As a rule, the family doctor who has known the patient for years is the best judge of her condition and of the earnestness and independence of her request. But he must also consult another doctor, an outsider, for an independent assessment; that doctor must also put his views in writing. Afterward, both reports are submitted to a monitoring committee, which may ask for further explanation and can refer problematic cases to the Inspector of Health and the Public Prosecutor. But their annual reports show that the monitoring committees do this only very rarely — in 2010, at the rate of one in every 300 reported cases.

We called for the consulting doctor, who spent the better part of an hour with Mathilde. Afterward, he called our family doctor and said he was not sure she was suffering enough.

What is unbearable suffering? It is an impossible question. The monitoring committees have given up trying to define it and adopted the view that the patient’s own judgment is decisive, provided the acting doctor is convinced of its earnestness and sincerity....

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