Medical decisions on behalf of others - trusted third party

The trustworthy person scheme was introduced by the Kouchner (2002), Leonetti (2005) and Claeys-Leonetti (2016) laws. This healthcare policy establishes that when a person is unable to express his or her wishes, the doctor has an obligation to enquire about the patient's wishes from third parties. In the absence of advance directives, he or she will obtain the testimony of the trusted support person or, failing this, any other testimony from the family or close friends. This situation of making medical decisions on behalf of others is set to become increasingly prevalent as the population ages and the presence of cognitive disorders increases
The Ehpad is a major arena for medical decision-making on behalf of others by a trusted support person. Indeed, in 2015, 150,000 people residing in Ehpad died, representing a quarter of all deaths recorded throughout France. The aim of this research project is to evaluate the effects of the trusted person mechanism on the quality of care for elderly and dependent patients residing in Ehpad and the well-being of their families.