Loi no 2005-370 du 22 avril 2005 relative aux droits des malades et à la fin de vie : amélioration du processus de décision de limitation et d’arrêt des traitements au moyen d’un programme pédagogique. Étude monocentrique prospective et rétrospective pilote

Chastrusse, Mélanie; Fulgencio, Jean-Pierre; Julien, F.; Naudin, Brice; Argo, Vincent; Bonnet, Francis; Ferrand, Édouard

doi:10.1016/j.lpm.2012.03.021

Cited by 6 publications

(1 citation statement)

References 21 publications

(24 reference statements)

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“…However, these position statements were not based on objective data. Since the enactment of Leonetti’s law in 2005 and of the decrees covering its application in 2006, numerous training measures have been introduced in intensive care [10]. In particular, the SRLF has updated its recommendations for clinical practices applied at the end of life, incorporating data provided by Leonetti’s law [7].…”

Section: Discussionmentioning

confidence: 99%

End of life in the intensive care unit: should French law be adapted?

Robert

Salomon

Haddad³

et al. 2014

Ann Intensive Care

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BackgroundLongstanding concerns regarding end of life in the ICU led in France to the publication of guidelines, updated in 2009, that take into account the insights provided by a recent law (Leonetti’s law) regarding patients’ rights. After the French President asked a specific expert to review end of life issues, the French Intensive Care Society (SRLF) surveyed their members (doctors and paramedics) about various aspects of end of life in the ICU.MethodsSRLF members were invited to respond to a questionnaire, sent by Email, designed to assess their knowledge of Leonetti’s law and to determine how many caregivers would agree with the authorization of lethal drug administration in selected end of life situations.ResultsQuestionnaires returned by 616 (23%) of 2,700 members were analyzed. Most members (82.5%) reported that they had a good knowledge of Leonetti’s law, which most (88%) said they have often applied. One third of respondents had received ‘assisted death’ requests from patients and more than 50% from patients’ relatives. One quarter of respondents had experienced the wish to give lethal drugs to end of life patients. Assuming that palliative care in the ICU is well-managed, 25.7% of the respondents would approve a law authorizing euthanasia, while 26.5% would not. Answers were influenced by the fear of a possible risk of abuse. Doctors and nurses answered differently.ConclusionICU caregivers appear to be well acquainted with Leonetti’s law. Nevertheless, in selected clinical situations with suitable palliative care, one quarter of respondents were in favor of a law authorizing administration of lethal drugs to patients.

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Section: Discussionmentioning

confidence: 99%

End of life in the intensive care unit: should French law be adapted?

Robert

Salomon

Haddad³

et al. 2014

Ann Intensive Care

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Fin de vie en réanimation : la loi Leonetti est-elle suffisante ?

Robert

Salomon

Haddad³

et al. 2013

Réanimation

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Withholding or withdrawing life-sustaining treatments in the COVID-19 pandemic: adherence to legal standards

Guastella,

Lambert,

Lafforgue

et al. 2023

BMJ Support Palliat Care

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ObjectivesIn France, when the patient is unable to express his wishes, the decision to withhold or withdraw life-sustaining treatment (WWLST) is made following a collegial procedure described by a law. The aim of our study was to assess how closely this WWLST decision-making procedure in end of life patients was maintained during the COVID-19 pandemic.MethodsThis retrospective observational multicentre study compared the rate of non-compliance with WWLST decision-making procedures during the pandemic period from March to June 2020 with control period in 2019, in Clermont-Ferrand and Lyon Hospitals. Secondary objectives were to determine the factors associated with non-compliance.ResultsIn 430 deceased patients included (176 in 2019 and 254 in 2020), the rate of non-compliance was 61.4% in 2019 and 59.1% in 2020 (p=0.63). In multivariable analysis, non-compliance was associated with immunosuppression status (OR 1.69, 95% CI (1.12 to 2.54), p=0.01) but was lower in intensive care unit (OR 0.54, 95% CI (0.36 to 0.82), p=0.003) and when the patient had visits from relatives (OR 0.41, 95% CI (0.22 to 0.75), p=0.004).ConclusionIn France, more than half of WWLST decisions do not comply with the law. The COVID-19 pandemic did not increase this non-compliance rate. Further studies are needed for a better understanding of the mechanisms underlying non-compliance with WWLST decision-making procedure.Trial registration numberNCT04452487.

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Loi no 2005-370 du 22 avril 2005 relative aux droits des malades et à la fin de vie : amélioration du processus de décision de limitation et d’arrêt des traitements au moyen d’un programme pédagogique. Étude monocentrique prospective et rétrospective pilote

Cited by 6 publications

References 21 publications

End of life in the intensive care unit: should French law be adapted?

End of life in the intensive care unit: should French law be adapted?

Fin de vie en réanimation : la loi Leonetti est-elle suffisante ?

Withholding or withdrawing life-sustaining treatments in the COVID-19 pandemic: adherence to legal standards

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