either refractory to treatment or, where treatment is refused or discontinued, regarded by the patient as unbearable; and, finally, be capable of expressing their wishes freely and in an informed manner. Psychological suffering alone is insufficient to qualify for this right, and individuals whose decision-making capacity is severely impaired at the time of the request are excluded from access to the procedure (Vie publique, 2026).

The legislation followed Emmanuel Macron’s 2022 electoral commitment, the outcomes of the Citizens’ Convention on the End of Life, and the bill on accompanying support and the end of life introduced in 2024. It provides that a person who has made such a request may, under specified conditions, obtain access to a lethal substance for self-administration or, where physically unable to administer it personally, have it administered by a physician or nurse. Assistance in dying under this law therefore encompasses both assisted suicide and euthanasia (Bonfanti-Dossat & Milon, 2026). Until now, France had permitted forms of passive euthanasia, such as the withdrawal of artificial life support, as well as deep sedation before death. Individuals seeking active means of ending their lives, however, had been required to travel to countries where assistance in dying was lawful. With the adoption of this law, France joins a relatively small group of countries that includes the Netherlands, Belgium, and Canada (Henley, 2026).

Comparable Experiences in Other Countries

Before France, a number of countries and jurisdictions—predominantly developed states commonly associated with the so-called Western cultural sphere—had already recognized certain forms of assisted dying or voluntary ending of life within their legal systems, albeit through differing approaches, restrictions, and regulatory requirements. These experiences are not uniform in terms of eligibility criteria, scope of application, the physician’s role, the manner in which consent is expressed, or the procedure through which assisted dying is carried out. Each country has developed its own specific legal framework. Nevertheless, examining these models provides a useful basis for comparison with the new French approach and for understanding its position among other legal systems.

For example, Belgium has a system broadly similar to the one adopted in France. In Belgium, active euthanasia is permitted under specifically defined legal conditions, and an individual may request an act resulting in death where the statutory requirements are satisfied. Under Belgian law, such a request may be made by a legally competent and conscious adult or emancipated minor and, under certain circumstances, by a non-emancipated minor who possesses sufficient capacity for discernment and understanding. One of the fundamental principles governing this system is that the request must be made directly by the person concerned; the wishes of relatives or family members cannot substitute for the individual’s own decision. Accordingly, no relative, regardless of the closeness of the family relationship, may request euthanasia on behalf of the person concerned (Public Health, Food Chain Safety and Environment, n.d.).

In the Netherlands, euthanasia and assisted suicide are, in principle, criminal offences under Articles 293 and 294 of the Dutch Criminal Code. The legislature has, however, created an exception for cases in which the procedure is performed by a physician in compliance with specific statutory requirements. This exception applies where the physician has satisfied the six statutory “due care” criteria set out in the Termination of Life on Request and Assisted Suicide (Review Procedures) Act. Under these criteria, the patient’s request must be voluntary, informed, and carefully considered; the patient’s suffering must be unbearable with no prospect of improvement; and the patient must be adequately informed about their medical condition and prognosis. In addition, both physician and patient must conclude that there is no reasonable alternative in the circumstances. The physician is also required to consult at least one other independent physician and must perform the procedure with the requisite degree of medical care and attention (Government of the Netherlands, n.d.).

In addition to the countries mentioned above, New Zealand has also enacted legislation in this area. In 2019, it adopted the End of Life Choice Act 2019, which came into force in 2021. The Act was introduced to provide a lawful option for individuals suffering from a terminal illness who also satisfy a defined set of legal and medical criteria. Under this framework, an eligible person may request medical assistance to end their life, and that request must be assessed through a prescribed procedure. According to the New Zealand Government, the purpose of the legislation was to establish regulated and lawful access to medical assistance in dying for persons who meet the statutory requirements (New Zealand Government, n.d.).

In the United States, medical assistance in dying is not recognized at the federal level, but a number of states and jurisdictions have legalized it under specified conditions. One of the earliest examples is the State of Oregon, where the Death with Dignity Act has, since 1997, permitted terminally ill patients to self-administer lethal medication prescribed by a physician (Oregon Health Authority, n.d.). A similar model exists in states such as Washington, where legislation was adopted in 2008. Key eligibility requirements include decision-making capacity, the presence of an incurable illness expected to result in death within a limited period—six months—and residence in the state (Washington State Department of Health, n.d.).

