“Each patient is a unique case,” says Anne de la Tour, a palliative care doctor in Argenteuil. She works mainly with cancer patients and is rarely faced with a patient like Lambert, who was unable to communicate about end-of-life decisions.
Lambert, 38, was left tetrapalegic and in a coma after a motorcycle accident in 2008. In January 2014 his doctors, backed by his wife, Rachel, and six of his eight siblings, decided to stop the intravenous food and water keeping him alive.
This was in line with a passive euthanasia law passed in 2005 allowing doctors to withhold care.
Lambert’s devoutly Catholic parents won a court injunction against the decision, saying that it would amount to active euthanasia, as they consider Lambert to be not brain dead, just handicapped.
The case ended up at the European court after France’s Council of State ruled that it was legal to end life support for someone who was not going to recover.
Ending life support is always a difficult decision, says de la Tour.
“We don’t easily stop food and hydration and the decision is always made after consulting the specialists and nurses and the whole team,” she said. “It’s never easy for the family to accept. It’s always difficult.”
The French society of palliative care (Sfap), of which she is a member, says the Lambert ruling shows the need for the 2005 law, which makes doctors feel less alone when making decisions to withhold treatment, and gives them a legal framework to work with.
Anti-euthanasia groups say the passive euthanasia law and the court ruling shows that France and Europe are on a slippery slope.
Jean-Marie le Méné, of the Jérôme Lejeune Foundation, a Downs Syndrome research group and a leading anti-euthanasia advocacy organisation, says passive euthanasia for someone injured in an accident will lead to similar decisions for people with mental illnesses.
“Why will we not decide that we’ll end the life of people with certain illnesses?” he asked rhetorically. He insists that it is not up to doctors to make end-of-life decisions.
“I am not fighting against people’s freedom,” he said. “People have the right to throw themselves out of the window or stop breathing. But to ask doctors to do it changes the role of medicine.”
The euthanasia discussion is ongoing, as parliament is considering an update to France’s 2005 law that would allow doctors to administer sedation to terminally ill patients. It would also make living wills legally binding.
Vincent Morel, president of the Sfap, says the Lambert case brings home the importance for everyone to write down what they would like to have happen in these cases and to designate a person to make decisions for them.
“In this case, the problem is that [Vincent Lambert] wrote nothing down,” he told RFI, adding that “We must all dare to take up a pen and paper” and write down our wishes.
The Lambert case hinges on his wife, who says that her husband would have wanted to be taken off life support, and his mother, who does not want to do it.
“Between the spouse and the mother, I can understand each of them,” says de la Tour. If Vincent Lambert had written a living will, “this family drama would not have taken place”.
Lambert is unlikely to be taken off life support right away. The doctor who made the original decision no longer works with him and so it is up to the new medical team to make a decision.
If the decision goes against their wishes, Lambert’s parents intend to take it to court again.