France

• June 2024 : Work on end-of-life bill suspended

End-of-life management has been regulated in France since 2016 by the Clayes-Leonetti law on deep and continuous sedation. Since then, reflection on the end of life has continued, due to societal demand. In 2022, the National Consultative Ethics Committee (Comité consultatif national d’éthique), which had been set up, published an opinion stating that it was in favour of strictly supervised "active assistance in dying", provided that palliative care was stepped up at the same time. A mission to evaluate the Leonetti law was set up in 2023.
One hundred and eighty-four French men and women were then appointed to take part in the debates of the Convention citoyenne sur la fin de vie (Citizens’ Convention on the End of Life). The Convention came out in April 2023 in favour of a conditional opening up of active assistance in dying, and more specifically of both assisted suicide and euthanasia. Considering that the existing legislative framework was insufficient, they said they wanted palliative care to be offered "for everyone, everywhere".
On this basis, the President of the Republic asked in March 2023 for a bill to be drafted. This was tabled on 10 April 2024 by Mr Faloni.

The bill integrates the concept of palliative care (the management of pain and the end of life) into the more encompassing concept of "supportive care", which also covers other modalities (nutritional care, psychological support, music therapy....) and provides for the creation of support centres for people at the end of life. With regard to assisted dying, the law aims to authorise and support the provision of a lethal substance to a person who so requests, so that they can administer it themselves or, if they are unable to do so, have it administered by a doctor, nurse, relative or a volunteer of their choice. The person concerned must be of full age, French (or a legal and stable foreign resident in France, able to express his or her wishes freely and in an informed manner, suffering from a serious and incurable disease with a life-threatening prognosis, a victim of suffering that is impossible to relieve or unbearable). A conscience clause has been introduced for healthcare professionals who refuse to take part in the assisted dying procedure : they will have to refer the person to a colleague.
The MPs debated the bill on first reading until 7 June 2024, and the law was due to be voted on 18 June 2024, but the work was interrupted by the dissolution of the National Assembly on 9 June 2024. For discussion to resume, the new government would have to re-table the bill on the Assembly’s table after the legislative elections on 30 June and 7 July 2024.

The debate did not attract a great deal of support, although it did provide an opportunity for communications from conviction-based groups. These various statements highlight a gap between French society as a whole, which is overwhelmingly in favour of this law as shown by polls and the Citizens’ Convention, and religious institutions.

These churches have mainly expressed their opposition or reluctance to this bill.

In 2022, the Conseil d’Églises Chrétiennes En France (CÉCEF) published a declaration on the end of life, signed jointly by the three co-presidents, Monsignor Éric de Moulins Beaufort (Conférence des évêques de France), Pastor Christian Krieger (Fédération protestante de France) and Metropolitan Dimitrios (Assemblée des évêques orthodoxes de France).

After expressing its reservations in 2022 in a pastoral letter, the Conférence des évêques de France again spoke out against on 28 March 2024.

Through the work of its Ethics and Society Commission, the Fédération Protestante de France has produced a report entitled Pour davantage d’humanité en fin de vie : interpellations protestantes.

The Conseil National des Évangéliques de France published a position statement in January 2023, which was presented to the Minister for Health ; it published a second statement in May 2024.

In 2023, the Assembly of French Orthodox Bishops (Assemblée des évêques orthodoxes de France) published a declaration on the end of life, followed in April 2024 by a declaration on the constitutionalisation of abortion and the end of life.

In 2024, the religious leaders of the major monotheistic religions, meeting in Paris, stated that there was "no united front" against a new text on active aid in dying, but once again expressed their opposition to this text.

Haïm Korsia, Chief Rabbi of France, also expressed his rejection of this text on 23 May 2024.

Finally, a manifesto has also been signed by various Christian associations.

See also Laetitia Atlani-Duault (dir.), Religions et fin de vie, Fayard, 2023.

