a doctor can go against advance directives from patients, rules the Constitutional Council

Advance directives are not everything. The Constitutional Council confirmed Thursday, November 10 that a doctor can dismiss the advance directives written in advance of a patient. This document, which everyone can decide to write, allows a person to specify how much they wish to be kept alive, in case they find themselves one day unable to express their choice.

This decision comes as Emmanuel Macron spoke last summer of a change in end-of-life legislation. The Head of State has set up a Citizens’ Convention, which is to meet from December, in order to make proposals.

The council said “in accordance with the Constitution” the legislative provisions that govern the “advance directives”. He wholeheartedly endorsed the 2016 law, which gives doctors the right to ultimately choose. Thus, directives no longer apply if they appear “inappropriate or not in accordance with the patient’s medical situation”.

For the Elders, the legislator is in its role by providing such a way out for doctors, in particular because the patient cannot be fully able to assess his situation upstream. The law aims to “ensure the preservation of the dignity of people at the end of life”believes the Constitutional Council, without going so far as to directly mention the notion of therapeutic relentlessness.

The Council had been seized by a family of a patient from Valenciennes (North), plunged since May into a coma after an accident. The family opposes the doctors, who consider her situation hopeless. The medical team wishes to stop the care (nutrition and artificial respiration), but this decision goes against the intentions expressed by the patient in his directives.

The board also considers that the law is sufficiently clear by referring to the case of directives “manifestly inappropriate” to the patient’s medical situation. Family advocates felt these terms were too vague.