At the crossroad of medical, psychological, philosophical and moral reflection, this involves complex and concerning fundamental

questioning on respect for life and for the person [1,2]. How can a happy medium be found between abandon and excessive therapeutic intervention? [3,4] How can a decision be reached which respects the person and which may require us to administer additional treatment, or to continue or withdraw treatment already in place? [5] When confronted with a compulsory choice, all doctors, care teams and families then Inhibitors,research,lifescience,medical face the double difficulty of responsibility and doubt. Concerning the determinants of decision-making, besides applying the main ethical principles [6], several Inhibitors,research,lifescience,medical publications [1,2,4,5,7-10] focus on taking directives into account, the role of the person of trust, the need to coordinate teamwork and the participation of carers in the decision-making process, and some others show the need to take into account the religious and moral beliefs of people as well as the cost of care and treatments [11,12]. Benett & al. recently Inhibitors,research,lifescience,medical highlighted the lack of emphasis on research which informs clinical decisions in end of life care [13]. In a recent review of the

different methods used by researchers in the end of life domain [14], the predominant Inhibitors,research,lifescience,medical use of qualitative or mixed methods which called on social science tools

was highlighted (interview, focus group, Arts/drama, Quality of life tools/surveys, Storytelling, Narratives/diaries, Mixed methods). The role of caregivers (http://www.selleckchem.com/products/ABT-888.html healthcare professionals and family) Inhibitors,research,lifescience,medical in the decision-making process must be understood before designing a research protocol on this topic. Their role depends on socio-cultural aspects, organisational aspects, professional guidelines and legislation. In France, if a patient is in an advanced or terminal phase of a severe and incurable disease, or if a patient receives only artificial AV-951 life sustaining treatment, French law (Code of Public Health, Law No. 2005-370 of 22 April 2005 on patients’ rights and end of life) allows the clinician caring for the patient to limit or stop unnecessary or disproportionate treatment. The decision is purely the responsibility of the clinician in charge of the patient, but it must be made after discussion with the care team and with a medical consultant outside the department. The patient’s physician must seek and take into account any previous directives made by the patient, and obtain the opinion of the family or relatives.