Despite the examples discussed above, as well as other jurisdictions not addressed here, Switzerland has adopted a different approach to active euthanasia. The Swiss legal system criminalizes the intentional killing of another person for the purpose of relieving their pain and suffering—what is generally described in legal and medical literature as active euthanasia—and does not permit another person to directly perform the lethal act on the patient. By contrast, passive euthanasia, understood as the non-initiation, withdrawal, or discontinuation of medical measures intended to prolong life, is not criminalized. Although it does not have an autonomous legal designation in the Swiss Criminal Code, it is regarded as permissible within specified medical and legal frameworks (Swiss Federal Office of Justice, 2026). The Swiss model therefore draws a clear distinction between a direct act intended to cause death and the withholding or withdrawal of life-sustaining treatment.

Supporters and Opponents of the Law in France

Like many other major legislative reforms, this law has sharply divided supporters and opponents in France. The bill was rejected three times by the French Senate before ultimately being adopted by the French National Assembly. Voting in the Senate was particularly close; in the final vote, the bill was rejected by 169 votes to 164 (David, 2026). Reviews also indicate that opponents introduced nearly 500 amendments to the bill (Bonverlet, 2026), illustrating the intensity of the legislative and political debate surrounding its adoption.

Anne Raynaud, a representative of the Association pour le Droit de Mourir dans la Dignité (ADMD) (Association for the Right to Die with Dignity), argued in support of the law: “Can it still be called life when the suffering is so great that you can no longer do anything? When people’s suffering has become unbearable and there is no longer any relief available to them, they should be able to decide for themselves when and how they wish to die” (Reuters, 2026). Supporters have also praised the bill as a “balanced” and “safe” measure, emphasizing the safeguards designed to ensure that recourse to assisted dying remains exceptional. Critics, however, argue that the safeguards provided are insufficient to prevent abuse affecting persons with disabilities or individuals suffering from terminal illness (Jérôme, 2026).

Religious institutions, particularly the Catholic Church, have been among the law’s most vocal opponents. Shortly after the vote, the Catholic Church in France stated in a press release that the legislation represented a major rupture in the country’s history. The Church warned that the consequences of the law were already beginning to emerge and stressed that it would alter society’s relationship with vulnerability, ageing, disability, and illness (EFE, 2026). In this context, one bishop threatened to bar lawmakers who had supported, and continued to support, the legislation from receiving Holy Communion (Al Jazeera, 2026).

The anti-euthanasia organization Alliance VITA also stated in an open letter to Emmanuel Macron: “Every effort must be made to ensure that people who are suffering have immediate access to palliative care and support. Presenting death as a desirable solution can never constitute an acceptable response to suffering and is contrary to human dignity” (Corbet & Petrequin, 2026). At the same time, the group Ultime Liberté wrote in a statement: “To gain access to this end-of-life assistance, individuals must satisfy a particularly restrictive set of medical criteria, and their wishes alone will not be sufficient. For Ultime Liberté, this logic is fundamentally backward. In a democracy, it is for the individual to act freely and with full awareness and to decide whether or not their life has come to an end” (Radziemski, 2026).

More broadly, opponents have raised several principal objections to the law:

Although a multidisciplinary panel is convened in relation to a patient, the final decision rests with a single physician;
The involvement of a psychologist or mental health professional in the individual’s decision-making process should be mandatory;
The overall period from the initial request to implementation is 17 days, while the mandatory reflection period is only 48 hours, which is considered excessively short;
The principal review mechanism should not occur only after the patient’s death, because if an error has occurred in the process, the death of the individual makes any meaningful remedy impossible (Bonfanti-Dossat & Milon, 2026);
The eligibility criteria for assisted dying, particularly the notions of an “advanced stage” of illness and “unbearable suffering,” may be open to interpretation;
Genuine and sufficient access to palliative care, medical support, and social assistance should be guaranteed before an individual chooses assisted dying.

