Rôle de facilitateur en éthique dans la qualité de la concertation collégiale

The Leonetti law, which is a remarkable legal frame for medical practice, forces thinking about the proportionality of care. In a certain amount of situation, that would need to be extended the medical decision has to be taken after collegial process. It is necessary to give this approach an ethical dimension so it is not reduced to a sham. Looking for the best possible decision in a particular situation has to take into account interdisciplinary and quality dialogue. This has to be accompanied by the creation of alternatives, which have to be backed up by arguments. That kind of ethical approach leads to an independent way of thinking by the staff as a team. The transformation of this practice has to consider the expectations of both the actors and an ethics facilitator. During these meetings, the facilitator supports the ethical concern of this exercise. This person must be aware of the stakes of this job but also the skill, knowledge and character that are needed. The facilitator carries and notifies this demand of quality. The mission of the facilitator is to develop a habit of debate but also to suggest ideas and arguments. It is a new practice which requires to become acquainted with the main topics of different dilemmas that we come up against during complex decision-making.