Expressing Your Choices

A trusted person is someone you freely choose to support you throughout your care journey. This could be a loved one, a family member, or anyone else you trust.

She can help you with the necessary procedures, attend medical appointments if you wish, and serve as a point of contact for the medical staff if you are no longer able to express your wishes.

Yes. The designation is optional and can be changed or revoked at any time.

Advance directives are a written document in which a person sets forth their wishes regarding end-of-life matters, particularly concerning whether to continue, limit, discontinue, or refuse certain treatments. Drafting them is voluntary and not mandatory.

Doctors are required to respect advance directives except in cases of a life-threatening emergency, during the time necessary to fully assess the situation, or when the patient’s medical condition does not correspond to the circumstances described in the advance directives. In such cases, the decision not to follow them must be made collectively by the physician and the care team after consulting with the patient’s trusted representative or, if none exists, the patient’s family or close relatives.

Advance directives must be written, dated, signed, and authenticated by the author’s last name, first name, date of birth, and place of birth. If the person is no longer able to write but remains capable of expressing their wishes, they may call upon two witnesses, one of whom must be their trusted representative. These witnesses will attest that the document is a true expression of the person’s free and informed will. These witnesses will state their names and attach their attestations to the advance directives.

Advance directives are valid indefinitely and may be amended at any time.

The storage arrangements must meet one obvious requirement: ease of access. For this reason, a wide range of options is available: storage in the attending physician’s file, in the patient’s medical record in the event of hospitalization, or by the patient themselves. A trusted person or a family member may also hold them.

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The Public Health Code and the Hospital Patient Charter require the patient’s prior consent before any medical procedure is performed.

A hospitalized patient may leave the healthcare facility at any time in accordance with the right to personal liberty. Except in cases provided for by law, namely:

• hospitalization for mental health disorders (involuntary or at the request of a third party),
• minors or adults subject to a legal protective measure,
• persons in police custody and hospitalized inmates.

In the event of a refusal of care, the physician must respect the patient’s wishes, in accordance with the principle of informed consent, provided that the patient’s refusal is “informed.” “Informed” means a refusal made with full knowledge of the facts (i.e., the risks) based on the information provided by the physician.

Refusal of care triggers a legal procedure. However, before initiating any proceedings, the physician is obligated to assess the situation of refusal, engage in dialogue with the patient and/or their family members to try to overcome their opposition, and verify the patient’s capacity to consent and, therefore, to refuse.

In the event of a refusal of care, the physician determines which specific aspect of the treatment is being refused, verifies the patient’s understanding of the treatment plan and the risks involved in refusal, and ensures that there are no cultural or communication barriers, no advance directives already in place, or a trusted person.

Finally, the doctor assesses the patient’s capacity to give or withhold consent by determining whether there are any conditions that might impair the patient’s rational understanding of the situation.

You have the right to individual liberty and may refuse any proposed treatment, procedure, or care.

If you are discharged against medical advice, the doctor will inform you of the risks involved given your health condition. You will be required to sign a document acknowledging your refusal of the proposed care. A copy of this document will be attached to your medical record. Even in this case, the administrative discharge procedures must be completed.

If the patient is unable to express a free and informed decision, the facility may keep the patient in the hospital against their will.

Every person is presumed to consent to the donation of their organs and tissues unless they have expressed a contrary wish during their lifetime.

Anyone who objects to organ donation must inform their loved ones, as their testimony will be taken into account. It is also advisable to register with the national opt-out registry.

Any person aged 13 or older may register on the registry to indicate that they refuse to have organs removed from their body after their death—whether for therapeutic purposes, to determine the cause of death, or for other scientific purposes.

You can request to be listed on the registry by filling out a form available for download from the Agence de la Biomédecine’s website, or by mail by writing to:

Agence de la Biomédecine

National Refusal
Registry 1 av du Stade de France 
93212 Saint Denis la Plaine cedex

Website: http://www.dondorganes.fr/046-comment-exprimer-son-refus 

The form must be dated, signed, and accompanied by a legible photocopy of your national ID card or residence permit, as well as a self-addressed, stamped envelope to receive confirmation of your registration if you have requested it. Any changes to your personal information must be reported; changes of address do not need to be reported.

Your refusal to consent to blood draws may be revoked at any time upon request, under the same conditions as registration.

Healthcare facilities are required to consult this registry before proceeding with any such blood draws.