Access to care and the end of life

In 2003, the death of Vincent Humbert marked a real turning point in the end-of-life debate in France and led to the adoption of the Léonetti law of April 22, 2005, prohibiting unreasonable obstinacy, formerly known as "therapeutic overkill". The current legal framework, stemming from the Claeys-Léonetti law of 2016, guarantees every person the right to a dignified and peaceful end of life, and notably enables the implementation of deep and continuous sedation causing altered consciousness maintained until death. While this legislative development has improved the care of patients at the end of life, practice shows that it remains insufficient and too cautious. In some situations, fundamental human rights such as dignity and freedom are not respected. Our country is also seeing an increase in exile to die and clandestine euthanasia. What's more, the provisions in force do not allow us to respond to all medical situations, such as those of patients suffering from degenerative diseases, or to all the requests of patients. As a result, "dying badly" in France is still a reality. Today, in addition to high-profile cases, the proposed law to establish the right to die with dignity has once again placed the issue of medical aid in dying at the heart of public debate. However, end-of-life care suffers from persistent disagreement as to the need for and nature of a new intervention, as well as opposition, particularly from medical and paramedical professionals. Opposition from palliative care professionals is also very marked. And yet, in 2019, 96% of French people were in favor of legalizing euthanasia. Against this backdrop, it seems essential to question the need for a new legislative development to guarantee everyone a dignified and peaceful end of life that is also free and chosen. In this research project, we will take stock of the provisions and means currently in place to support patients at the end of their lives, and ask whether they guarantee respect for the fundamental rights of all people at the end of their lives. We will also consider the possibility of legalizing medical aid in dying, and how this might complement existing provisions, particularly those relating to palliative care.

Under the direction of Johanne SAISON.

Link to theses.fr: https://www.theses.fr/s323324