La souplesse relative des règles relatives à la fin de vie, corollaire d’un objet insaisissable

Abstract

The Claeys-Léonetti law of 2 February 2016 provides a framework for the practice of deep and continuous sedation causing an alteration of consciousness maintained until death (SPCMD). In order to apply this measure, the doctor must implement a collegial procedure and respect certain conditions set out in the legislative provisions, but which are not defined and are therefore subject to interpretation. Moreover, the criteria for inclusion in the so-called “end-of-life” phase are not specified. This flexibility, deliberately chosen by the legislator, seems adapted to the complexity and variety of clinical situations and mobilizes the ethical deliberation of practitioners who must dialogue with the patient to implement an ad hoc medicine. However, this terminological vagueness may result in legal uncertainty and be a source of inequalities in the use of SPCMD. In any case, in order to promote the interests of patients and equal opportunities, it is urgent to reduce territorial inequalities in the provision of palliative care and to provide solid training on the law in force.