title: Consequences of brain damage in the public debate regarding the end of life. The mediatic prism: a reflection of reality?
abstract: For the last 20 years or so, conflicts on life-support have become the object of widespread media coverage. By focusing public opinion on the alleged physicians' unreasonable obstinacy, these publicized cases impact social debates on life-support. By these, they justify claims for the legalization of assisted suicide, specifically the practice of termination of life by lethal injection. Via a conducted survey of the various caretakers and families involved in this type of situation, we propose an analysis based on the different forms of unreasonable obstinacy. The reasonable or unreasonable nature of treatments can often be perceived differently by physicians, caretakers and families. At least 6 unreasonable obstinacy cases can be brought to light. Publicized cases always involve a conflict between the physicians in charge and the families who view the situation as unreasonable. Nonetheless, evidence shows that in these situations, the roles are often reversed, and the families are the ones demanding the use of unreasonable care. A typical example of this is a recent case that became the object of legal proceedings in France. As it turns out, the publicized filter does not reflect the true reality of cases involving unreasonable care. Specific procedures could aid in notifying the existence of such situations. The role of health care professionals (excluding physicians) appears to play an essential part in preventing these situations from happening.
authors.affiliation: Service de médecine palliative, centre hospitalier René-Dubos, 6, boulevard de l'Ile-de-France, 95300 Pontoise, France. Electronic address: bernard.devalois@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Devalois
mesh_terms: D001293:Attitude to Death; D001925:Brain Damage, Chronic / Q000150:complications; D017028:Caregivers / Q000523:psychology; D003244:Consciousness Disorders / Q000209:etiology; D034462:Dissent and Disputes; D005065:Euthanasia / Q000941:ethics / Q000331:legislation & jurisprudence; D005602:France; D006801:Humans; D008402:Mass Media; D018447:Medical Futility / Q000941:ethics; D010361:Patients / Q000523:psychology; D010820:Physicians / Q000523:psychology; D011368:Professional-Family Relations; D011639:Public Opinion; D017236:Suicide, Assisted / Q000941:ethics / Q000331:legislation & jurisprudence; D013727:Terminal Care / Q000941:ethics / Q000331:legislation & jurisprudence; D020458:Third-Party Consent / Q000331:legislation & jurisprudence; D028761:Withholding Treatment / Q000941:ethics / Q000331:legislation & jurisprudence
keywords: Life-sustaining treatment; Limitation ou arrêt de traitement; Maintien artificiel en vie; Medical futilities. Altered conscious state; Obstination déraisonnable; Withdrawing; Withholding; États de conscience altérée