The French Citizens’ Convention on the End of Life: Lessons learned
An interview with Marjan Ehsassi
Following the Citizens’ Convention on Climate in 2019–2020, the French government organised a second deliberative process at the national level — the Citizens’ Convention on the End of Life (CCFV). The OECD discussed with Marjan Ehsassi, one of the four guarantors [1] and expert on deliberative democracy, who observed the process from the start.
France’s second national Citizen Assembly organised by the Conseil Economique Social et Environnemental (CESE) was tasked to deliberate and provide recommendations on the following question: “Is the framework for end-of-life support adapted to the different situations encountered or should changes be introduced?”.
In April 2023, 184 citizens, selected through civic lottery, released their final report comprising 65 collective proposals to reform the end-of-life framework. In the upcoming weeks, the French government is expected to unveil an updated model for assisted suicide, building on the contributions made by the citizens. Among the 566 representative deliberative processes identified by the OECD, 48 of them focused on health-related topics (8,5%), positioning it as the fourth most frequently addressed subject. [2]
The assembly consisted of nine three-day sessions over a period of five months (27 days in total). In similar processes, the average time of deliberation is 13,5 days [3]. The Convention comprised three main phases: the learning phase, the deliberation phase, and the harmonisation and restitution of the final report. Overall, 4,2 million euros were allocated to this assembly. In comparison, the average budget dedicated to national citizens’ assemblies is approximately 1,9 million euros [4].
Members of the Convention were selected by random selection. Six specific criteria were chosen to ensure diverse representation among citizens:
- Gender
- Age: from 18 years upwards
- Urban area typologies: major urban centres, inner suburbs or rural communes
- Region of origin: all French regions were represented
- Level of qualification: 6 categories to reflect the French population
- Socio-professional category: blue-collar, white-collar, managerial, etc
The CCFV involved several key stakeholders:
- A governance committee
- External providers
- Thematic experts, along with fact-checkers who ensured the accuracy of information.
- Four international experts served as guarantors
- Observers, including researchers, and evaluators who helped monitor the assembly
At the end of the 9 sessions, the assembly declared itself in favour of euthanasia and assisted suicide, under certain conditions. If this stance represents the majority opinion, the minority opinion is also presented in the report for transparency.
Lessons learned — an interview with Marjan Horst Ehsassi
Q1: What have you learned from the governance of the CCFV? Has the CESE evolved in its role since the French Citizens’ Convention on Climate (CCC)?
It’s the first Citizens’ Convention in France since the reform in early 2021 which granted the CESE its official role as Third Chamber with a mandate that sits at the crossroads of citizen participation. If we take a look at the CCC in 2020, the CESE had more of a convening authority, versus the current role with a mandate to engage citizens in public debates.
On the governance of the CCFV more generally, there was strong collaboration between the governance committee, facilitators, and guarantors. However, to ensure a more balanced and neutral governance structure, I would recommend reconsidering the composition of the governance committee. To signal a more equitable and fair representation, it would be beneficial to have a majority of the governance committee consisting of external experts and to designate a non-CESE co-president to assist in the day to day management of the convention.
Q2: Can the CCFV be considered a success? Would you say the CCFV enabled a safe space for all citizens to deliberate?
It is too premature to conclude, primarily because its effects on both the law and as a democratic undertaking still need to be evaluated. However, if we measure the success on the fact that citizens, from all backgrounds, had a say in such an important topic, we have already witnessed noteworthy outcomes.
The convention recognized the significance of giving sufficient space and meaningfully acknowledging the minority opinion and the members of minority groups. This sense of empowerment most likely emanated both from a consistent feedback loop — which led to the implementation of several design suggestions that came from participants during and in between sessions — as well as an environment of mutual respect. A result of this environment of trust, social cohesion and balanced representation is the Common Convictions section of the final report.
This trust was also evident throughout the sessions. For instance, in some debates, 50% of the allocated time was allocated to the minority. During one such debate, one of the members, expressed his surprise that the minority, of which he was a part, was allocated 50% of the time. Another member, was among those whose position was against a change in the law, placing her in the minority opinion. During one of the final sessions, she expressed gratitude to the majority for granting space to the minority opinions. This is positive effect in times of polarisation, is noteworthy and attributable to both the assembly’s carefully designed process and the citizens’ commitment.
Q3: Any final piece of advice for governments considering implementing nationwide Citizens’ Assemblies?
A critical shift that I would like to see across deliberative assemblies is for a greater involvement of citizens in the selection of topic. We could for example question President Macron’s decision to convene a Citizens’ Convention on the end of life and not on pension reform. In Switzerland, they are currently organising a citizens’ assembly for youth aged 18 to 24. They have included a vote in the design process and have asked young people to identify their priority area. The commitment of elected representatives to address the issue is important and, therefore, there needs to be a system in place so that topic areas are vetted by political leaders but ultimately chosen by citizens.
Finally, we often speak of power without deliberation or deliberation without power. While CCFV policy outcomes have yet to be realised, it demonstrates that with strategic leadership and clear objectives, a 184-person citizens’ convention can combine deliberation and power. With political will, a mandate that is merely consultative need not be binding to be consequential. Given CCFV’s success in process and the expected change in the law, it will likely become a strong standard bearer for the next wave of citizens’ assemblies worldwide.
[1] The guarantors played a vital role in ensuring adherence to principles such as tolerance, pluralism, inclusion, and respect for the voices of all participants, particularly those of the minority and marginalised. She actively participated in the preparation of all sessions and was present for seven of the nine sessions.
[2] The topic of urban planning ranks first (13,5%), followed by strategic planning (13%) and the environment (12%). See OECD Database of Representative Deliberative Processes and Institutions (2021).
[3] According to data from the OECD Database of Representative Deliberative Processes and Institutions (2021), compared with other Citizens’ Assembly of similar size at the national/federal level.
[4] See OECD Database of Representative Deliberative Processes and Institutions (2021)
