End of life: Constitutional Council reaffirms right of doctors to derogate from anticipated directives of a

The council was seized of a QPC on the case of a medical team wishing to stop the care of a patient who expressed beforehand the desire to be maintained alive, even artificially.

Le Monde with AFP

A doctor is not necessarily forced to respect the “early directives” by which a patient expresses his will or not to be maintained alive. The principle has been confirmed Thursday November 10 by the Constitutional Council , which validates the legislation in force. The law, which provides that the doctor can overcome these directives if they are “inappropriate” to the patient’s situation, complies with the “safeguard of the dignity of the person” as to his “personal freedom”, estimates the council.

This decision is made when the debates at the end of life return in the public field. President Emmanuel Macron plans a change in legislation, but refers responsibility to a citizen agreement which must meet from December.

The Constitutional Council had been seized by the family of a patient, plunged into a coma since May after an accident and whose doctors deem the desperate situation. The medical team at the Valenciennes hospital (North) wishes to stop care – artificial nutrition and breathing -, but this decision goes against the intentions shown by the patient in his “early directives”. These, which consist of a document previously written and signed by the patient, are supposed to testify to his will in case he is no longer able to express a choice.

provisions “nor imprecise neither ambiguous “

But the law provides that the medical team, after a collegial procedure, can overcome if they appear “not in accordance with the patient’s medical situation”. It was on the validity of this law that the council had to decide. He considered that the legislator had been in his role by providing for such a leaving door to doctors, especially because the patient cannot be fully able to assess his situation in an early manner.

The law thus aims to “ensure the safeguard of the dignity of people at the end of their lives”, estimates the Constitutional Council, without going so far as to directly evoke the notion of therapeutic relentlessness. He also judges that the law is sufficiently clear by evoking the case of manifests “manifestly inappropriate” to the patient’s medical situation, while family defenders estimated these too vague terms. “These provisions are neither imprecise nor ambiguous,” says the Council.

also recalling that such a decision was made only after a collegial procedure and that it could be the subject of a “useful use of the family or loved ones , the Council concluded that the legislation in force did not ignore “neither the principle of safeguarding the dignity of the human person nor personal freedom”.

/Media reports.