The Constitutional Council confirms that doctors can go against the advance directives concerning the end of life transmitted by a patient, when the latter is in a serious condition, considered hopeless.
- In France, any adult can write advance directives relating to their end of life, which are in principle binding on the doctor.
- They concern the “conditions for the continuation, limitation, cessation or refusal of treatment or medical acts”, in the event that the person is no longer able to express themselves.
The wise have decided. In a press release, published Thursday, November 10, the Constitutional Council makes a new decision concerning the end of life: doctors are not obliged to respect the advance directives of a patient at the end of life when they are “manifestly inappropriate or inconsistent with the patient’s medical situation”.
Family challenges doctors’ decision to stop treatment
Last August, the Constitutional Council was seized by the family of a patient. The latter had written advance directives, this document which allows everyone to express what they wish concerning their end of life, in case they find themselves unable to formulate their choice. This man had expressed his wish to be kept alive. In a letter to his doctor, he wrote:I hope that they will continue to keep me alive, even artificially, in the event that I have lost consciousness for good”relates France Blue North. However, following an accident in May, this forties was plunged into a coma. He is placed on an artificial respirator and no improvement in his case is possible. For doctors, continuing care, i.e. nutrition and artificial respiration, is disproportionate, and stopping care is legal, despite advance directives insofar as treatments are judged “inappropriate to the medical situation”. For the family, this decision is contrary to the patient’s choice.
A “ssafeguarding the dignity of people at the end of life”
From a legal point of view, a doctor can indeed decide not to respect advance directives when they are “manifestly inappropriate or non-compliant” to the patient’s medical situation. For the Constitutional Council, this law of 2016 is in conformity with the Constitution. “By allowing the doctor to set aside advance directives, the legislator considered that the latter could not be imposed in all circumstances, since they are written at a time when the person is not yet confronted with the particular situation. end of life in which she will no longer be able to express her will due to the seriousness of her condition, says the Constitutional Council. In doing so, he intended to guarantee the right of everyone to receive the most appropriate care for his condition and to ensure the safeguard of the dignity of people at the end of life..” The Elders also recall that doctors only make this decision after a collegial procedure to guarantee a fully informed choice.
A citizens’ convention on the end of life
Although the Constitutional Council has confirmed the constitutionality of this law, the debate on the end of life is far from over in France. At the beginning of December, a citizens’ convention must meet. It will bring together 150 French people, drawn by lot, to reflect on the end of life. The proposals made will be sent to the government in the spring, which should use them to guide its choices.