PARIS — A top court in France on Friday paved the way to remove life support from a man who has been in a vegetative state for more than a decade, after a yearslong legal battle in a landmark case on the right to die.

The court in Paris struck down a lower court’s ruling that had ordered doctors to continue artificially feeding and hydrating the patient, Vincent Lambert, 42, a nurse who was injured in a car accident in 2008.

Mr. Lambert did not leave written instructions about his end-of-life wishes, and his family has been bitterly divided over his treatment. His parents and other relatives say that he is not suffering and should be kept alive. His wife, Rachel Lambert, and others say he would not have wanted to live this way and should be taken off life support.

Following the ruling on Friday, a lawyer for Mr. Lambert’s wife said that it signaled the “end of this dispute.”

“There are no more legal obstacles that stand in the way of resuming the end of the treatments as of now,” the lawyer, Patrice Spinosi, told reporters in Paris.

Still, it was not immediately clear when Mr. Lambert might be taken off life support. A lawyer for Mr. Lambert’s parents threatened to file a complaint for murder if doctors went ahead with the procedure.

Doctors had declined to take Mr. Lambert off life support in 2015 despite a court order allowing it, because they said there was not enough “serenity and security” in the case after hospital staff members had received anonymous threats.

Medical experts define a vegetative state as a condition in which the part of the brain that controls thought and behavior no longer works, but vital functions such as the sleep cycle, body temperature control and breathing persist. Such patients can sometimes open their eyes and have basic reflexes, but they do not have meaningful responses to stimulation and do not display any sign of experiencing emotions.

Doctors first decided to remove Mr. Lambert from life support in 2013, in consultation with his wife, after years of physical therapy and care had failed to improve his condition. But his parents opposed the decision and obtained a court ruling that reversed it.

The legal dispute wound its way through top French and European courts, including the European Court of Human Rights. Then, last month, with the cooperation of Mr. Lambert’s wife — who was made his legal guardian in 2016 — doctors at a hospital in the northeastern French city of Reims stopped feeding and hydrating him, and began administering strong doses of sedatives to ease any suffering.

But hours later, a Paris appeals court granted a legal challenge filed by his parents’ lawyers to stop the process.

The court ruled that France had to put Mr. Lambert back on life support, pending review of his case by a United Nations-affiliated body, the Committee on the Rights of Persons With Disabilities, where Mr. Lambert’s parents had referred his case, and which had asked that the French state continue to feed and hydrate him.

On Friday, the Cour de Cassation, France’s highest judicial court, struck down that ruling.

While euthanasia is illegal in France, the law allows “passive euthanasia,” in which terminally ill or injured patients with no chance of recovery are taken off life support and put under heavy sedation until their death, after extensive consultation with their families and medical experts.

Mr. Lambert’s parents, observant Roman Catholics who are supported by pro-life activists, argue that he is not terminally ill but disabled, and that he does not fall under the purview of France’s legislation regarding end-of-life decisions.

Mr. Lambert’s wife and her supporters point to multiple medical assessments that found her husband to be in an irreversible vegetative state, and to court rulings that said artificial means of keeping him alive constituted “unreasonable obstinacy” as defined by French law.

In its ruling Friday, the Cour de Cassation had to settle a legal point that arose because of the existence in France of two parallel court systems: an administrative one, which handles claims against national or local governments or against public administrations, and a judicial one, which handles criminal cases and disputes between private parties.

Until last month Mr. Lambert’s case had been handled only by administrative courts because it involved the public hospital that was treating him, and his parents’ legal challenge with the Paris appeals court — a judicial court — had been widely expected to fail.

But the appeals court ruled that Mr. Lambert’s situation was the rare exception in which a judicial court can intervene in such cases — when the French State is infringing upon someone’s “personal freedom.”

In its ruling on Friday, the Cour de Cassation said the appeals court had overreached and that Mr. Lambert was not in a situation, like an arbitrary detention, where his personal freedom was at risk.

French law gives hospitals the possibility, “under certain conditions, to cease giving vital treatments to a patient,” the court noted in a statement, adding that several administrative courts, as well as the European Court of Human Rights, had ruled in favor of Mr. Lambert’s wife.

The French state, the court concluded, was not bound by the Committee on the Rights of Persons With Disabilities’ request to keep Mr. Lambert on life support.

Follow Aurelien Breeden on Twitter: @aurelienbrd.

Source: Read Full Article