title: [The surrogate: Partner in the shared decision-making].
abstract: The legislative process of the surrogate appears to be unclear to health professionals and to patients and next of kin. To better adapt this process to the clinical practice our objective was here to document how the persons designated as surrogate perceived their role and how they described the difficulties encountered in oncology.
  
  
  METHODS
  Qualitative survey with an ethnographic approach carried out in 2014-2015, fieldwork, face-to-face interviews (n=26 including 20 surrogates and 6 patients) in a mobile palliative care unit located at a Regional Comprehensive Cancer Centre.
  
  
  RESULTS
  Close relationship, psychological and cognitive competences were the main attribute to designate a surrogate. Perceived roles included the fact to be involved in decisions, to protect the patient, to be present, and to be a messenger. This process gives the next of kin the feeling to be part of the patient management. In the context of divorced families, it sometimes allows to rehabilitate and to reinforce the affective links. Our data highlight the confusion between the designation of the 'person to call' and 'the surrogate'.
  
  
  CONCLUSIONS
  Our results highlight the 'surrogate' protective role of the patient, and the positive sides of the process, in particular in the context of divorced/rebuilt families. We recommend splitting the process to designate the 'person to call' and the 'surrogate', as administrative and medical duties, respectively.
authors.affiliation: SESSTIM, UMR912 Inserm-IRD-AMU, 232, boulevard Sainte-Marguerite, BP 156, 13273 Marseille cedex 9, France. Electronic address: aline.sarradon@inserm.fr.
authors.forename: Aline
authors.initials: A
authors.lastname: Sarradon-Eck
authors.affiliation: Institut Paoli-Calmettes, 232, boulevard Sainte-Marguerite, BP 156, 13273 Marseille cedex 9, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Capodano
authors.affiliation: SESSTIM, UMR912 Inserm-IRD-AMU, 232, boulevard Sainte-Marguerite, BP 156, 13273 Marseille cedex 9, France.
authors.forename: Eve
authors.initials: E
authors.lastname: Bureau
authors.affiliation: SESSTIM, UMR912 Inserm-IRD-AMU, 232, boulevard Sainte-Marguerite, BP 156, 13273 Marseille cedex 9, France; Institut Paoli-Calmettes, 232, boulevard Sainte-Marguerite, BP 156, 13273 Marseille cedex 9, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Julian-Reynier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005191:Family Characteristics; D005260:Female; D033062:Friends / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care; D010344:Patient Advocacy; D036301:Qualitative Research; D012380:Role; D035502:Trust
keywords: Droit du patient; Ethnographie; Ethnography; Palliative care; Patient's right; Personne de confiance; Soins palliatifs; Surrogate