Messika Jonathan, Boussard Noël, Guérin Claude, Michel Fabrice, Nseir Saad, Yonis Hodane, Barbier Claire-Marie, Rouzé Anahita, Fouilloux Virginie, Gaudry Stephane, Ricard Jean-Damien, Silverman Henry, Dreyfuss Didier
Université de Paris, Infection, Antimicrobials, Modelling, Evolution, IAME, UMR 1137, INSERM, Paris, France.
Service de Réanimation Médico-Chirurgicale, AP-HP, Hôpital Louis Mourier, Colombes, France.
New Bioeth. 2020 Mar;26(1):53-74. doi: 10.1080/20502877.2020.1720421. Epub 2020 Feb 16.
French end-of-life law aims at protecting patients from unreasonable treatments, but has been used to force caregivers to prolong treatments deemed unreasonable. We describe six cases (five intensive care unit patients including two children) where families disagreed with a decision to withdraw treatments and sued medical teams. An emergent inquiry was instigated by the families. In two cases, the court rejected the families' inquiries. In two cases, the families appealed the decision, and in both the first jurisdiction decision was confirmed, compelling caregivers to pursue treatments, even though they deemed them unreasonable. We discuss how this law may be perverted. Legal procedures may result in the units' disorganisation and give rise to caregivers' stress. Families' requests may be subtended by religious beliefs. French end-of-life law has benefits in theoretically constraining physicians to withhold or withdraw disproportionate therapies. These cases underline some caveats and the perverse effects of its literal reading.
法国临终关怀法旨在保护患者免受不合理治疗，但却被用来迫使护理人员延长被认为不合理的治疗。我们描述了六个案例（五名重症监护病房患者，包括两名儿童），在这些案例中，家属不同意停止治疗的决定，并起诉了医疗团队。家属发起了紧急调查。在两个案例中，法院驳回了家属的调查请求。在另外两个案例中，家属对该决定提出上诉，并且在两个案例中，一审判决均得到维持，迫使护理人员继续进行治疗，尽管他们认为这些治疗不合理。我们讨论了这项法律可能如何被滥用。法律程序可能导致科室混乱，并给护理人员带来压力。家属的请求可能有宗教信仰的支撑。法国临终关怀法在理论上有助于约束医生停止或撤销过度治疗。这些案例凸显了一些注意事项以及对其字面解读的不良影响。