• April 2024 : Women’s freedom to terminate pregnancy enshrined in the Constitution

In 2024, a law enshrined in the 1958 Constitution the freedom of women to have recourse to voluntary interruption of pregnancy (IVG).
The bill was presented to the Council of Ministers on 12 December 2023 by Prime Minister Elisabeth Borne. On 30 January 2024, it was passed by the Members of Parliament without amendment (493 votes to 30), despite the tabling of more than 170 amendments.
On 28 February 2024, the Senators also passed the Bill unamended (267 votes in favour, 50 against and 22 abstentions).
On 4 March 2024, Parliament approved by 780 votes to 72, with 50 abstentions the bill to enshrine abortion definitively in the Constitution.
The bill includes a single article amending article 34 of the 1958 Constitution to state that "the law determines the conditions in which the freedom guaranteed to women to have recourse to a voluntary interruption of pregnancy is exercised".
In France, abortion is decriminalised and regulated since the Veil law of 17 January 1975, reinforced by the abortion law of December 1979. The right to abortion has subsequently been strengthened by a number of texts : the offence of obstructing an abortion, created in 1993 ; the 2013 Social Security Funding Act, which allows abortions to be carried out free of charge ; a 2014 law abolishing the reference to a "situation of distress" ; the law of 20 March 2017, which extended the offence of obstructing an abortion ; and finally the law of 2 March 2022, which extended the legal time limit for recourse to an abortion from 12 to 14 weeks.
Christian religious groups expressed their reticence : the Vatican had declared itself opposed to this inclusion in the Constitution. On 29 February 2024, the French Bishops’ Conference published a press release concerning the Senate’s vote in favour of including voluntary interruption of pregnancy (abortion) in the Constitution. The President of the Protestant Federation stated that he considered the inclusion of abortion in the Constitution to be "untimely" ; the Conseil national des évangéliques de France (National Council of French Evangelical Protestants, CNEF) expressed its reservations.

• September 2022 : End-of-life

The issue of the end of life has been regularly addressed in France for the past two decades : with Law No. 99-477 of 9 June 1999 aimed at guaranteeing the right to access to palliative care, and then Law No. 2016-87 of 2 February 2016 creating new rights for patients and people at the end of life (known as the Claeys-Leonetti Law).
It has gained importance in France over the last few years, first with the Falorni Report on the end-of-life and the proposed law giving the right to a free and chosen end of life, in April 2021.
Recently, the publication of a book denouncing the poor living conditions of elderly residents in private clinics and Ehpads (accommodation establishments for dependent elderly people) managed by the Orpea group has re-launched the debate (Victor Castanet, Les fossoyeurs, Fayard, 2022).
The National Consultative Ethics Committee for Life Sciences and Health, founded in 1983, recently published an opinion on Ethical issues relating to end-of-life situations.
Among other things, the committee said that "active assistance in dying" could be applied in France, but "under certain strict conditions". President Emmanuel Macron has announced a consultation with a view to a possible law by the end of 2023.
Several European countries have already legislated on end-of-life issues.

Further information :
– Press release of the Comité consultatif national d’éthique pour les sciences de la vie et la santé
– Comité consultatif national d’éthique pour les sciences de la vie et la santé, Avis 139 sur les questions éthiques relatives aux situations de fin de vie : autonomie et solidarité
– Olivier Falorni, Rapport fait au nom de la Commission des affaires sociales sur la proposition de loi donnant le droit à une fin de vie libre et choisie, April 2021
– Réforme, "Fin de vie en France, 20 ans de débat et de lois", September 2022

• December 2021 : Conversion therapy

In 2019, the television channel Arte broadcast an investigation entitled "Homotherapies, conversion forcée" (Homotherapies, forced conversions), directed by Bernard Nicolas. Practices aimed at changing a person’s sexual orientation or gender identity, most often in religious groups and called sexual reorientation therapies or conversion therapies, have thus become the focus of public attention.
In July 2019, a flash mission on practices claiming to modify sexual orientation and gender identity had been created, with Laurence Vanceunebrock-Mialon (MP of La République en Marche, centre party, for Allier) and Bastien Lachaud (MP of La France insoumise, extreme left party, for Seine-Saint-Denis) as co-rapporteurs. The mission published a communication and a synthesis in December 2019.

