title: [Inadequate involvement of general practitioners in end-of-life's decisions in an intensive care unit].
abstract: Patients' general practitioners (GPs) could be relevant consultants for collegial decisions of withholding or withdrawing treatment (WWT) defined by the Leonetti law. We therefore studied their implication by intensivists in end-of-life decisions and collected their feelings. Their wishes for the coming law revision were also investigated.
  
  
  METHODS
  Retrospective descriptive study conducted in the polyvalent intensive care unit (ICU) of Longjumeau's hospital (France) using a distributed questionnaire to GPs of patients who benefited from collegial decisions of WWT in 2012.
  
  
  RESULTS
  The response rate was 60.4% (32/53) and only 18.8% of the respondents participated as a consultant in WWT's decision for their patient. Two GPs out of three reported that they never participate in such decisions for their others patients. All uninvolved GPs did not contribute because intensivists did not consult them. Only 43.7% of GPs were contacted by intensivists during the stay and 21.9% at the discharge or death of their patient. GPs took news about their patient during ICU hospitalization in 37.5% of cases. Regarding uninvolved GPs, their participation could have changed WWT's decisions made for two patients (7.7%). Most respondents felt available (78.1%) and skilled (81.2 %) to participate in this kind of decision. A third was also questioned by the patient's family about it. Only 21.7% of GPs report to be familiar with the French end-of-life legislation. In case of a next revision, two thirds considered important to make the use of GPs obligatory in such decisions.
  
  
  CONCLUSIONS
  Despite an undeniable interest, GPs are rarely involved in collegial processes of WWT in ICUs, partially related to an insufficient knowledge of the law by the healthcare providers. At the dawn of end-of-life law's revision, their share could however improve our practices in this field.
authors: Centre hospitalier général de Longjumeau, service de réanimation polyvalente, 91160 Longjumeau, France. Electronic address: matthieu.lemeur82@gmail.com.
authors: Matthieu
authors: M
authors: Le Meur
authors: Centre hospitalier général de Longjumeau, service de réanimation polyvalente, 91160 Longjumeau, France.
authors: Laurent
authors: L
authors: Lainé
authors: Centre hospitalier général de Longjumeau, service de réanimation polyvalente, 91160 Longjumeau, France.
authors: Nicolas
authors: N
authors: Roucaud
authors: Centre hospitalier général de Longjumeau, service de réanimation polyvalente, 91160 Longjumeau, France.
authors: Nelly
authors: N
authors: Muller
authors: Centre hospitalier général de Longjumeau, service de réanimation polyvalente, 91160 Longjumeau, France.
authors: Rémi
authors: R
authors: Paulet
authors: Centre hospitalier général de Longjumeau, service de réanimation polyvalente, 91160 Longjumeau, France.
authors: Martial
authors: M
authors: Thyrault
authors: Centre hospitalier général de Longjumeau, service de réanimation polyvalente, 91160 Longjumeau, France.
authors: Jean-Michel
authors: JM
authors: Coudray
authors: Centre hospitalier général de Longjumeau, service de réanimation polyvalente, 91160 Longjumeau, France.
authors: Laurent
authors: L
authors: Montesino
mesh_terms: D001291:Attitude of Health Personnel; D003657:Decision Making; D005260:Female; D005602:France; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D028761:Withholding Treatment / Q000706:statistics & numerical data*