title: [Euthanasia, assisted suicide and palliative care: a review by the Ethics Committee of the French Society of Anaesthesia and Intensive Care].
abstract: BACKGROUND
  Management of the end of life is a major social issue which was addressed in France by law, on April 22nd 2005. Nevertheless, a debate has emerged within French society about the legalization of euthanasia and/or assisted suicide (E/AS). This issue raises questions for doctors and most especially for anesthetists and intensive care physicians.
  
  
  OBJECTIVE
  To highlight, dispassionately and without dogmatism, key points taken from the published literature and the experience of countries which have legislated for E/AS.
  
  
  RESULTS
  The current French law addresses most of the end of life issues an intensive care physician might encounter. It is credited for imposing palliative care when therapies have become senseless and are withdrawn. However, this requirement for palliative care is generally applied too late in the course of a fatal illness. There is a great need for more education and stronger incentives for early action in this area. On the rare occasions when E/AS is requested, either by the patient or their loved-ones, it often results from a failure to consider that treatments have become senseless and conflict with patient's best interest. The implementation of E/AS cannot be reduced to a simple affirmation of the Principle of autonomy. Such procedures present genuine difficulties and the risk of drift.
  
  
  CONCLUSIONS
  We deliver a message of prudence and caution. Should we address painful end of life and moral suffering issues, by suppressing the subject, i.e. ending the patient's life, when comprehensive palliative care has not first been fully granted to all patients in need of it ?
authors.affiliation: Pôle d'anesthésie-réanimation, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France. lbeydon.angers@invivo.edu
authors.forename: L
authors.initials: L
authors.lastname: Beydon
authors.forename: C
authors.initials: C
authors.lastname: Pelluchon
authors.forename: S
authors.initials: S
authors.lastname: Beloucif
authors.forename: H
authors.initials: H
authors.lastname: Baghdadi
authors.forename: A
authors.initials: A
authors.lastname: Baumann
authors.forename: J-E
authors.initials: JE
authors.lastname: Bazin
authors.forename: P
authors.initials: P
authors.lastname: Bizouarn
authors.forename: S
authors.initials: S
authors.lastname: Crozier
authors.forename: B
authors.initials: B
authors.lastname: Devalois
authors.forename: B
authors.initials: B
authors.lastname: Eon
authors.forename: F
authors.initials: F
authors.lastname: Fieux
authors.forename: C
authors.initials: C
authors.lastname: Frot
authors.forename: E
authors.initials: E
authors.lastname: Gisquet
authors.forename: C
authors.initials: C
authors.lastname: Guibet Lafaye
authors.forename: N
authors.initials: N
authors.lastname: Kentish-Barnes
authors.forename: O
authors.initials: O
authors.lastname: Muzard
authors.forename: A
authors.initials: A
authors.lastname: Nicolas-Robin
authors.forename: M O
authors.initials: MO
authors.lastname: Lopez
authors.forename: F
authors.initials: F
authors.lastname: Roussin
authors.forename: L
authors.initials: L
authors.lastname: Puybasset
mesh_terms: D000776:Anesthesiology / Q000941:ethics* / Q000331:legislation & jurisprudence; D003422:Critical Care / Q000941:ethics; D017041:Ethics Committees; D005060:Europe; D005065:Euthanasia / Q000941:ethics* / Q000331:legislation & jurisprudence; D005190:Family; D005602:France; D006801:Humans; D007883:Legislation, Medical; D009922:Oregon; D010166:Palliative Care / Q000941:ethics* / Q000331:legislation & jurisprudence; D010820:Physicians; D012955:Societies, Medical; D017236:Suicide, Assisted / Q000941:ethics* / Q000331:legislation & jurisprudence; D013727:Terminal Care / Q000941:ethics