The law of February 2, 2016, and the decree of August 3, 2016, establish new rights for patients and individuals at the end of life. This legislation allows every adult citizen to express their wishes regarding end-of-life care, whether they are healthy or ill.
In practical terms, the law aims to better respond to the desire to die with dignity by improving the management of suffering and clarifying the use of deep and continuous sedation until death in terminal phases.
The law also reinforces the importance of the patient’s expressed wishes in the decision-making process, particularly their “previously expressed wishes.”
Advance directives are now legally binding for physicians. However, a doctor may choose not to follow them if they are deemed “clearly inappropriate” or in cases of “vital emergency.” In the absence of advance directives, the medical team will consider the patient’s wishes as conveyed by the trusted person, or if unavailable, by any family member or close relative.
The law confirms the right to refuse, not to receive, or to discontinue treatment in cases of unreasonable therapeutic persistence.
The legislation allows every adult citizen to express their wishes regarding end-of-life care, whether they are in good health or ill. In practical terms, the law aims to better respond to the desire to die with dignity by improving the management of suffering and clarifying the use of deep and continuous sedation until death in terminal phases.
The law also reinforces the importance of the patient’s will in the decision-making process, particularly their “previously expressed wishes.”
Advance directives are written statements in which an adult expresses their wishes in the event that they are no longer able to communicate them (e.g., unconsciousness, coma, severe acquired cognitive disorders), especially regarding end-of-life care (conditions for continuing, limiting, stopping, or refusing treatment or medical procedures). These directives can be revised or revoked at any time and by any means by the person concerned.
To be taken into account, advance directives must be accessible. Depending on the individual’s choice, the document may be placed in the general practitioner’s file, in the patient’s hospital medical record, or entrusted to a trusted person, a family member, or a close friend. It is important that the patient informs the medical team of the existence of such directives upon hospital admission.
Advance directives take precedence over any non-medical opinion, including that of the trusted person or family members.
To Help You Write Your Advance Directives
The French National Authority for Health (Haute Autorité de Santé – HAS) provides a public guide titled “Why and how to write my advance directives”, along with templates to help you express your wishes.
You can access it here: https://www.has-sante.fr/jcms/c_2619437/en/advance-directives-concerning-end-of-life-situations.
A form is available from the healthcare teams if you wish to complete it before or during your hospital stay.
The Clermont-Ferrand Ethical Reflection Group (Groupe de Réflexion Éthique Clermontois – GREC) is also available to support and guide you on this topic.
Practical Guide: How to Write Your Advance Directives
Clermont-Ferrand Ethical Reflection Group – GREC
The GREC is also available to support you on this topic.
It is located in the General Directorate building (Place H. Dunant, Clermont-Ferrand).
To contact them:
04 73 75 24 54 or 04 73 75 10 47
espace.ethique@chu-clermontferrand.fr
Go to ereara.com
The law of March 4, 2002 allows you to freely designate, in writing, a person of your choice, known as a “trusted person,” who may, according to your wishes, accompany you through all hospital procedures and assist you during medical consultations to help you make decisions.
This written designation, co-signed by the designated person on a document provided by the University Hospital (CHU), is valid for the entire duration of the hospitalization, unless you decide otherwise. A form is available at the end of this booklet if you wish to complete it before your hospital stay.
Upon admission to the hospital, you will also be asked to provide the name of a person to contact in case of need. This person may be different from your trusted person.
