End of life and the person's wishes

The subject of the end of life and the person's will raises the delicate ethical and legal questions of society's handling of death and the possibility for every person to freely dispose of their body.

The law recognizes that "every person makes, with the healthcare professional and taking into account the information and recommendations he or she provides, decisions concerning his or her health. Every person has the right to refuse or not to receive treatment (...). The doctor is obliged to respect the person's wishes after informing him or her of the consequences of his or her choices and of their seriousness."[1] .From now on, the relationship between patient and doctor is one that is rooted in the affirmation of shared information and respect for the person's wishes by the doctor. Thus, according to Henri Oberdorff, we have moved from "the sick citizen" to "the sick citizen"[2].

The observation of greater autonomy granted to the person receiving care by the law is clear, for all that, in the event of the end of life, does this person have the right to dispose of his or her life? Can they decide when to die? How to end their life?

These questions are encountered mainly in healthcare establishments, which are then faced with end-of-life patients in the sense of article L.1110-5-2 C. santé pub. i.e. a "patient suffering from a serious and incurable condition whose vital prognosis is engaged in the short term"In these highly medicalized care arrangements within hospitals, what place is given to the person's will in the face of increasingly high-performance medical techniques and the doctor's knowledge?

How do we strike a balance between life and survival, between curative and palliative care, between continued treatment and unreasonable obstinacy? In this fragile balance how can we reconcile acts of prevention, investigation, treatment and care while respecting the person's wishes?

The debate on the end of life and the person's will to choose the conditions of his or her end of life is a debate that goes beyond the borders of France. Should anyone suffering from an incurable disease be given the power to dispose of their life by requesting active assistance in dying, through euthanasia or assisted suicide? As the law currently stands, the only way to dispose of one's life without incurring criminal penalties is suicide. Is suicide the only way to freely express one's will?

France, unlike other European countries such as the Netherlands or Belgium, does not authorize assisted suicide or euthanasia. Questions relating to the end of life are found around the law of February 2, 2016[3], which creates a "casuistic right" whose main objective is to guarantee a dignified and appeased end of life without falling under the criminal qualification of murder or assassination. Thus we find the right to refuse all unreasonable obstinacy, the right to refuse all treatment including nutrition and rehydration, the right to request the limitation, suspension or cessation of treatment, and the right to request deep and continuous sedation until death. Can we speak, in this case, of "droit du mourant"[4]?

Project objectives:

• To determine the place given to the will of the hospitalized person at the end of life.

• Determining the place given to the will of the person at the end of life in the face of increasingly high-performance medical techniques and the doctor's knowledge
• How to reconcile the right to life and the refusal of care

• Defining the different ways of expressing the wishes of people at the end of life

• Determine the effectiveness of the lo idu February 2, 2016 within healthcare establishments.

Under the direction of Marion GIRER, at the Groupe de Recherche Appliquée Pluridisciplinaire sur l'Hôpital et les Organisations de Santé (GRAPHOS, EA 4588).

Link to theses.fr: https://www.theses.fr/s259091

[1] Article L.1111-4 C. santé pub.

[2] OBERDORFF (H), Droits de l'homme et libertés fondamentales, LGDJ, 2019, 732 p., p. 466.

[3] Loi n° 2016-87 du 2 février 2016 créant de nouveaux droits en faveur des malades et des personnes en fin de vie. JORF n° 0028 of February 3, 2016.

[4] In the words of PY (B), Pratiques médicales de fin de vie : aspect pénal, in Fin de vie et droit pénal, Le risque pénal dans les situations médicales de fin de vie, Editions Cujas, 2014, 190 p., p.58.