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Master Thesis

Les directives anticipées en neuroréanimation : l’éthique de conviction du médecin en difficulté

Abstract : Advance directives participate empower patients in their medical care and respect their will. Despite their existence since 2005, they are still rarely written by citizens. Except for the context of a chronic illness, they require a projection and anticipation of his life on a situation unknown at the time of writing. The clinical physician may disagree with advance directives and hesitate between personal conviction and medical responsibility. How is decision-making organized when the application of an advance directive is not suitable to the doctor? This single-center qualitative study was carried out in April 2021 with semi-structured interviews. They were carried out with several caregivers in an intensive care unit in order to question them about their feelings about advance directives in intensive care. The main results collected show that clinical physician are in constant uncertainty in an emergency situation and do not integrate advance directives initially. They are considered secondly but are imprecise and do not integrate resilience. Moreover, the handicap is not equated with an unsatisfactory quality of life by the doctors who therefore try their best to save the patient's life. But each decision taken is always with the objective of finding the best possible solution for the patient without give up their personal ethics. Advance directives are therefore not embodied and not followed in intensive care because they do not appropriate in emergency and do not integrate the adaptive capacity of each person. The human relationship is essential between doctor and patient and if it is impossible, the doctor can only make a decision in accordance with his personal conviction.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03575186
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Submitted on : Monday, February 21, 2022 - 5:07:28 PM
Last modification on : Thursday, April 7, 2022 - 2:28:02 PM

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  • HAL Id : dumas-03575186, version 1

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Caroline Tabillon. Les directives anticipées en neuroréanimation : l’éthique de conviction du médecin en difficulté. Ethique. 2021. ⟨dumas-03575186⟩

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