The report on the end of life of MEPs Claeys and Leonetti has been submitted to the President. It opens up new rights to patients. The ex-doctor of Vincent Lambert welcomes this progress “which will not resolve some family tragedies despite everything.”
Proposals for a new law on the end of life were submitted to the President of the Republic this Friday morning by the deputies Jean Leonetti (UMP) and Alain Claeys (PS). Among the main measures that should be adopted: the patient’s right to limit or refuse treatment. Moreover, terminally ill patients, whose vital prognosis is short-term, will have the right to request deep and continuous sedation until their death. Its objective is to achieve in the patient (whose vital prognosis is engaged in the short term) a total alteration of consciousness, preventing any suffering, including that resulting from “seeing oneself die”.
The other strong measure consists in simplifying and generalizing the drafting of advance directives. They will no longer be simply “consulted” by the doctor but will be imposed on him so that the patient’s decision is respected. And in the case of Vincent Lambert, a 38-year-old quadriplegic in a state of minimal consciousness “plus” (whose family is torn to keep him alive) it is precisely these advance directives that were sorely lacking. In this context, why actor exclusively obtained the reaction of Dr Eric Kariger, Vincent Lambert’s ex-doctor. In favor of stopping life-sustaining treatments on this patient, he commented on our microphone on this new bill.
What do you think of the patient’s right to terminal sedation?
Eric kariger : Sedation is a technique already widely used in palliative care. It can be made more or less deep or definitive depending on the clinical situation. But it is a technique that has a palliative vocation, that is to say, it is used to relieve an uncomfortable symptom. So we remain in this palliative strategy between the two extremes of euthanasia and unreasonable obstinacy. We are indeed on this 3rd path that we are in the process of thickening, on the patient’s right to refuse any treatment (including those of nutrition and hydration) and the right if the situation requires it to fall asleep. sick as a precaution.
But in my palliative culture, on a personal level, the goal is to keep the patient conscious whenever possible. Sedation, in fact, is the weapon of last resort to use when needed.
This right passes from the doctor to the patient, is it a novelty?
Eric kariger : Yes, but anyway, din palliative care services, physicians are at the service of the patient and not at the service of personal values or convictions. Today, the greatest quality of a doctor is to listen to his patient, and of course to respond to his suffering by accompanying him to the end. For this, sedation should be used whenever necessary. Be careful, however, that it does not become a facility, that is to say a weapon of precautionary principle: “come on as soon as you suffer a little, I will put you to sleep and I will never wake you up again”.
Isn’t this a disguised euthanasia?
Eric KarigeA: With all the weapons we now have in palliative care, we can bypass euthanasia easily and offer the patient something else. Sedation is one of the options on the table. And in this case, even if we shorten the life of a patient by a few days or a few weeks, the intention of the medical profession is first of all to offer him a quality of life (without suffering), everything is in the intention. And after the greatest judge of the doctor, it remains his conscience.
But without directives, this law does not regulate cases like that of Vincent Lambert?
Eric kariger : It’s a painful memory for me. But in these situations when there is a major conflict, even if Vincent Lambert had had advance directives, there would still have been an appeal from part of the family. When there is unreason in a camp, the law does not protect. And above all, the law is not intended to regulate exceptions. But the Leonetti law has the merit of being totally ethical since it provides a framework for the fairest reflection to arrive at the best decisions. They are able to respond to many situations. In this regard, I pay tribute to the two deputies who made consensual proposals. Death is too difficult to make room for controversy and extremists.
What to do then to avoid these tragedies in the families?
Eric kariger : From now on, advance directives will be highly restrictive for doctors. It is also an opportunity for the French to take their share of responsibilities. They cannot expect everything from the law. They must therefore help the medical profession and at least write what they do not want. Finally, they can also appoint someone they trust, which may be easier. The latter will then say what we have not managed to write. It takes two minutes, it is signed, it dates. And so we can avoid family conflicts, because no law can avoid them.
.
