2024-04-25 08:30:15
We, palliative care professionals engaged in their teaching in France and invested in research, are shaken by the bill relating to the support of patients at the end of life, and particularly by the proposal to rename palliative care “care of ‘accompaniement “. What might appear as a minor semantic development has, on the contrary, worrying implications for the development of palliative care and patient care.
Palliative care, widely developed worldwide, is defined by the World Health Organization (WHO) as “a multidisciplinary approach aimed at improving the quality of life of patients and their loved ones facing a serious illness. They aim to prevent and relieve physical, psychosocial or existential suffering, to provide care in accordance with patients’ preferences and to anticipate crisis and emergency situations, sometimes as soon as a serious illness is diagnosed.. Palliative medicine cannot be reduced, as the bill suggests, to a simple “medical management of pain at the end of life”.
Support is a polysemous notion, used in various fields such as education, justice and management. It evokes a presence with others, attention to the person, listening without judgment, without specific intention other than to provide human support. The support posture, which is part of our approach, as in other disciplines, is distinct from care.
Indeed, the latter implies an active approach, with an intention to meet the needs of the person. This requires technical, relational and ethical skills acquired through diploma courses and evaluable according to known and published quality criteria. The caregiver takes responsibility and puts his knowledge at the service of the patient, in a shared decision-making process.
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The naming proposal “supportive care” put forward by Professor Franck Chauvin and presented to the Minister of Health on December 11, 2023, leads to deplorable confusion. It does not result from our initiative or from scientific data, and is not used in any other country.
The implementation of the bill, currently under discussion, requires a significant financial investment from the State. This funding is in line with the recommendations of the end-of-life citizens’ convention, in 2023, which advocates the development of palliative care provision. The redefinition of “supportive care” would open the door to abuses which would include in this financing initiatives having no link with palliative care.
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