[Withholding and withdrawal decisions in oncology: legal frame and practice].
Whereas medicine is progressing in illness treatment that used to be incurable, physicians are still faced with treatment failure. Hippocrates used to say: "primum non nocere" [1]. When the patient cannot expect benefit from potentially aggressive care, current or possible treatments have to be challenged to leave just the ones giving immediate benefice. To determine a legal frame and to protect people in the end of life, law n degrees 2005-370 concerning to the rights of ill people and end of life was declaimed during April 2005. After presenting a clinical course illustrating a situation of difficult end of life, we propose an introduction point by point of the law, opposing practical situations to law and medical deontological code. Withholding and withdrawal decisions theme is taken by the standpoint of the doctor initiating this thought, the patient request, and the case of patient who cannot express his will.
Laude
Cécile
C
Oncologie radiothérapie, hospices civils de Lyon, Lyon, France. ceciliaude@hotmail.com
Deygas
Serge
S
D001254:Astrocytoma / Q000532:radiotherapy; D001932:Brain Neoplasms / Q000532:radiotherapy; D018450:Disease Progression; D005190:Family; D005602:France; D006801:Humans; D008297:Male; D018447:Medical Futility / Q000331:legislation & jurisprudence; D008495:Medical Oncology / Q000331:legislation & jurisprudence*; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010358:Patient Participation; D016079:Refusal to Treat / Q000331:legislation & jurisprudence*; D013727:Terminal Care / Q000331:legislation & jurisprudence*; D028761:Withholding Treatment / Q000331:legislation & jurisprudence*