Attending physicians are in the best position to educate patients about advance directives, according to an IGAS report.
The General Inspectorate of Social Affairs (IGAS) examined the methods of managing advance directives. In a report published on Tuesday at the request of the Ministry of Health, it makes several recommendations on the register which centralizes all the directives.
Indeed, article 8 of the law creating new rights in favor of patients and people at the end of their life “provides that any adult can write advance directives in the event that they are one day incapacitated. express its will and that these directives are kept in a national register ”.
To raise awareness
The priority is first of all to make this register better known to patients and to enable them to appropriate their rights, whereas the previous law on the end of life seems to have missed this objective.
“The 2005 law, the precise content of which is little known to the general public, did not allow citizens to seize it, with regard to advance directives. In fact, in 2009 only 2.5% of the people who died that year had written directives, ”write the rapporteurs.
However, for this patient awareness mission, doctors seem to be in the best position, estimates IGAS. “Anyone wishing to draft these guidelines must be accompanied”, and the attending physician is “the local professional, most likely to provide support to the patient, especially when the latter is already the carrier of a chronic disease (10 million patients are currently in long-term illness with a monthly visit to their general practitioner) ”, we can read in the report.
Other medical specialists or hospitals, as well as professionals in the medico-social sector, are also invited to discuss this issue with patients, in particular if the latter so request.
Shared Medical Record
IGAS recommends that this communication mission to the general public and healthcare professionals be carried out by the future National Center for Palliative and End-of-Life Care, the creation of which is provided for by a decree currently being published.
Advance directives should be integrated into the future Shared Medical File (DMP), the implementation of which will be ensured by the Health Insurance. Provided for in the health law, the DMP will be deployed within 18 months to 2 years, which is “completely compatible with the law, which specifies that the register is only one of the means of conservation”, judge IGAS.
“The DMP is the most suitable tool for ensuring the identification of people, preservation and security during questioning at a lower cost. None of the other existing operators will do better, faster and at a lower cost, ”the mission concludes.
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