In March 2021, Laurence Vanceunebrock tabled a bill in the National Assembly prohibiting practices aimed at changing a person’s sexual orientation or gender identity. For her part, the Socialist Senator Marie-Pierre de la Gontrie tabled a bill in the Senate in June 2021.
The Vanceunebrock bill passed its first reading in the National Assembly on 5 October and was adopted by the Senate after intense debate. The Senate voted the proposal on Tuesday 7 December, with 305 votes in favour and 28 against. Automatic line return
The adopted law creates an offence punishable by two years imprisonment and a fine of 30,000 euros for "repeated practices, behaviour or statements aimed at modifying or repressing the sexual orientation or gender identity, real or assumed, of a person and having the effect of altering his or her physical or mental health".

A joint committee responsible for proposing a text on the provisions of the bill still under discussion was convened on 8 December 2021.
The Minister for Citizenship, Marlène Schiappa, then announced that she was entrusting Miviludes with a mission on these "conversion therapies", to "explain, exemplify and quantify the phenomenon, analysing in particular its sectarian dimension", according to a press release, and will have to formulate "operational proposals within a month to perfect the means of combating these practices". Miviludes, the body responsible for combating sectarian aberrations attached to the Ministry of the Interior, will be assisted by the assistance and intervention cell for sectarian aberrations (CAIMADES), attached to the Central Office for the Repression of Violence against Persons (ORCVP), and by the Central Office for the Fight against Environmental and Public Health Violations (OCLAESP).

A round table on conversion therapies took place in November 2021 at the EHESS ; the video recording of the debates is online.

• April 2021 : End of life

A proposed law giving the right to a free and chosen end of life was debated on Thursday 8 April in the French National Assembly. Led by MP Olivier Falorni of the Radical Left Party, it would allow in certain cases "any capable person of age" to request "medical assistance" to die, "through active help".
Currently, physician-assisted suicide is illegal in France. The Leonetti-Claeys law on patients’ rights and the end of life prohibits "unreasonable obstruction" and "artificial prolongation of life" by the medical profession. Passed in 2016, this law allows deep and continuous sedation until the patient’s death.
The parliamentary debates could not succeed : some MPs are opposed to this law. Some conservative MPs tabled nearly 3000 amendments, while the time allowed to complete the debate was only one day.
Health Minister Olivier Véran considers that a better application of the Claeys-Leonetti law would be preferable to a new law. Several ministers also believe that in the midst of a health crisis, the time is not right for this debate.
The parliamentary debates could not be concluded : only the first article could be discussed. The bill should be put back on the agenda of the National Assembly, but it is not sure that there will be an opportunity before the end of the legislature. However, the majority of MPs support this bill, which is also supported by a large part of public opinion (as the Vincent Lambert case had shown), while the text has been opposed by the Roman Catholic Church.

See also :
– Law n° 2016-87 of 2 February 2016 creating new rights for patients and people at the end of life (Loi n° 2016-87 du 2 février 2016 créant de nouveaux droits en faveur des malades et des personnes en fin de vie), also named Leonetti-Claeys Law
– Survey The French view of end of life (Le regard des Français sur la fin de vie), IFOP for Association pour le Droit de Mourir dans la Dignité, April 2021
– Survey The French and the end of life (Les Français et la fin de vie), IFOP for "Soulager mais pas tuer", March 2021
– The Roman Catholic Church and the end of life

• May 2020 : Religion and the Covid 19 epidemic

An article by Jacqueline Lalouette takes stock of religions in France at the time of Covid 19 (Jean Jaurès Foundation).

