On May 3, 2019, the U.N. Committee on the Rights of Persons with Disabilities (CRPD) issued a request to the French Government to halt the euthanasia of Vincent Lambert while the CRPD Committee reviews the petition by Mr. Lambert’s parents requesting the same. This request has caused confusion and astonishment, as, three days earlier, the European Court of Human Rights (ECHR), conversely consented to Mr. Lambert’s euthanasia by dehydration.
Obviously embarrassed, the French Minister of Health stated on May 5, 2019 that “the medical team in charge of this case is entitled to stop the care”, adding contradictorily that “We are not legally bound by this committee, but of course we take into account what the UN says and we will answer them,” and on May 10, the French Government informed the CRPD Committee that it will not comply with the Committee’s request.
In order to understand this complex case, it is necessary to clarify the order of the case, including the Committee’s decision, from where it derives its authority, and its interaction with the ECHR.
Two decisions have already been made by the committee in Geneva
This recent decision is actually the second one the CRPD Committee has made regarding the Lambert case: first, they accepted the application lodged by the parents of Vincent Lambert and then they granted interim measures.
The petition was first examined by the Secretary-General of the CRPD who decided that it fulfilled the “preliminary criteria” of admissibility and consequently registered and communicated it to the French Government (Article 56 of the Committee’s Rules of procedure). This is an initial step that proves that the petition was well formulated and fell within the jurisdiction of the Committee.
The French Government now has a period of six months in which to respond to the accusations made against the French medical and judicial decisions, both on the admissibility and on the merits of the petition. The French Government will have to find arguments other than those stated Sunday by the Minister of Health, when she declared this Committee incompetent to protect people in the condition of Vincent Lambert on the grounds that he is not disabled but in a “vegetative” state. In fact, Mr. Lambert’s state of health perfectly fits within the Convention’s definition of disability.
Vincent Lambert is neither at the end of his life nor suffering from an illness, but in a state of altered consciousness after a traumatic brain injury. He breathes on his own, wakes up in the morning and falls asleep at night. Although his swallowing reflex is now fully functioning, he is fed and hydrated through a simple gastric tube. He can, depending on the time and the stimulations, turn his head or follow his interlocutors with his eyes, which is a sign of consciousness according to specialists. Even his nephew, though a supporter of Mr. Lambert’s death, explains that he doesn’t go to the hospital anymore because he is afraid that his additional presence will overwhelm Mr. Lambert as “it is probably unbearable to have so [many people] around him” (Europe1, 05.05.2019). This is indeed a recognition that Vincent Lambert is aware of his surroundings.
Thus, Vincent Lambert is neither brain-dead, nor sick, nor at the end of his life. He is simply handicapped, like 1,700 other people in the same situation in France.
The French Government has committed, in international law, to comply with the decision of the Committee on the Rights of Persons with Disabilities
The appeal having been registered, the Committee logically requested that the French Government ensure that the hydration and nutrition of Vincent Lambert be maintained until the review of the appeal has been completed. Despite what the Minister of Health may say, the French Government is bound, by international law to the Committee’s decision, as it committed itself to any Committee decision, in the name of France, by ratifying the Convention on the Rights of Persons with Disabilities. It is the very text of this Convention which bestowed on the Committee the power to request interim measures. The French Government is, however, free to challenge this measure with the Committee, but the former would then have to prove that it is urgent to euthanize Mr. Lambert.
The decisions of the Committee, like the decisions of all international bodies (including the ECHR), are not directly enforceable as are domestic legal procedures. Rather, the national legal authorities must implement Committee decisions in accordance with France’s international commitments, under the direction of the CRPD and other States Parties to the Convention. However, to claim that France can “ignore” its own human rights commitments (Lemonde.fr, 24.04.2019) is both legally false and politically irresponsible. The entire international system created to protect human rights relies on the good faith and cooperation of States to respect their international law commitments. This is both its greatness and its weakness.
Only if the Committee exceeded its powers - by ruling “ultra vires” - could France legitimately refuse to comply with the Committee’s requests. This was the case, for example, when a U.N. Committee in 2014 claimed that the Vatican State had an obligation to legalize abortion in the name of children’s rights! But it is clearly not the case here: the CRPD Committee is perfectly within its jurisdiction.
