End of life: the Elders confirm the right of doctors to go against advance directives from patients


Yasmina Kattou, edited by Laura Laplaud

Seized by a family, one of whose members has been in a coma since May, the Constitutional Council had to decide on the following question: should we follow the man’s last written wishes or let the doctors judge the follow-up ? The Constitutional Council has confirmed that a doctor can, if he considers the case of a patient desperate, dismiss these indications.

It is a decision that comes at a time when the debate on the end of life is coming back to public life: the Constitutional Council confirms that a doctor can, when the case of a patient is deemed hopeless, set aside the indications given to the prior to it. In a decision rendered Thursday, the Council declared “in accordance with the Constitution”, the legislative provisions which govern the “advance directives”. Directives that anyone can write to express their will to be kept alive, or not. However, they do not resolve all situations, as shown by the situation referred to the Constitutional Council.

The man had indicated his last wishes: to be kept alive

The family of a patient from Valenciennes, in the north of France, seized the Constitutional Council. Before being plunged into a coma last May after an accident, the man had written his last wishes: to be kept alive. But the doctors consider his situation hopeless, wish to stop the care and therefore go against the directives written and signed by the patient.

The Constitutional Council decides: doctors have the last word

The Constitutional Council decided on Thursday: it is up to doctors to have the last word, as already provided for in the 2016 law on the end of life. The text is clear: the medical team can override these directives if they are “inappropriate” to the patient’s situation. For the Council, the patient could not be fully able to assess his situation upstream.

Emmanuel Macron spoke at the end of the summer of a change in end-of-life legislation. He refers the responsibility to a citizens’ convention which must meet from the beginning of December. This convention, made up of 150 French people in the process of being drawn by lot, will formulate proposals next spring which will be supposed to guide the choices of the State.



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