2024-03-11 17:00:18
In the field of end of life in France, all attention is currently being paid to the creation and modalities of a law concerning active assistance in dying. This is a crucial decision, but it is not enough to account for the complexity of the different care pathways. The specificity of the end of life of elderly people invites us to question their support, emphasizing the usefulness of a case-by-case and multidisciplinary reflection.
In old age, in fact, it is extremely difficult to know how quickly the vital prognosis is engaged. With good support, people can live for several years without a worrying acute episode. A fall, a lung infection, dehydration? Nothing that medicine cannot easily solve. This long time breaks with the usual limits between « end of life”, to be embellished as much as possible, and the “end of life”, to be recognized in order to better support it. Especially since people’s cognitive slowdown can make them doubt their words, making the assessment of their suffering perilous.
In countries where active assistance in dying is authorized, the law does not take this geriatric specificity into account. To be eligible for this assistance, you must have a life-threatening medical problem and/or unbearable suffering. Even in countries where elderly people can access it – either on the grounds of a serious and incurable pathology (in Belgium), or by having written advance directives for the day when they are no longer capable of making choices for themselves – same (in the Netherlands) – no legislation allows people to be actively helped to die just because they are “tired of living”. Furthermore, no law can assure an individual that their request, even legal, will be fully respected.
If their death was like them
Neither the laws nor the recommendations for good practice therefore exhaust the need to think on a case-by-case basis. This imperative is all the greater because patients’ expectations are not always easy to take into account.
Take the case of Jacques, 95 years old. Vision and walking problems, beginning cognitive problems, his condition prevents him from living the way he wants. He rejects the idea of ending his life as a dependent in a nursing home, where he had to go. He decides to implement a deep desire, declared several times to those around him, to go to Switzerland to obtain an assisted suicide. The caregivers around him do everything they can to dissuade him and get him used to his new life. The certificate requested by Switzerland to study its request was initially refused. Jacques ends up giving up on this project, and dies a few months later without being able to choose the conditions of his end of life.
You have 53.97% of this article left to read. The rest is reserved for subscribers.
1710178388
#casebycase #imperative #greater #expectations #elderly #patients #easy #account
