Repères pratiques sur l'application de la loi Léonetti

The supportive care team of the Loir et Cher and the palliative care unit of the Luynes University Hospital in Tours conducted an analysis of clinical situations where discontinuation of life sustaining treatments were requested by the patient. In France, the law of April 2005 details the legal framework and the practical aspects of the decision making process for such situations. While the law provides the necessary framework, complementary reflection on care practices is needed. Two types of risk can be identified. The first would be to structure the patient-caregiver relationship in such a manner so as to limit it essentially to information delivery within the legal framework allowing application of the law. The second would be to use sedation systematically. To avoid both types of risk, we propose a few practical modalities for healthcare teams. Integrating these points of importance and the will to preserve a vigilant attitude should favour the construction of a better healthcare and supportive approach using tact, creativity, openness, and respect for the individual. This should enable application of the law as an ethical tool for healthcare practices.