Health
French Senate Rejects Assisted Dying Bill, Sends It Back to Lower House
The French Senate on Wednesday rejected a law aimed at regulating assisted dying, sending the bill back to the National Assembly, where it could now be approved without further Senate consent. The proposed legislation would have allowed adults with incurable illnesses to take lethal medication, with assistance from a doctor or nurse only if their physical condition prevented them from doing so themselves.
To qualify, patients must be over 18 and either French citizens or residents of the country. A team of medical professionals would need to confirm that the individual has a grave, incurable illness at an advanced or terminal stage, is experiencing intolerable and untreatable pain, and is seeking lethal medication voluntarily. Patients with severe psychiatric conditions or neurodegenerative disorders, such as Alzheimer’s disease, would not be eligible.
The law would have included a conscience clause for healthcare professionals who object to participating, requiring them to provide patients with names of other practitioners willing to assist.
First proposed in 2024, the bill was approved by the National Assembly in May 2025 before moving to the Senate. However, it was blocked in the upper chamber with 181 votes against and 122 in favour. Critics ranged from right-wing politicians who oppose assisted dying on principle to earlier supporters who considered the final text diluted and insufficient.
On January 21, the Senate rejected Article 4 of the bill, which defined the conditions for medical assistance in dying. The Socialist group in the chamber said the rejection rendered the entire bill “meaningless.” Bruno Retailleau, president of the liberal-conservative Republicans party, argued that instead of new legislation, France should focus on expanding palliative care. “End-of-life care is accompaniment, not abandonment,” Retailleau said on X.
In the same session, the Senate approved a separate law to strengthen access to palliative care across the country. The legislation passed almost unanimously, with 307 votes in favour and 17 against, reflecting broad support for improving end-of-life services.
Yaël Braun-Pivet, president of the National Assembly, expressed regret at the Senate’s rejection but said the process will continue. “As assisted dying responds to a deep-seated desire among the French people, I regret the Senate’s rejection of this bill today,” she said, noting that a second reading in the Assembly is scheduled for the week of February 16. Braun-Pivet predicted the legislation could be definitively adopted by summer 2026, with the Assembly retaining the final say even if the Senate attempts further amendments.
President Emmanuel Macron pledged in 2022 to introduce an assisted dying law following his reelection. France would join Belgium, Luxembourg, the Netherlands, and Spain, where euthanasia is permitted under medical supervision. Austria, Germany, and Italy allow physician-assisted suicide for terminally ill patients, while several other European countries, including Ireland, Cyprus, Malta, Portugal, and Slovenia, are exploring similar legislation.
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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026
Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.
“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.
Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.
At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.
The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.
A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.
The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.
Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.
International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.
If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.
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