Législation et fin de vie : l'exemple de la réanimation

The period of end-of-life is more and more medicalized. The intensive care units (ICU), which by definition are specialized in the management of serious organ failures, are particularly concerned by this evolution. The ICU medical staff and nurses are then confronted with heavy decisions, in particular when it acts of therapeutic abstention. The debate is very difficult to structure because it gathers various aspects: philosophical and religious considerations, ethical dilemmas but also variability in practices, elusive knowledge of patient's wishes, poor communication… A legal framework, which joins it, until now, could define neither the rights of the intensivists, nor those of the patient. The recent proposal for a law to the French national Assembly answers to the request of a regulation adapted to the problem of the end-of-life, with a double objective: to protect the patient and to provide medical practice guidance in end-of-life cares.