The High Authority for Health wants general practitioners to be able to prescribe a powerful sedative to support end-of-life patients, in a recommendation sent to the public authorities.
Have the right to die at home. The High Authority for Health (HAS) took a step in this direction on Monday February 10 by publishing a recommendation addressed to public authorities. She wants GPs to be able to prescribe Midazolam, a product that permand placing the patient in a state of continuous deep sedation until death (SPCJD).
Doctors indicted for prescribing midazolam
“Today, we very clearly recommend that the doctor be able to access it directlyasserts Dr. Pierre Gabach, member of the HAS, who participated in the drafting of the recommendations, during an exchange with the press. It is up to the Ministry of Health to ensure that now, by regulation, this is possible“.
1? #Communicated | To help healthcare professionals support their end-of-life patients? HAS publishes the terms and conditions for the use of medicines from the #sedation in hospital and at home
???? Read the press release online: https://t.co/ftKZxqjVil pic.twitter.com/7GRuyFiPQ3
– High Authority for Health (@HAS_sante) February 10, 2020
Currently, the law does not prohibit the prescription of this drug by general practitioners, but its use is highly regulated and, in fact, almost impossible. At the end of 2019, a couple of doctors from Normandy were indicted and banned from practicing for having administered Midazolam to five patients a few days before their death. A decision that shocked many members of the profession who launched a petition of support and shared several media platforms demanding a change in the Claeys-Leonetti law on the end of life.
The Minister of Health will have to decide
Pierre-Louis Drouais, general practitioner in Yvelines (78) and member of the HAS, has several times been confronted with end-of-life patients and, for him, it is obvious that this sedative must be made available to general practitioners. “Imagine a patient who suffers from bone metastases, prostate cancer for example, it is horribly painful, he explains to France info. He is on morphine at doses that sometimes make pharmacists shudder and we realize that even with that, he continues to suffer.
In its recommendation, the High Authority for Health specifies that the prescription of this powerful sedative must respect certain rules. Thus, the decision must be taken collectively, the doctor must be in contact with a palliative care unit and the patient must be able to be placed in a hospital if the situation becomes complicated. The Minister of Health, Agnès Buzyn, will have to decide on these recommendations and on the framework for the use of Midazolam outside hospitals.
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