End of life: "The right to deep sedation until death is gradually being established"

Igas has made an initial assessment of the Claeys-Leonetti law on the end of life. She believes that "the two years of application of the text are positive, although contrasted".

The report of the Igas on the Claeys-Leonetti law was eagerly awaited. Health Minister Agnès Buzyn had ordered it last November, implying that she was waiting for it to decide on a potential new end-of-life law.

An adapted answer

Recall that complex legislation on the end of life has been progressively developed over the last twenty years and completed by the Claeys-Leonetti law of February 2, 2016. The latter confers new rights to patients at the end of their life, especially the right to establish binding advance directives and the right to request deep and continuous sedation until death.
The assessment made by the IGAS concerning the two years of application of the law of February 2, 2016 is positive, although contrasted. "The law offers a response adapted to the care of the vast majority of end-of-life paths and its appropriation progresses on the ground," noted the authors first overall. "The number of people claiming to know the law has progressed, that of the drafters of advance directives also, and the dialogue on the end of life between health professionals and patients has opened, expanded and improved." The right to resort to sedation deep and continuous until death is slowly being established, "they continue.

Difficulties remain

On the other hand, the difficulties remain, namely: data and studies indispensable for the end of life are still largely lacking and research in this area is also too poor; governance and steering of the device are not yet at the level; the information of the general public as professionals is insufficient and must take a new step; the flaws in initial and continuing education have not been filled and the academic discipline of palliative care is not structured as it should be.

Progression of the number of deaths

It remains to be seen what the government will do with these observations. The end-of-life issue is central in French society, particularly because of the increase in the number of deaths and people suffering from disabling chronic pathologies, cancer or very severe motor, sensory and cognitive sequelae that now sometimes survive. many years thanks to advances in medicine.
The mission's investigations were based in particular on numerous interviews with health professionals and the medico-social sector, experts, patient associations, etc., in Paris and in four regions (Île-de-France , Grand Est, Pays-de-la-Loire, Center-Loire Valley); the visit of some thirty health or medico-social establishments or services, public or private; the analysis of medical records of deceased patients who have been deeply sedated; two sets of questionnaires to regional health agencies and health and medico-social institutions.

Video: A Good Death: The inside story of a hospice (January 2020).