[Trusted person and living will: information and implementation defect]

Rev Med Interne. 2014 Oct;35(10):643-8. doi: 10.1016/j.revmed.2013.10.331. Epub 2013 Nov 25.
[Article in French]

Abstract

Purpose: The French law allows the persons of age to appoint a trusted person and to draft advance directives in case they are one day in a condition that prevents them from expressing their will regarding their health care. Our study objective was to assess patients' and relatives' knowledge and collecting their opinion regarding these means of expression of their will.

Methods: An anonymous survey by self-administered questionnaire was conducted in the admission offices of the University Hospital of Nancy in April 2011. The questions focused on trusted person and anticipated directives.

Results: We collected 367 answers, 61.8% of which were females. Average age of respondents was 48.7 years old (standard deviation: 15.6). Three fourths of respondents were informed of their possibility to appoint a trusted person and were able to establish the difference between a trusted person and a contact person. Respondents mainly chose their spouse (52%). They thought that the trusted person's opinion takes precedence over the family's or relatives' one (64.7%), given that this opinion is based on indications previously provided by the patient (74.8%). The majority of people surveyed were ignorant of the possibility to draft advance directives but were glad of it (57.5%). They would include herein their refusal of unreasonable obstinacy (75.8%), their wishes to withhold/withdraw of some treatments, to stop active treatments in case of high odds of chronic coma or vegetative state (52.8%) or their will to donate organ after death (50.6%). More than three fourths of the patients wished to include these informations on their health care card chip.

Conclusion: Legal means of expression of the patient's wishes and are not systematically known by the population. The possibility to appoint a trusted person is much more known than that to draft advance directives. After the release in December 2012 of the Sicard report regarding the end of life in France, an important information campaign of the general public remains to be undertaken.

Keywords: Directives anticipées; Droit des patients; End of life care; Fin de vie; Health care proxy; Living will; Patient rights; Personne de confiance.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Advance Directive Adherence* / legislation & jurisprudence
  • Advance Directive Adherence* / statistics & numerical data
  • Awareness
  • Data Collection
  • Female
  • France
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interpersonal Relations*
  • Living Wills* / legislation & jurisprudence
  • Male
  • Middle Aged
  • Patient Admission / statistics & numerical data
  • Surveys and Questionnaires
  • Trust
  • Trustees* / statistics & numerical data