No physician-assisted suicide was reported

and BMS-907351 molecular weight euthanasia (at the patient’s request) is very rare. According to our results, a fifth of medical decisions that possibly or certainly hastened deaths are made at the patient’s request, (a third for deaths with a decision to administer a medication to deliberately hasten death). This is much lower than in the Netherlands and Belgium (where Euthanasia is legal). It is higher than in other European countries in the 2001 Eureld survey. Discussion of the decision with competent patients was more frequent in France (80%) than in most European countries in 2001 with the exception of the Netherlands. Also for non-competent patients, the family is very often involved in the discussion (78%), less Inhibitors,research,lifescience,medical frequently than in

the Netherlands, similarly to Belgium-Switzerland but much more frequently than in other countries. This might reflect an effect of the French Inhibitors,research,lifescience,medical law on discussion with patients or relatives. Overall, the main results on end-of-life medical decisions are consistent with those of surveys Inhibitors,research,lifescience,medical conducted in other countries: intensification of pain relief treatment is the most common decision [17] and administration of drugs to intentionally end the patient’s life is rare. Discussion of the findings in light of the French law In France, the 2005 law on patients’ rights and the end of life defined a legal framework allowing patients Inhibitors,research,lifescience,medical to refuse any treatment they consider unreasonable, and allowing doctors to decide on treatments that may have the side effect of hastening death, in accordance with the wishes expressed by the patient [1]. The medical decisions observed in our survey mostly complied with French legal requirements, as the 2005 Act allows withholding

and withdrawal of life support, and intensified alleviation of symptoms even when it may (unintentionally) hasten death. Indeed 80% of the physicians who made this Inhibitors,research,lifescience,medical decision said they were aware of its potential “double effect”. Some decisions overstepped the law, although very rarely. A drug was administered with the explicit intention of hastening death – an act that can be considered as poisoning under French law – at the patient’s explicit request in 0.2% of these deaths, and without a clear patient why request in another 0.6%. Intention to hasten death was also declared, even if very infrequently, in some of the decisions of life support withholding or withdrawal or of intensified alleviation of symptoms. As a whole, decisions with intention to hasten death amounted to 3.1% of all deaths, and only one out five of these decisions was made on the patient’s explicit request, whereas such a request is mandatory in all countries where the law permits euthanasia in specific cases, and is part of the ONFV definition of euthanasia [1]. The decision making processes observed in our survey were far from complying with the 2005 legal procedures, which are required whatever the end-of-life decision made.