Tribune. Dying with dignity: no one wants the opposite. The question is how to get there. Addressing such a subject requires great modesty, a refusal of any simplification, a constant desire to respect the autonomy of the person, and the absolute need for collective solidarity. In fourteen years, from 2002 to 2016, the legislator passed three laws which significantly strengthened the rights of patients.
These laws have established the principle of informed consent of the patient to acts and treatments, proscribe unreasonable obstinacy. The 2016 law, in particular, clarified the conditions for stopping treatment for refusing unreasonable obstinacy, established a right to deep and continuous sedation until death for people whose prognosis is threatened. short term, and made the patient’s advance directives enforceable. They have helped to deepen the relationship between patient, family and doctor.
Undoubtedly, these three laws have strengthened the place of the citizen in the health system, they clarify the medical support from which he will benefit. Their development marked above all a “paradigm shift”, because they were born from a broad consultation: associations of patients, families, researchers, medical community, association “for the right to die with dignity”, philosophical currents, religious authorities …
Territorial or social inequalities in care
At the same time, the National Consultative Ethics Committee has had to reflect on these questions several times over the past twenty years. He thus recommended “ the need to put an end to all the situations of unworthiness which too often surround the end of life ”. These legislative provisions require more than ever an information campaign as close as possible to our fellow citizens and a precise assessment.
Indeed, let us not hide the truth from ourselves: we all know, among our families and our close relations, women and men who have an unworthy end of life. There are multiple reasons. They are sometimes accentuated by territorial or social inequalities in care.
Progress has been made but it must be significantly increased today. Take the strengthening of palliative care. Despite the efforts made, the National Palliative Care Center, created by Marisol Touraine in 2016, still experiences unequal access: twenty-six departments do not have palliative care units, disparities exist within the health sector, as well. between the health sector and the medico-social sector.
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