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Master Thesis

Information des patients par les médecins, en oncologie, sur le droit à demander une sédation profonde et continue maintenue jusqu’au décès

Abstract : In 2016, the so-called "Claeys-Leonetti" law, creating new rights for patients and persons at the end of their lives, was promulgated and introduced the notion of deep and continuous sedation maintained until death subject to conditions, in particular to be implemented at the request of the patient, if this one is suffering from an incurable disease, with refractory suffering and a vital prognosis initiated in the short term. In addition, in oncology, physicians are very often confronted with the management of the end of the life of their patients, who are able to express their wishes most of time. Our study focus on the information given to patients by oncology physicians about the possibility of deep and continuous sedation maintained until death (DPCSMD), subject to conditions. The main hypothesis of this work is that oncologists and palliative care physicians rarely provide information to the patient about the possibility of DPCSMD. Qualitative research, using semi-structured interviews with oncologists and palliative care physicians, was conducted between January and March 2019. In order to capture a variety of enough important practices, physicians from different types of centers were interviewed (UHC, cancer center, for-profit center, non-profit hospital center). Twenty-four physicians were contacted by email, five of them did not answer to the email, and thirteen physicians were interviewed, including ten oncologists and three mobile palliative care team physicians. This survey shows that according to physicians, the information provided to the patient about the possibility of a DPCSMD is perceived differently. For the large majority, information about DPCSMD should be relevant to a minority of patients and it is up to the physician to assess the relevance of providing this information. Others believe that information on DPCSMD should be wider and systematically provided in a clear, fair and appropriate way to all patients with incurable cancer, so that they can decide whether to use it or not, if the conditions of the law are met. Most doctors in Medecine indicate that giving this information before the so-called "refractory suffering” would be preferable.
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Master Thesis
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Noémie Claudon. Information des patients par les médecins, en oncologie, sur le droit à demander une sédation profonde et continue maintenue jusqu’au décès. Ethique. 2019. ⟨dumas-02390114⟩

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