Bioethical impact of the law on patients' rights and the end of life on the decision to limit and discontinue active therapies as part of the Maastricht category III organ procurement procedure

The shortage of organs is a matter of national public health policy. It is also associated with a social issue as it relates to donation and the end of life. In this context, the extension of the conditions for inclusion of patients in the Maastricht Category III organ procurement procedure offers a new perspective for waiting patients, but also raises questions of health policy strategy in the face of this shortage. It raises concerns about the social relationship with the end of life, and has ethical and moral consequences for medical and nursing practice, in the modification of the social field of death and the paradigm of care that it impacts and transforms. The research will focus on end-of-life legislation, in particular the Clayes-Léonetti law, and its impact on ethics and medical and nursing practice, as well as on the use of the procedure for limiting and discontinuing active therapies in the context of the procedure for multi-organ harvesting after cardiocirculatory arrest in Maastricht category III.
The collegial decision-making procedure remains the most important element of the end-of-life process
The collegial decision-making procedure remains more topical than ever with the forthcoming citizens' convention and the ongoing debate on the end of life. The aim of this thesis project is to examine the relationship between "end-of-life legislation and decisions to limit and discontinue active therapies in the context of the Maastricht Category III organ procurement procedure". More specifically, through an empirical and sociological investigation, the aim is to study the behaviours and discourses of the actors involved. Among other things, the aim is to observe the relationship between intensive care physicians and harvesting surgeons, and more generally to understand how the decision to stop treatment is actually taken, by examining the financial aspects of this type of policy in a context of graft scarcity and increasing budgetary and managerial constraints. In so doing, the aim is to illustrate how healthcare professionals confront the paradox of "ending life while maintaining it in order to preserve organs". A question arises from this: whether one day "intensive care units would be destined to become palliative care areas for organ conservation and maintenance."

Under the direction of David SMADJA.

Link to theses.fr: https://www.theses.fr/s356442