Possible outcome of the procedure
The persons who support Vincent Lambert’s immediate euthanasia primarily rely on a theory of non-admissibility of the case before the Committee on the grounds that the case was already lodged before the ECHR. The rules of procedure do provide that a request (called ‘communication’) is inadmissible when the question “has been or is being examined under another procedure of international investigation or settlement”. The ECHR or the CRPD are supposed to withdraw when the same question has been lodged with the other one first; however, this is not always the case. Indeed, the U.N. Committees, because they have a global competence, consider themselves “above” regional jurisdictions, such as the ECHR. Finally, U.N. Committees, such as the CRPD, are specialized in the protection of certain rights, or categories of persons, while the ECHR is non-specialized, so that the former consider they should determine the international norm in their respective fields. Accordingly, it should be the ECHR that follows the decisions of the CRPD on the rights of persons with disabilities, and not the other way around. A fact that supports this theory is the initiative that the CRPD took the time to examine a draft European convention on involuntary placement, and then called on European states “to oppose” it on the grounds that this text did not respect the rights of people with disabilities.
Regardless, in the current case, the lawyers for Mr. Lambert’s parents made sure that all legal questions were submitted to the Strasbourg Court and the Geneva Committee. Moreover, in 2015, the ECHR had refused to adjudicate on a series of serious human rights violations, such as the deprivation of care of Mr. Lambert, his confinement, or the refusal to transfer him to a specialized unit. These questions have so far received no response from international bodies.
The question of hydration and nutrition
On the merits, Mr. Lambert’s parents can avail themselves of many provisions of the U.N. Convention, such as the right to life, the right to care, or the right not to be locked up. More specifically, Article 25 prohibits states from “discriminatory denial of health care or health services or food and fluids on the basis of disability.” This means that States cannot deprive a person of his nutrition or hydration because of his disability: yet, this is precisely what Dr. Sanchez, at the Reims University Hospital, decided to do, with the approval of the French authorities. The CRPD also stated that “the right to life is absolute, and that substitute decision-making in regard to the termination or withdrawal of life-sustaining treatment is inconsistent with this right.” (Consideration the report submitted by Spain, 19.10.2011).
Thus, the Committee could note multiple violations of the Convention by France. Such a decision would not be incompatible with that made by the ECHR in 2015, but would complete it. Indeed, not only did the ECHR remain silent on several points, but it also avoided stating whether nutrition and hydration are or are not treatments that can be stopped. Rather, the ECHR simply invoked a “lack of European consensus” on this central question, effectively washing its hands and abandoning Mr. Lambert to death. Article 25 of the Convention on the Rights of Persons with Disabilities, which the ECHR failed to mention, now answers this question left open by the ECHR decision.
In the event of a “conviction” of France, the Committee will indicate to the Government a series of specific measures to be taken to repair the violation found and remedy its causes. The Government shall then, within six months, submit to the Committee a written reply indicating the measures that the French Government has taken to remedy the violations found. These measures will then be verified and evaluated by the Committee, which, if it deems them insufficient, will sue the French Government until it has given satisfaction.
The procedure could last 6 years
Whatever the outcome of the case, it is almost certain that it will be a long process, even up to six years, which is the average length of procedures before the Committee.
This raises the question of Mr. Lambert’s fate during these years. It would be indecent for Mr. Lambert to remain locked up in a palliative care unit unsuited to his condition and deprived of the specific care that is dispensed daily in specialized units. This is an intolerable situation, and has been denounced by 70 doctors who specialize in the care of people with altered consciousness. These doctors stated on April 19, 2018, in a tribune published in Le Figaro, that Mr. Lambert should be treated like all people with this disability, and not be treated as a dying man – because he is not. They insist on the fact that he is not the object of therapeutic obstinacy – meaning, Mr. Lambert is not facing irreversible death.
The specialists know that if Mr. Lambert is allowed to effectively be abandoned to death, their 1,700 patients may also suffer the same fate, based on false “compassion” and a Government concern for budget savings. Moreover, these dependent people will no longer be regarded as patients, but as dead weight on society.
