Comment améliorer les connaissances des praticiens de demain au sujet de la loi du 22 avril 2005 relative aux droits des malades et à la fin de vie ? Enquête auprès de 20 internes

The law of April 22nd, 2005 relative to the rights of the patients and at the end of life, said “law Leonetti”, registered in a legal framework the rights and the duties of the patients and the doctors who have responsibility by specifying the status and the roles of the reliable person, the early directives, the refusal of the unreasonable stubbornness, the principle of decision-making corporatism as well as the use of the therapeutic, in certain cases, to shorten the time of life. It also defines the decision-making approach to be followed according to the clinical state of consciousness of the patient. We wondered about the knowledge of the students about this law. From 20 half-managed interviews led by students of different specialities from universities of Bordeaux and Poitiers, the declarative, procedural and conditional knowledge relative to this law were studied. It seems that these knowledge are insufficient and that the students wish a training, more based on a practical learning of the palliative care. The interpretation of the results, in the educational domain, allows to understand the necessity of a good joint of the learning of the declarative, procedural and conditional knowledge, so allowing the student to acquire the theoretical basic principles of the palliative practice as well as the skills necessary for the bed of the patient; to understand that the teaching has to set the theory and the practice by means of hospitable training courses, but also of pluri-professional readings of the law of April 22nd, 2005. From the results and their analysis, recommendations are proposed. They include methods of learning of the palliative care in the university program with a practical training, associating hospitable training courses with trade guilds and works of reflections in groups, a teaching integrating the main ethical questions which underlie the palliative practices and finally, the use by the students of two brochures intended to give them marks in the decision-making initiatives.