Révision des lois de bioéthique, l’étude du Conseil d’Etat

http://monsite.orange.fr/seiler/page7.html (avec l'aimable autorisation de l'auteur)En février 2008, le Premier ministre a chargé le Conseil d’État de réaliser une étude préalable au réexamen des lois de bioéthique notamment en identifiant d’éventuelles lacunes de la législation et en proposant d’éventuelles évolutions possibles.

Cette question a notamment été évoquée ici ou et ne manque pas de susciter les passions les plus vives, certains projetant leur propre foi pour appréhender l’éthique du vivant.

Dans un rapport rendu public le 6 mai dernier, globalement bien accueilli par la presse, le Conseil d’État considère que, eu égard à la relative stabilité et et au caractère ancré des principes posés par loi de 1994, il y a lieu d’apporter certains aménagements aux règles actuelles, sans qu’il soit besoin de bouleverser les équilibres existants. La Haute juridiction propose par ailleurs de « ne pas renouveler l’obligation de réexamen des lois de bioéthique à l’issue d’un délai de cinq ans. »

Sept thèmes de réflexion sont proposés :

1. Soumettre la recherche de l’embryon humain surnuméraire et sur les cellules qui en sont issues à un régime permanent et strict d’autorisations.

Le décret n°2006-121 du 6 février 2006 autorise les recherches sur les embryons pour une période de cinq ans (art. R. 2151-2 du code de la santé publique), la délivrance d’autorisation prenant fin le 6 février 2011. Le renouvellement de cette période n’aurait de sens que s’il existait de bonnes raisons de croire que ces recherches deviendraient inutiles à coup sûr après cette période. Or, selon les données scientifiques disponibles, il faudra vraisemblablement plus de temps pour que les recherches tranchent définitivement cette question. Aussi le maintien d’un régime spécifique apparaît-il, d’après le Conseil d’État, plus approprié s’il prend la forme d’un régime permanent.

2. Renforcer l’information et l’accompagnement dans le cadre législatif actuel du diagnostic prénatal et du diagnostic préimplantatoire.

Le Conseil d’État observe une quasi généralisation de l’eugénisme individuel en se fondant sur le cas de la trisomie 21. En France, « 92% des cas sont dépistés et 96% des cas détectés donnent lieu à une interruption volontaire de grossesse, ce qui traduit une pratique individuelle d’élimination presque systématique des fœtus porteurs. » Le Conseil d’État invite dès lors à rester vigilant afin que la politique de santé publique ne contribue pas à favoriser un tel comportement collectif – donc en amont – mais permette une meilleure prise en charge de ce handicap – en aval. Il s’agit, soit dit en passant, d’une hypocrisie évidente, aucun parent ne souhaitant de prime abord être contraint, à l’occasion d’un heureux évènement, de gérer un handicap aussi difficile.

S’agissant du double DPI ou « bébé médicament », le Conseil d’État estime que par les questions éthiques qu’il soulève et son faible taux d’utilisation en pratique, le législateur pourrait envisager de supprimer cette pratique. Dans le cas contraire, cette expérimentation gagnerait à faire l’objet d’une évaluation quinquennale.

3. Mieux prendre en compte l’intérêt de l’enfant pour l’assistance médicale à la procréation

Il s’agit sans doute de l’une des questions les plus polémiques et les plus sensibles. Le Conseil d’État considère en effet que l’accès des femmes célibataires et des femmes homosexuelles à l’assistance médicale à la procréation n’est pas souhaitable car « cela supposerait d’admettre la conception médicalement assistée d’un enfant sans ascendance masculine. » Traduisez : l’enfant a besoin d’une figure paternelle pour s’épanouir.

Le Conseil d’État recommande également de ne pas légaliser la gestation pour autrui (pratique des « mères porteuses »), pratique dont l’interdiction s’explique par la protection de la dignité de la personne humaine ((Se reporter à cette occasion à l’éclairante lecture de D. Roman, « A corps défendant » La protection de l’individu contre lui-même, Recueil Dalloz 2007, p. 1284.)), et la « non-commercialité » du corps humain (art. 16-7 et 1129 du code civil).

4. Respecter la volonté des personnes et renforcer leur information pour les examens des caractères génétiques.

Le législateur doit adapter la protection et apporter des garanties pour les tests génétiques qui se généralisent et sont notamment commercialisés sur Internet.

5. Renforcer la solidarité et la transparence pour les dons, les prélèvements et les collectes d’éléments du corps humain.

S’agissant des prélèvements d’organes post-mortem, le Conseil d’État sur l’attention sur son souhait d’encadrer cette pratique en insérant une disposition au code de la santé publique indiquant que le prélèvement d’organes sur un patient décédé d’un arrêt cardiaque ne peut intervenir que si le patient a fait l’objet « d’une tentative de réanimation d’une ampleur et d’une durée telle que son absence de succès permet de conclure à l’irréversibilité de la mort. »

6. Améliorer les soins palliatifs et interdire l’euthanasie.

Sans surprise, le Conseil d’État se montre hostile à l’idée d’accéder à la demande d’un patient d’arrêter son traitement ayant pour effet d’abréger sa vie, la prise en charge immédiate de ce dernier par une équipe de soins palliatifs étant préférable.

Face à la demande d’ « aide active à mourir », le Conseil d’État considère que le développement de soins palliatifs constitue le moyen le plus sûr de ne pas y recourir.

7. Instaurer un mécanisme d’examen éthique en France des projets de recherche menés par les équipes françaises dans les pays en voie de développement.

Omar YAHIA

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