This survey is performed to examine if during the Covid's crisis, the practitionner's have respected the modalities of the law about the end of life, in particular concerning limitations and stop of therapeutics
In the current legislativ context notably the Clayes Leonetti law, a very large majority of
ICU (Intensive Care Unit) patients die with the establishement of a procedure for the
limitation and cessation of therapeutics (LAT). During a viral pandemic, medical resources
can be saturated, limiting reflexive abilities in favour of binary decisions. This sorting of
patients leads to LAT that could be performed without the elementary modalities stated by the
law. Thus, arbitrary medical decisions made alone could expose patients to unjustified " loss
of luck ". Increasing the resources mobilized during a pandemic must not make us forget the
quality of care provided for the benefit of quantity. In therefore seems legitimate to keep
the LAT modalities to ensure our ethical principles. No work in the literature based on
actual facts explores the impact of a pandemic on compliance with and maintenance of ethical
principles and the legisltaive framework, in particular as regards the procedures of the
application of LAT.
The purpose of this study is to assess whether the terms of the LAT are being complied during
a pandemic for patients with or without Covid.
Behavioral: decisions of limitations and stop processing
Compliance of the modalities of decisions of limitations and stop processing
Inclusion Criteria:
- Hospitalized major patient
- Infected or not with Covid-19
- having a management with a LAT defined by an anticipated or factual restriction of a
therapeutic resource ( organ replacement, specific treatment) while his or her state
of health requires or may require it, leading or not a death. The patient's death
occurs either after a cariac massagewhich corresponds to a maximum management with
therapeutic failure or within the framework or in the context of brain death, in these
cases there is no LAT ; either without cardiac massage and in this case there is de
facto a LAT wether or not it is performed according to legisltaive procedures. All
patients who die will beclassified according to this diagram for the inclusion
criterion. For surviving patients, an analysis of the record in search of LAT elments
will be performed. In the absence of LAT elment in the record, i twill be considered
that the patient did not have LAT and therfore will not be included.
Exclusion Criteria:
None
CHU de Clermont-Ferrand
Clermont-Ferrand, France
Hospices Civiles de Lyon
Lyon, France
CH de Vichy
Vichy, France
Lise LACLAUTRE
+33473754963
promo_interne_drci@chu-clermontferrand.fr
Virginie Guastella, Principal Investigator
University Hospital, Clermont-Ferrand