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European Court of Human Rights; France: Ruling on French Case of Discontinuation of Treatment

(June 17, 2015) On June 5, 2015, the Grand Chamber of the European Court of Human Rights (ECHR), in the case of Lambert and Others v. France, held by a majority opinion that the application of the French Conseil d’État decision of June 24, 2014, allowing the discontinuation of life-sustaining treatment to Vincent Lambert, would not violate article 2 (right to life) of the European Convention on Human Rights. (Lambert and Others v. France (application no. 46043/14) (June 5, 2015), ECHR website; Convention for the Protection of Human Rights and Fundamental Freedoms [Nov. 4, 1950] as Amended by Protocols No. 11 and No. 14 [with hyperlinks to Protocols No. 15 & 16], Council of Europe website.)


Following a road traffic accident on September 29, 2008, Vincent Lambert suffered a severe brain injury that rendered him quadriplegic and in a state of complete dependency. The medical report ordered by the Conseil d’État on February 14, 2014 reveals that he is in a persistent vegetative state. Since the accident, Vincent Lambert has been receiving artificial nutrition and hydration. (Lambert and Others v. France, ¶ 11-12.)

In 2012, Vincent Lambert’s caregivers perceived signs from him of what they understood to be increasingly marked opposition to daily care. In early 2013, the medical staff initiated the collegiate procedure to determine whether to end treatment or not, including the involvement of Lambert’s wife Rachel in the process, a procedure provided for in the French law on patient’s rights and end of life issues. (Loi n° 2005-370 du 22 avril 2005 relative aux droits des malades et à la fin de vie (Leonetti Act), LEGIFRANCE).

Indeed, the Public Health Code, as modified by article 1 of the Leonetti Act, states: “[a]cts of medical care should not be pursued with unreasonable obstinacy. When they appear to be of no use, disproportionate, or having no other effect than artificial maintenance of life, they can be suspended or not be undertaken.” (Code de la santé publique, art. L. 1110-5, al. 2 (last updated Apr. 23, 2005), LEGIFRANCE.) It was therefore decided to withdraw life-sustaining treatment, and in April 2013, nutrition was stopped and hydration was reduced. (Lambert and Others v. France, ¶¶ 14-15.)

Conseil d’État Ruling

In May 2013, the parents, a half-brother, and a sister of Vincent Lambert sought an injunction to force the hospital to resume treatment. The dispute ultimately wound up before the Conseil d’État, the highest administrative jurisdiction in France. The Conseil ruled that all the conditions prescribed by law on the decision-making process had been fulfilled and that the decision to end life-sustaining treatment was consequently lawful. (CE, 24 juin 2014, Mme F…I…et autres, Nos 375081, 375090, 375091, Conseil d’État website.)

ECHR Decision

The recent ruling by the ECHR Grand Chamber supports the Conseil d’État decision:

The Court observed that there was no consensus among the Council of Europe member States in favour of permitting the withdrawal of life-sustaining treatment. In that sphere, which concerned the end of life, States must be afforded a margin of appreciation. The Court considered that the provisions of the Act of 22 April 2005, as interpreted by the Conseil d’État, constituted a legal framework which was sufficiently clear to regulate with precision the decisions taken by doctors in situations such as that in the present case.

… [T]he Court reiterated that it was primarily for the domestic authorities to verify whether the decision to withdraw treatment was compatible with the domestic legislation and the Convention, and to establish the patient’s wishes in accordance with national law.” (Press Release, European Court of Human Rights, Lambert and Others v. France: There Would Be No Violation of Article 2 of the European Convention on Human Rights in the Event of Implementation of the Conseil d’État Judgment of 24 June 2014 (June 5, 2015), ECHR website.)

The ECHR underlined that the Leonetti Act does not authorize either euthanasia or assisted suicide, but rather discontinuation of treatment – including life-sustaining treatment – if continuing such treatment demonstrated unreasonable obstinacy. (Id.)

(For a discussion of an assisted suicide case in the Netherlands, see Wendy Zeldin, Netherlands: Precedent Set in Case of Son-Assisted Suicide, GLOBAL LEGAL MONITOR (June 17, 2015).)

Prepared by Geneviève Claveau, Law Library of Congress intern, under the supervision of Nicolas Boring, Foreign Law Specialist.