Human Rights Challenges

The adoption of the assisted dying law in France, alongside the recognition of a new sphere of individual autonomy at the end of life emphasized by its supporters, raises important questions concerning the relationship between this right and the right to life, human dignity, free and informed consent, and the protection of vulnerable persons. For this reason, assessment of the law cannot be confined to its substantive provisions alone; attention must also be given to the safeguards designed to prevent pressure, abuse, and decisions that are not genuinely voluntary. On the one hand, rules must be established to protect patients against exploitation and coercion; on the other, those safeguards should not become so burdensome that access to assisted dying is rendered excessively difficult in practice. This tension also exposes the limits of a framework based solely on individual rights, since a person’s right to access medical assistance in dying is necessarily constrained by social obligations to ensure that the decision is voluntary and to prevent harmful consequences for others (Buchbinder, 2018). One of the central arguments in the debate over assisted dying is that no legal regime can be made sufficiently safe to protect vulnerable individuals. The London-based Care Not Killing organization captures this concern in the phrase: “the right to die can easily become a duty to die.” On this view, because vulnerable persons are entitled to protection, any relaxation of legal restrictions and authorization of assisted dying may carry serious risks (Mullock & Lewis, 2025).

According to the United Nations, despite significant progress in recognizing the rights of persons with disabilities at both international and national levels, deeply entrenched negative perceptions regarding the value of their lives remain widespread across societies. These perceptions are rooted in what is known as ableism: a value system that treats certain conventional characteristics of body and mind as necessary conditions for living a life considered worthwhile. Based on rigid standards relating to appearance, functioning, and behaviour, ableist attitudes tend to regard disability as a form of misfortune associated with suffering and deprivation and, in doing so, continually diminish the perceived value of human life (United Nations, 2019). Such perceptions of persons with disabilities, however, should not result in their being deprived of the right to life or of access to the various services associated with full citizenship. In relation to France, for example, the Convention on the Rights of Persons with Disabilities has recommended the adoption of measures to ensure that persons with disabilities have access to affordable and accessible housing based on individual choice and outside any form of congregate setting. It has also recommended the establishment of a timetable and benchmarks for achieving their full access to mainstream social services, including education, health care, work, and employment, as well as ensuring access to support for independent living and inclusion in the community, such as user-directed budgets and personal assistance, so that persons with disabilities are able to exercise choice and control over their own lives (United Nations, 2025a). In addition to recognizing and strengthening the rights of persons in particular circumstances within society, such measures may also serve as a powerful incentive and source of support that can reduce the likelihood of an individual requesting to end their life.

More broadly, any legal regime governing medical assistance in dying must be designed with particular caution, placing the protection of the right to life and the prevention of discrimination against persons with disabilities at its core. The UN Committee on the Rights of Persons with Disabilities (CRPD Committee) has warned that if disability, suffering, or a perceived low quality of life is interpreted in a way that directly or indirectly becomes a basis for access to self-chosen death, this may reflect ableist and discriminatory attitudes. Likewise, an individual’s choice can only be regarded as genuinely free where structural factors such as poverty, inadequate access to healthcare, lack of suitable housing, social isolation, and the absence of psychological and social support have not influenced that decision (United Nations, 2025b).

Conclusion

The new law in France demonstrates that the legal regulation of end-of-life decisions depends on designing a mechanism that both recognizes individual autonomy and prevents that autonomy from being transformed into a decision shaped by pressure, inequality, or the absence of social support. The experience of France, considered alongside those of Belgium, the Netherlands, New Zealand, the United States, and Switzerland, shows that the principal differences among legal systems lie less in the basic acceptance or rejection of assisted dying than in the nature of the safeguards adopted, the degree of medical involvement, the methods used to establish valid consent, and the level of oversight. From this perspective, the quality of legislation in this field should be assessed not merely by whether it recognizes a right to choose, but by its capacity to protect human freedom and human vulnerability at the same time.

At the same time, the most significant human rights challenge posed by such laws emerges where social and economic conditions influence an individual’s decision. If poverty, social isolation, inadequate access to palliative care, insufficient access to healthcare services, or discriminatory attitudes toward disability play a role in shaping a request to end one’s life, it becomes difficult to regard that decision as solely the product of the individual’s free will. The legitimacy of such a legal regime therefore depends on the existence of genuine guarantees for living with dignity. In other words, to the same extent that the law regulates the possibility of death, it must also guarantee the material, medical, and social support necessary for the continuation of life. From this standpoint, the French law may be understood not as the conclusion of a controversy, but as the beginning of a new phase in the debate over the boundaries between autonomy, protection, and the state’s responsibility toward human life.

References