End-of-life medical decisions in France

In France, almost half of deaths (48% in 2010) are preceded by a medical decision that may hasten death. But only in 1% of cases are drugs administered to deliberately end life. The large majority of decisions taken are based on the provisions of the Leonetti Act, which enables physicians, under specific circumstances, to withhold or withdraw treatment or to administer drugs in order to alleviate pain or symptoms that may have the effect of hastening death. However, the legal provisions governing these decisions are still not always fully known or complied with: end-of-life decisions are not always discussed with the patients and medical teams, and very few patients draw up advance directives, as recommended in the Leonetti Act, to express their wishes to the physicians responsible for their care.