title: Opinions about the new law on end-of-life issues in a sample of french patients receiving palliative care.
abstract: BACKGROUND
  In February 2nd 2016, the French government enacted the Claeys-Leonetti law that forbade euthanasia and established the right to deep and continuous sedation for end-of-life patients. Moreover, the law also obliges clinicians to abide by any advance directives regarding treatment and investigation, except in cases where they are "obviously inappropriate" in a given medical situation, or in cases of emergency, in order to allow medical staff to take time to assess the patient's situation. Artificial feeding and hydration are considered as treatment. The aim of this report is to investigate individuals receiving palliative care about their opinion about euthanasia, about advance directives, about the right to deep and continuous sedation, and the right to stopping artificial feeding and hydration.
  
  
  METHODS
  The study was an opinion survey conducted among patients treated in two different palliative care institutions: a palliative care unit at the University Hospital (Timone, Marseille, France) and a non-profit association palliative care home ("La Maison", Gardanne, France). Face-to-face interviews were performed by two investigators. The survey included sociodemographics, clinical data, and opinions about euthanasia, deep and continuous sedation, stopping artificial feeding and hydration, and advance directives.
  
  
  RESULTS
  Forty patients were interviewed. The mean age was 59.8 years (standard deviation 12). Fifty three percent reported opposition to legalized euthanasia. Eighty three percent were in favour of the right to deep and continuous sedation in patients with refractory pain, 75% when it concerns a patient unable to express their wishes, and 68% when the patient decides to stop vital treatment. Fifty eight percent reported that artificial nutrition and hydration should be considered as care. Fifty eight percent of the patients interviewed would like to see doctors follow the express wishes contained in advance care directives and 53% that advance directives should be subject to a validity period.
  
  
  CONCLUSIONS
  This work demonstrates the feasibility of discussing sensitive issues such as euthanasia, continuous and deep sedation and cessation of care with patients receiving palliative care. These preliminary results point to the need to perform a larger study in order to find determinant factors in this specific situation and to incorporate them into thinking about end-of-life laws.
authors.affiliation: Service d'Oncologie Médicale et de soins palliatifs, APHM Timone, Marseille, France.
authors.forename: Augustin
authors.initials: A
authors.lastname: Boulanger
authors.affiliation: Service d'Oncologie Médicale et de soins palliatifs, APHM Timone, Marseille, France. Theo.CHABAL@ap-hm.fr.|Département de médecine générale, Université d'Aix-Marseille, Marseille, France. Theo.CHABAL@ap-hm.fr.
authors.forename: Théo
authors.initials: T
authors.lastname: Chabal
authors.affiliation: Service d'Oncologie Médicale et de soins palliatifs, APHM Timone, Marseille, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Fichaux
authors.affiliation: La Maison, Gardanne, France.
authors.forename: Mireille
authors.initials: M
authors.lastname: Destandau
authors.affiliation: La Maison, Gardanne, France.
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: La Piana
authors.affiliation: Unité d'Aide Méthodologique à la Recherche Clinique et Epidémiologique, AP-HM, Marseille, France.|Self-perceived Health Assessment Research Unit, Aix Marseille Université, EA3279, Marseille, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
authors.affiliation: Unité d'Aide Méthodologique à la Recherche Clinique et Epidémiologique, AP-HM, Marseille, France.|Self-perceived Health Assessment Research Unit, Aix Marseille Université, EA3279, Marseille, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Baumstarck
authors.affiliation: Service d'Oncologie Médicale et de soins palliatifs, APHM Timone, Marseille, France.|Aix Marseille Université, Marseille, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Salas
mesh_terms: D000328:Adult; D016223:Advance Directives / Q000331:legislation & jurisprudence / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D000072716:Cancer Pain / Q000523:psychology / Q000628:therapy; D054810:Deep Sedation / Q000523:psychology; D005065:Euthanasia / Q000331:legislation & jurisprudence / Q000523:psychology; D005260:Female; D005440:Fluid Therapy / Q000523:psychology; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D018529:Nutritional Support / Q000523:psychology; D010166:Palliative Care / Q000331:legislation & jurisprudence* / Q000523:psychology; D013727:Terminal Care / Q000331:legislation & jurisprudence* / Q000523:psychology; D028761:Withholding Treatment / Q000331:legislation & jurisprudence
keywords: Euthanasia; Opinions; Palliative care; Patients