On 18 May 2020, the President of the court of the Council of State ordered the Government to lift the general and absolute ban on assembly in places of religion and to enact in its place measures strictly proportionate to the health risks and appropriate at this beginning of "deconfinement".

• March 2020 : Facing the coronavirus epidemic

In the face of the coronavirus epidemic currently affecting most European countries, many religious groups have provided guidance on following the containment guidelines during this health crisis.

Catholicism : the Conférence des évêques de France has decreed that no Mass should be celebrated with an assembly. Funerals may be celebrated with a congregation of less than 20 people, who should be spread throughout the church ; finally, confessions should be made in places that allow a distance of one meter and not be face to face.
Islam : The Conseil français du culte musulman has called on all mosques to "suspend the organization of Friday prayers" starting next week and "until further notice". Chems-eddine Hafiz, rector, announced the closure of the Grand Mosque of Paris. The CFCM invites the faithful to do their ablutions at home, before going to the mosque. The ritual cleansing of the deceased is also suspended.
Protestantism : most Protestant churches have announced the closure of places of worship : the Eglise protestante unie de France asks to limit activities as much as possible, the Union of Protestant Churches of Alsace-Lorraine cancels all worship services, the Baptist and Adventist churches have asked to close.
Judaism : the Consistoire central israélite has announced the closure of the synagogues.
Orthodoxy : Orthodox religious services have also been suspended. (See the communiqué from Métropole de France calling for the closure of the churches.)

According to a YouGov poll published by huffingtonpost.fr, 93% of respondents approve of the containment measure, which is considered necessary to combat the pandemic.

This year, the religious feasts of the monotheisms will all take place in April (Pesah from the 8th to the 16th ; Easter around the 12th of April for Catholics and Protestants and for Orthodox on the 19th ; Ramadan around the 24th of April). On 23 March, the President of the Republic brought together by audio conference the leaders of the main religious denominations (Muslim, Catholic, Protestant, Buddhist, Orthodox) as well as lay and Freemasonry associations, and announced that these future religious holidays would have to take place "without gathering".
The president also said that there was no question of cremation becoming widespread for those who died of Covid-19. However, the question of funeral spaces will have to be taken into account, knowing that several Muslim squares are reaching saturation point.

• January 2017 : Changes regarding organ donation

Law no. 2016-41 of 26 January 2016 on the modernisation of the French health system came into effect on 1 January 2017. This law covers in particular the issue of organ donation.
The Caillavet Act of 1976 already provided that any deceased person is considered a donor unless they are previously registered in the national register of refusals. In practice, however, where the deceased has not voiced any preference, the family and friends of the deceased were often called upon by the caregivers, which led to a high number of refusals to donate.
The Ministry of Health sought ways to increase the number of donors. It held several consultations with a view to establishing a ministerial decree on the procedures for refusing organ donation. One of them brought together representatives of religious institutions. Currently, no religious institution condemns organ donation in France. Some support the principle, such as the Catholic Church and most Protestant Churches, while others such as Judaism or Islam refer each individual to their own decision.
Law no. 2016-41 of 26 January 2016 was drafted following these consultations. It confirms the 1976 Cavaillet Act, and every French person remains a presumed donor unless they expressly object during their lifetime to the removal of any organ, as stated by Decree 2016-1118 of 11 August 2016 regarding procedures for stating the refusal of organ removal after death. This objection may be made by being listed on the National Registry of Refusals. The objection may also be expressed in writing to a relative, or even by verbal notification to the relatives ; the objection may be revoked at any time.
See also, in the chapter on the legal status of religions, the specific provisions regarding organ donation.

References :
– Law no. 2016-41 of 26 January 2016 on the modernisation of the French health system
– Decree 2016-1118 of 16 August 2016 approving the rules of good practice relating to the interviewing of relatives with regard to organ and tissue removal
– National website for organ donation