Year: 2023
Type: preprint
Study design: Systematic Review
Abstract: Background: While North America and Europe vary in their approach, studies show that patients and professional caregivers are not always taking full advantage of patients’ rights. For instance, in France, the trusted person system allows a designated person to support and accompany a patient, with their testimony prevailing over others in end-of-life situations. It seems that the understanding of this legal tool and its implementation by the actors on the ground is not in line with the intent of the law. However, there is no comprehensive inventory of studies on this system in France, particularly for elderly patients. Objective: To undertake a scoping review integrating qualitative, quantitative, and mixed studies on the trusted person system in France. The review focuses on frail elderly individuals, their trusted person, their family, and health professionals in the French context. Methods: Bibliographic databases (Pubmed, Embase and CINAHL) and databases with French-written resources (BDSP, CISMEF, LISSA, BNDS, Cairn.info, SUDOC,ScienceDirect) were screened. Papers published from January 2002 to December 7, 2021, focusing on the trusted person system with French patients above 65 years were identified.Results: Of 1952 titles and abstracts, 34 documents met our criteria. The main measured outcomes in French research are: designation of trusted persons, roles actually fulfilled in the field, insertion in their legal ecosystem, actual criteria of decisions for therapies, information provided to relatives on patients health, quality of death. The documents also identify explanatory factors, policy recommendations and research avenues.Conclusion: The trusted person system struggles to develop in a country where the patientphysician relationship is traditionally paternalistic. The results of this research can inform policymakers and researchers in countries with similar cultures and public health characteristics to France.
Source: HAL
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4390850791