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An Interprofessional Process for the Limitation of Life Sustaining Treatments in France.

Blythe JA, Kentish-Barnes N, Debus A-S, Dohan D, Azoulay E, Covinsky K, Matthew T, Curtis JR, Dzeng E.

Journal of Pain and Symptom Management. 2021

Introduced in 2005, Leonetti’s Law is a French law that provides a legal means to limit potentially non-beneficial life-sustaining treatments on a patient through a collegial procedure called the limitation et arrêt des traitements (LAT). The LAT is an interprofessional process that enables all care team members to initiate a discussion about withholding or withdrawing treatment for a patient until reaching a consensus. In this qualitative study interviewing 25 physicians and nurses across two Parisian hospitals, we found that the LAT process led to unified messaging from the care team to their family members and surrogates, the empowerment of nurses to initiate de-escalation discussions, the reduction of moral distress among clinicians, and the production and maintenance of an ethical environment.  

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