Facing Assisted Dying Requests Where It Is Illegal: Lessons From Clinical Ethics Consultations

End-of-life legislation and the authorization of euthanasia or assisted suicide are highly debated topics in France. The challenges raised by the right to access continuous deep sedation and requests for assisted dying outside the current legal framework present many ethical challenges in clinical settings. Between 2017 and 2023, our Clinical ethics center was solicited 30 times regarding assisted dying requests and conducted full-fledged clinical ethics consultations in 14 of these situations. This experience offers a valuable opportunity for enhancing our understanding of these clinical situations and of the ethical considerations involved in several ways. First, it allows us to identify the tensions that requests for assisted dying may cause at the patient's bedside. Secondly, our experience allows us to confirm the relevance of clinical ethics consultations for all stakeholders involved in these situations. Finally, taking a closer look at the arguments exchanged by all concerned parties during the consultation process provides novel insights about the ethical debate about continuous deep sedation and assisted dying, in both the French context and internationally, by highlighting the issues of ambivalence, timing, and personal as well as professional responsibility.