title: [Refractory sufferings at the end of life: Which considerations, which propositions?].
abstract: Refractory suffering of terminally ill people may be physical (pain, dyspnea, vomiting...) or existential (spiritual sufferings, anxiousness...). End-of-life decisions are often around ethics. Decision making near the end of life consists in witholding and withdrawing life-support treatment and prescribing both of treatments with risk of double effect and sedation for distress. In France, such decisions are defined by the deontology code and by the law of April 22nd, 2005 concerning the end of life and patients' rights. Recommendations from medical societies specify the means of implementation: obtaining other medical opinions, the patient's informed consent and full transparency of the decision (noted in the patient's medical chart).
authors.affiliation: CHU Charles-Nicolle, unité régionale de soins palliatifs, 76031 Rouen, France. clemence.joly@chu-rouen.fr
authors.forename: Clémence
authors.initials: C
authors.lastname: Joly
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Ghazi Elie
authors.forename: Eric
authors.initials: E
authors.lastname: Maillet
authors.forename: Didier
authors.initials: D
authors.lastname: Hannequin
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Guédon
mesh_terms: D000328:Adult; D032722:Advance Care Planning / Q000941:ethics* / Q000331:legislation & jurisprudence; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000009:adverse effects; D016292:Procedural Sedation / Q000941:ethics; D003299:Cooperative Behavior; D028663:Ethical Theory; D004992:Ethics, Medical; D005260:Female; D005602:France; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D033183:Interdisciplinary Communication; D008020:Life Support Care / Q000941:ethics / Q000331:legislation & jurisprudence; D018447:Medical Futility / Q000941:ethics / Q000331:legislation & jurisprudence; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects; D010146:Pain; D010166:Palliative Care / Q000941:ethics / Q000331:legislation & jurisprudence; D013315:Stress, Psychological; D017236:Suicide, Assisted / Q000941:ethics / Q000331:legislation & jurisprudence; D013727:Terminal Care / Q000941:ethics* / Q000331:legislation & jurisprudence; D028761:Withholding Treatment / Q000941:ethics* / Q000331:legislation & jurisprudence
chemical_list: D014151:Anti-Anxiety Agents; D009294:Narcotics