At stake: the concept of human life and dignity
What is ultimately at stake in the Lambert case is the concept of the dignity of man. This is why this case is so emblematic and controversial. The opinion of everyone, including that of judges, in favor of either Mr. Lambert’s life or death, stems directly from their individual view of human life and dignity. One tends to opt for death or life depending on whether one is materialistic or humanist, atheist or a believer. For some, “life” has no value in and of itself; instead, purely biological, it is worthy only proportionally to the human consciousness which animates it. For others, on the other hand, the life of every man is “human,” and has the same worth and dignity, no matter one’s health condition.
It is this universal and egalitarian concept of dignity that founded the Universal Declaration of Human Rights in 1948 and the subsequent texts, when they declared dignity “inherent” to every human being and prohibited discrimination on the grounds of disability or health condition. To describe dignity as inherent means that it is possessed by man because he is human, and not because of the decision of a judge. This also applies to the “right to life” which is the only right described as “inherent to the human person” by the International Covenant on Civil and Political Rights (article 6).
In 1949, René Cassin, the father of the Universal Declaration, signed a declaration of the Academy of Moral and Political Sciences rejecting “absolutely all methods with the aim of causing the death of subjects considered monstrous, malformed, deficient or incurable,” adding that “euthanasia and, in a general way, all methods which have the effect of provoking a ‘soft and quiet’ death, by compassion, of the moribund, must also be rejected”, without which, doctors would be granted “a kind of sovereignty over life and death” (14 November 1949).
In light of these statements, the five judges of the ECHR rightly deplored the “frightening” Lambert judgment of 2015, in that it marked “a retrograde step in the degree of protection which the Convention and the Court have hitherto afforded to vulnerable people.”
We can hope that the CRPD will be able to accurately see Mr. Lambert as a “disabled person,” with specific rights and needs, and not as a dead-weight on society. We hope that, since it is composed of experts in the field, some of whom are themselves disabled, the Committee will declare that it wants to combat “prejudices against persons with disabilities as being a burden on society” (General Comment No. 6, 2018).
It is often believers, especially Christians, who maintain a keen sense of the dignity of human life and who oppose euthanasia. This value for human life and dignity is often criticized and vilified. For example, journalists continually point to the Catholic faith of the Lambert parents as being despicable. But for believers, the life of every man is a gift from God. Admittedly, we must not desperately persist in retaining it, but we cannot deliberately end the life of an innocent person, even if in an altered state of consciousness. It must be remembered that it was the Catholics who alone had the courage to publicly denounce, even before the tribunals, the systematic euthanasia of the mentally ill in Nazi Germany. Euthanasia which was due to dehydration and progressive malnutrition, motivated by this same materialistic and atheistic ideology.
France must honor its international legal obligations and protect Vincent Lambert
The Protocol to the Convention on the Rights of Persons with Disabilities ratified by France on February 18th, 2010, gives the Committee the competence “to receive and consider communications from or on behalf of individuals or groups of individuals subject to its jurisdiction who claim to be victims of a violation by that State Party of the provisions of the Convention” (Article 1-1). Moreover, it grants the Committee the authority to “request that the State Party take such interim measures as may be necessary to avoid possible irreparable damage to the victim or victims of the alleged violation” (Article 4-1). The U.N. Human Rights Committee has confirmed the binding nature of such provisional measures by stating that “Failure to implement such interim or provisional measures is incompatible with the obligation to respect in good faith the procedure of individual communication established under the Optional Protocol” (General Comment No. 33, CCPR/C/GC/33, 2008. See also Zhuk v. Belarus, No. 1910/2009, October 30, 2013).
Mr. Lambert would indeed be irreparably harmed if the interim measures the Committee has requested of France are not followed. France voluntarily submitted itself to the jurisdiction of the Committee by ratifying the CRPD. France must now honor the commitment it has made to protect the rights of disabled persons by following the Committee’s direction to continue administering food and water to Mr. Lambert.
05.20.2019 UPDATE: The Court of Appeal of Paris just ordered the French Government to respect the request of the U.N. Committee on the Rights of Persons with Disabilities to stop the euthanasia of Vincent Lambert!
Just a few hours before, the European Court of Human Rights shamefully refused to order it.
This is a great victory.
We now have to continue to defend Vincent Lambert's right to life before the United Nations Committee.
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