[Withholding or withdrawing life-sustaining treatments in acute oncology situations: History and regulatory aspects in France]

Abstract

The management of oncology patients, especially hospitalized patients, can lead to almost daily discussions regarding therapeutic limitations. Here, we review the history and propose a summary of the texts framing the notion of "withholding and withdrawing life-sustaining treatment" in oncology practice in France. This decision is regulated by the Claeys-Léonetti Law of February 2, 2016 recommending a collegial discussion and its documentation in the medical record. The decision to withhold or withdraw life-sustaining treatments is the subject of discussion between the patient, his physicians and his family and may take place at any time during his management. The work of intensive-care physicians provides many useful recommendations for acute oncology situations, however articles specific for oncology practice are scarce; this is a topic that oncologists must take up.

Keywords: Decisions to forgo life sustaining therapy; Directives Anticipées; End of life; End of life decision making; Limiting care; Obstination déraisonnable; Palliative care; Therapeutic limitation; Unreasonable Obstinacy; Withdrawing; Withholding; advance directives; collective procedure; life-sustaining treatment; «Limitation et/ou Arrêt des Thérapeutiques Actives».