Acharnement thérapeutique : que faire pour éviter la mise en route d'un traitement déraisonnable ? (podcast)

The unreasonable obstinacy, defined as the initiation or pursuit of an unreasonable treatment, is likened to a morally reprehensible maleficent act. Law no. 2005-370 of April 22nd, 2005 relative to the rights of patients and on the end of life made it illegal. When the informed patient is not capable any more of expressing his preferences, our problem consists in deciding what defines, individually, the unreasonable obstinacy. The decision owes hold one of the two following options: (1) to start or to pursue a treatment; (2) not to start or to limit or to stop a treatment. How to make the good decision, or at least the least bad? Having reminded briefly the legal framework, we shall detail the usual decision-making process. Clearly, our decisions are not only rational. The knowledge of the role of our emotions can allow us to prevent some mistakes, especially during emergency. The collective procedure, when it is available, is an additional countermeasure, by mobilizing the collective system of more reasonable slow thought. Then, the decision emerges from an effective rational procedure, which warrants it, including in case of limiting or interrupting a considered unreasonable treatment.