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Master thesis

La "personne de confiance" : cadre légal et difficultés de mise en pratique. Enquête réalisée au centre médical Paul Spillmann du CHU de Nancy

Abstract : Introduction: Law N°2002-303 of 4 March 2002 on the trustworthy person allows an adult person (or grown-up person) to designate a "trustworthy person" who can be a relative, a close friend or a selected doctor, in order to support, back-up when decisions must be taken and represent her if needed. Objectives: After having defined the patient-doctor relationship in a legal way/basis, we studied the reliability of the patient designation in hospital where flow-up care and palliative care are given at the Medical Center Paul Spillmann at the CHU Nancy. Method: We compared answers given by an hetero-valuation's results from vulnerable patients to semi-directive questionnaires distributed to health-care workers over a six month period. Moreover, we tried to figure out who is designate and what are the declaration's limits, in evaluating the concept degree learnt. Results: 89 "patientdoctor couples" were selected over 101. 34.83% of patients were judged incompetent when designating a Trustworthy person. Less than a third of the patients who chose a trustworthy person recalled having one, according to what healthcare workers say. Almost one person over two doesn't know what is a trustworthy person. A close relative (such as a child, husband and wife and not thereferent doctor) was picked after the patient received enough information. The lack in information is the principal cause to the concept poor diffusion and utilization. There is a dissention between the trustworthy person designation to healthcare workers and the trustworthy person designation declared by patients. Discussion: It seems that vulnerable population, who are the measure's first "target", aren't well represented by this measure. Patients and Healthcare workers information and knowledge about the trustworthy person?s mission and part are clearly insufficient. Conclusion: The"trustworthy person"'s creation allows patients to have a representative, someone who can stand for them and who can evoke/serve their will in case they couldn't do it themselves. Nevertheless, this law suffers from numerous deficiencies which make it tough to apply. The patient incapacity valuation remains an ethical and legal open question
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Abraham Christmann. La "personne de confiance" : cadre légal et difficultés de mise en pratique. Enquête réalisée au centre médical Paul Spillmann du CHU de Nancy. Sciences du Vivant [q-bio]. 2011. ⟨hal-01732799⟩

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