End of life: the importance of writing its early guidelines

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End of life: the importance of writing its early guidelines

Press release From the National Academy of Medicine [1]

December 7, 2021

Anyone has the right to indicate in advance their will on the conditions of their end of life, following an illness or another cause (traffic accident, etc.), in case it is one day in theinability to make it known.

By writing anticipated directives [2], an adult [3] can therefore express themselves, at any time of their existence, on the prosecution, the limitation, the stop, or the refusal of treatment or medical acts.The directives allow the patient's wishes to be respected and the action of the caregivers will be guided.

These guidelines are revisable and revocable.Mentioning the identity of their author, they are written [4], dated and signed.They can be written according to a model, but without obligation [5], and they benefit From being easily accessible.Their conservation can be entrusted to third parties: trusted person, family member, close, attending physician, health establishment, medico-social establishment.They can also be integrated into the personal medical file.

Since the law of February 2, 2016, [6] creating new rights in favor of patients and people at the end of life, early guidelines are imposed on the medical profession: it must apply them.Their content takes precedence over the opinions or testimonies of the confidence or relatives.Health professionals can only derogate From it in the event of a vital emergency, the time to assess the situation, and when they appear "inappropriate or not in accordance with the medical situation".In the latter case, a collegial procedure is followed.

End of life: the importance of writing its early guidelines

In the absence of early guidelines, the doctor must collect the advice of the trust person, or any other opinion of the family or relatives.Depending on this opinion, this professional makes his decision with regard to the medical situation.

The early guidelines are not only intended to respect the choices of the person outside the state to show their will, but also to protect relatives by preventing a possible disagreement between them.

The practice shows that our fellow citizens ignore this means of expressing their will.The same is true of health professionals, who do not sufficiently master the most recent legislative provisions [7].

It is advisable to set up an educational policy focused on the reflection of each citizen, whatever their age, in anticipation of their end of life, and thus to lift the psychological and technical brakes.

Early guidelines must be explained and made as accessible as possible.Everyone must know that he can, at any time or during hospitalization, write early guidelines in anticipation of an end -of -life situation altering their discernment.

Health professionals, in particular general practitioners, must be ready to express themselves on the advance directives in their practice, in order to best support their patients in their writing.

The National Academy of Medicine consequently underlines the need:

[1] Press release From the Academy's rapid communication platform validated by the members of the Board of Directors on December 6, 2021.

[2] Art.L 1111-11, 1111-12, 1111-15 Public health code

[3] A person subject to a legal protection measure with representation relating to the person may write anticipated directives with the authorization of the Judge or the Family Council

[4] When the author of the early guidelines is unable to write and sign himself, two witnesses can attest to the document.

[5] Art.R 1111-18 Public health code;V.Especially on www.public service.en/Individuals/Vosdroits/F32010, www.let's talk about.Fr/I-militres-a-la-fin-de-vie/The-directives-anticipees/, www.haste.Fr, www.National council.doctor.Fr

[6] N ° 2016-87

[7] According to a survey carried out by the National Center for Palliative Care and the End of Life (CNSPFV) in 2021, 60% of those questioned know that there is a law that governs the end of life, 48% have heardearly guidelines, 18% have written.91 % of those questioned did not discuss it with their doctor.Senate, audition of DR.Sarah Dauchy, president of the CNSPFV guidance council, April 7, 2021, report of the Social Affairs Committee.

[8] The CNSPFV carried out two information campaigns around the existing end -of -life devices in 2018 and 2019, CNSPFV 2019 activity report, www.let's talk about.Fr

Has Consulting Social Life