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Master Thesis

La « faim » de vie en Oncologie. Représentations de la fin de vie en Oncologie et étude des pratiques médicales chez les médecins oncologues médicaux et exerçant les soins palliatifs

Abstract : Prescriptions for specific active therapies such as chemotherapy increase at the end of life. However, some studies show that concomitant palliative management and often leading to oncological therapeutic abstention increases the survival time and quality of life of patients. The concept of end-of-life, which is widely used in the literature and is entitled to several laws, is not clearly defined at the legislative level. What is the end of life in Oncology? The main objective of our work was to define the notion of end of life through the study of the representations of physicians oncologists and practicing palliative care and its implementation in the exercise of the medical function. A qualitative study was conducted in the Pays de la Loire region using 14 semi-structured interviews from January 2019 to March 2019. The interviews were recorded and analyzed according to a so-called thematic content analysis. The end of life is a complex notion that could not be defined in a consensual and unique way. Two end-of-life concepts have been established: the end of life "objective" and the end of life "subjective". These two concepts made it possible to establish two decision models for stopping active oncology therapeutics. The "objective" end of life was not precisely defined but referred to the clinico-biological approach to death, the accumulation of arguments or evidence in favor of the inevitability of death and decreasing the prevailing medical uncertainty. The end of life "subjective", meant the understanding of the near death and by these multiple representations it shaped the sense of the medical actions. This work sheds additional light on the notion of end-of-life, highlighting the integration of a subjective personal component subject to numerous representations to rational medical practice based on validated knowledge and skills.
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Master Thesis
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Marie Coudert. La « faim » de vie en Oncologie. Représentations de la fin de vie en Oncologie et étude des pratiques médicales chez les médecins oncologues médicaux et exerçant les soins palliatifs. Ethique. 2019. ⟨dumas-02394480⟩

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