Le médecin face au malade en fin de vie : enquête auprès du corps médical sur la formation aux soins palliatifs et l'accompagnement des malades en fin de vie

Until recently, the lack of training in the care of the terminally ill in the medical curriculum contrasted with the first months of experience in medical wards. We wanted to learn more about the patient-physician relationship in end-of-life situations. Historically, death was a common feature of human experience familiar to all. Attitudes evolved progressively towards comprehension then rejection leading to the current situation where death is taboo. We conducted a survey concerning 181 emergency unit patients who died within 72 hours of their admission to the Clermond-Ferrand university hospital. Among these patients, we identified 19 who had terminal cancer which was the reason for their referral to hospital. This observation led us to reconsider the role of physicians in the end-of-life situation. We sent 576 questionnaires and received a response for 70%. We found that physicians were insufficiently trained in palliative care and often had difficulty managing these patients. Many expressed a desire for training. The recent introduction of palliative care training in the medical curriculum is a first step. Awareness of the reality of death, by physicians and the society in general, is an indispensable corollary for advancing towards a more serene approach to accompanying the terminally ill.