Modot Matthieu, Rougé-Maillart Clotilde
LUNAM, université d'Angers, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 09, France.
LUNAM, université d'Angers, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 09, France; LUNAM, université d'Angers, UFR de droit, centre de recherche juridique et politique Jean-Bodin, UPRES EA 4337, 49933 Angers, France; LUNAM, CHU d'Angers, institut de biologie en santé, GEROM UPRES EA 4658 IRIS-IBS, 49933 Angers cedex 09, France.
Presse Med. 2018 Apr;47(4 Pt 1):375-383. doi: 10.1016/j.lpm.2018.03.004. Epub 2018 Apr 12.
The care of persons placed under guardianship has changed considerably since the law of March 5, 2007, as greater autonomy is granted to them. By advocating greater autonomy of protected adults, the French Civil Code is in opposition with the French Public Health Code since the latter states that the systematic consent of the guardian is required in addition to that of the protected adult for so-called general care. In cases of serious injury to bodily integrity, the guardianship judge's opinion must be sought by the guardian. For some specific medical procedures (medically assisted procreation, abortion, etc.), the consent of the guardian does not seem necessary. A protected adult can now, if he/she is able to understand the information, with the agreement of the guardianship judge or the family council, appoint a trusted person and draft advance directives without possible representation by the guardian. The legislator promotes greater autonomy while not neglecting their protection. It also helps relieve the guardian, who is generally trained in asset management, of sometimes difficult medical decisions. Harmony between the Civil Code and the Public Health Code seems essential so as to move towards greater autonomy of the person under guardianship in the care relationship.
自2007年3月5日法律颁布以来,被监护人员的照护情况发生了很大变化,因为他们被赋予了更大的自主权。法国《民法典》主张被保护成年人享有更大自主权,但这与法国《公共卫生法典》相悖,因为后者规定,对于所谓的一般照护,除了被保护成年人的同意外,还需要监护人的系统性同意。在身体完整性受到严重伤害的情况下,监护人必须征求监护法官的意见。对于某些特定的医疗程序(医学辅助生殖、堕胎等),监护人的同意似乎并非必要。如果被保护成年人能够理解相关信息,在监护法官或家庭委员会同意的情况下,他/她现在可以指定一个值得信赖的人,并起草预先指示,而无需监护人代理。立法者在促进更大自主权的同时,也不忽视对他们的保护。这也有助于使通常在资产管理方面受过培训的监护人免于做出有时很困难的医疗决定。《民法典》与《公共卫生法典》之间的协调一致对于在照护关系中朝着被监护人员更大的自主权迈进似乎至关重要。