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Euthanasia, palliative care and aggressive treatment

Interviewed in Le Monde Edouard Ferrand, anesthetist and a member of several committees of medical ethics, said: "Euthanasia is the wrong answer to a real problem. All the studies show that people die very ill in hospital. [...] Three quarters of patients die alone, without family, accompanied by a caregiver, while the death was foreseeable. [...] The study MAHO (for "Death to the hospital") has showed that 80% of patients who died had symptoms of choking and did not have analgesia or sedation. Three quarters of patients die alone without their families, accompanied by a caregiver, while the death was foreseeable. Caregivers are not trained, the process of palliative physicians is not valued. [...] The surgeries are still performed while the patient had no chance of recovery. The patient is on artificial life support, it is wrong to die without family present. Caregivers find themselves on treating complications complication. However, aggressive treatment is always in good faith, even due to a lack of traceability. Leonetti law is far from being implemented as it should, even though it is a good frame. The legislation includes the possibility for the patient to appoint a trustee, but this is hardly done. The only provision actually translated into practice is the drafting of advance directives (living will of the patient). The improvements are due to changing attitudes, more than the strict application of the law. Leonetti law gives more security forensic doctors to make a decision. The study Latara 2, we shortly present the results shows that caregivers get together more often and in a third of cases, it is for them to continue a therapeutic project. The law rightly provides that families should be consulted. She especially loved the idea of traceability in the medical record of all decisions. We do not do what we can not write. The palliative approach is, by definition, a limitation of movements and actions. However, as this approach is not valued, there is no interest, even economic, to develop. We need the palliative approach, the culture of therapeutic project irrigates all the services and community medicine [...] To say that people die evil does not refer to the question of the right to euthanasia, but the need to improve and evaluate the care of dying [...] Do not make the collegiality quarter of an hour before the patient's death. Caregivers should discuss upstream, sit around a table, knowing the patient's environment, which is what he wanted his story.
There are probably hundreds of patients who, despite the proposed palliative care, loss of sense of dignity leads to a death wish. But this is marginal compared to the real problem of end of life which arises in France. [...] Maybe it's time to address a broader problem: what do we want make health? Do we want to focus on the scanner all the time or otherwise improve the patient's rights in all their forms, which requires adequate? I fear that if there was a law on euthanasia, it obscures the view of the patient's right upstream. "