Opinions about the new law on end-of-life issues in a sample of french patients receiving palliative care

BMC Palliative Care

Research Article

Jean Marc La Piana¹  Mireille Destandau¹  Augustin Boulanger²  Marie Fichaux²  Sébastien Salas³  Théo Chabal⁴  Pascal Auquier⁵  Karine Baumstarck⁵ 

[1] La Maison, Gardanne, France;Service d’Oncologie Médicale et de soins palliatifs, APHM Timone, Marseille, France;Service d’Oncologie Médicale et de soins palliatifs, APHM Timone, Marseille, France;Aix Marseille Université, Marseille, France;Service d’Oncologie Médicale et de soins palliatifs, APHM Timone, Marseille, France;Département de médecine générale, Université d’Aix-Marseille, Marseille, France;Unité d’Aide Méthodologique à la Recherche Clinique et Epidémiologique, AP-HM, Marseille, France;Self-perceived Health Assessment Research Unit, Aix Marseille Université, EA3279, Marseille, France;

关键词: Euthanasia;    Opinions;    Patients;    Palliative care;   

DOI  :  10.1186/s12904-016-0174-8

 received in 2016-07-19, accepted in 2016-12-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn February 2nd 2016, the French government enacted the Claeys-Leonetti law that forbade euthanasia and established the right to deep and continuous sedation for end-of-life patients. Moreover, the law also obliges clinicians to abide by any advance directives regarding treatment and investigation, except in cases where they are “obviously inappropriate” in a given medical situation, or in cases of emergency, in order to allow medical staff to take time to assess the patient’s situation. Artificial feeding and hydration are considered as treatment. The aim of this report is to investigate individuals receiving palliative care about their opinion about euthanasia, about advance directives, about the right to deep and continuous sedation, and the right to stopping artificial feeding and hydration.MethodsThe study was an opinion survey conducted among patients treated in two different palliative care institutions: a palliative care unit at the University Hospital (Timone, Marseille, France) and a non-profit association palliative care home (“La Maison”, Gardanne, France). Face-to-face interviews were performed by two investigators. The survey included sociodemographics, clinical data, and opinions about euthanasia, deep and continuous sedation, stopping artificial feeding and hydration, and advance directives.ResultsForty patients were interviewed. The mean age was 59.8 years (standard deviation 12). Fifty three percent reported opposition to legalized euthanasia. Eighty three percent were in favour of the right to deep and continuous sedation in patients with refractory pain, 75% when it concerns a patient unable to express their wishes, and 68% when the patient decides to stop vital treatment. Fifty eight percent reported that artificial nutrition and hydration should be considered as care. Fifty eight percent of the patients interviewed would like to see doctors follow the express wishes contained in advance care directives and 53% that advance directives should be subject to a validity period.ConclusionsThis work demonstrates the feasibility of discussing sensitive issues such as euthanasia, continuous and deep sedation and cessation of care with patients receiving palliative care. These preliminary results point to the need to perform a larger study in order to find determinant factors in this specific situation and to incorporate them into thinking about end-of-life laws.

【 授权许可】

CC BY   
© The Author(s). 2017