End of life: the conditions of access to assisted dying clarified, a “prognosis” on the patients in question

The draft law on the end of life is being examined; by the deputies é from April 22 and the text could be modified. For health personnel, a condition of access to help à Dying is particularly debated.

New stage in the legislative journey of the bill on the end of life:   Starting from Monday April 22 and for one month, a special commission of the National Assembly will scrutinize the text and conduct numerous hearings. The text will then arrive in the hands of all the deputies. from May 27. This long period of examination could cause the text to evolve and delete, modify or specify certain provisions. One of them, which conditions access to help ' die à a "vital prognosis engagedé &agrav; short or medium term", does not convince health personnelé whether they are for or against the bill.

The absence of a clear definition of what is an “engaged vital prognosis” &agrav; short or medium term" asks questions. The Minister of Health, Catherine Vautrin, tried to do so. to specify these deadlines referring to France 2 a period "of a few days or a few months" for the short term and ranging from "six à twelve months" for the medium term. Estimates taken from the "reading of the High Authorityé health&eac;". But another definition of short term used in the Claeys-Leonetti law of 2016 and given by the Société été French support and palliative care (Sfap) provides for a long-term temporality. of "a few hours or a few days".

An assumed vagueness, but counterproductive?

Although they are different, neither of these two definitions is unanimously agreed upon. with doctors. They remain too vague to provide guarantees to caregivers who will provide nursing care. die according to Jean Daquin, doctor and delegate national officer in charge of the caregivers commission within the Association for the Right to Care die with dignity (ADMD). "Will the estimate be the same for a loved one, a caregiver or a lawyer ? If there is a trial , how to define this short or medium term ?", he asked on franceinfo in March.

The other limit of these definitions subject to change interpretation is that they could make the law on the end of life inapplicable. "This notion of vital prognosis engagedé &agrav; short term has already come to fruition made the Claeys-Leonetti law very restricted" and could have the same consequences on the new text analyzes Martine Lombard, jurist and professor emeritus of public law at university Paris II-Panthéon-Assas, in L'Express. Some doctors fear that these short and medium term timeframes will not be used by health professionals. opposed to help & die to refuse to end the life of a patient who requests it.

However, the absence of a clear definition for "vital prognosis engagedé short and medium term" is assumed by the deputy and former Minister of Health. who worked on the text, Agnès Firmin Le Bodo. "To define a [precise] term, it would perhaps be, & within a few days, prevent someone from benefiting from financial assistance. die" she explained at the microphone of franceinfoApril 22. The elected of the majority presidential office (Horizons) has also left hear his will not to further specify the temporalities.

Difficult vital prognoses à &eac;value

Health professionals opposed to help ' dying also express reluctance to accept about this measure conditioning access to help ' die à a vital prognosis engagedé &agrav; short or medium term. And for good reason, beyond of a few hours, it is difficult to make a prognosis on how much time remains. live to the patient. "We are very regularly wrong about a potential estimate of life expectancy" underlines Stéphanie Träger, oncologist and palliative care doctor at Paris, on franceinfo. Even when a prognosis is given, a patient's condition can still change and undermine the estimates: patients who see their condition suddenly worsen and others see it worsen. who was given little time & live which stabilize. As prognoses are not an exact science, but only calculations based on statistics, some doctors fear that patients will choose the best option. help à die when they had a chance of seeing their condition improve.