J Med Ethics 34:279-280 doi:10.1136/jme.2006.019075
  • Law, ethics and medicine

Ethical issues arising from the requirement to sign a consent form in palliative care

  1. I Plu1,2,
  2. I Purssell-François1,2,
  3. G Moutel2,3,
  4. F Ellien4,
  5. C Hervé2,3
  1. 1
    Service de Médecine Légale, Hôpital Général, Centre Hospitalo-universitaire, Dijon, France
  2. 2
    Laboratoire d’Ethique Médicale et de Médecine Légale, Faculté de Médecine, Université Paris V René Descartes, Paris, France
  3. 3
    IIREB, Institut International de Recherche en Bioéthique, Faculté de Médecine, Université Paris V René Descartes, Paris, France
  4. 4
    Réseau Soins Palliatifs Essonne Sud, Champcueil, France
  1. Dr Isabelle Plu, Laboratoire d'éthique médicale et de médecine légale, Faculté de médecine des Saints-Pères, 45 rue des Saints-Pères, 75006 Paris, France; depluzenplus{at}
  • Received 7 September 2006
  • Revised 15 January 2007
  • Accepted 13 February 2007


French healthcare networks aim to help healthcare workers to take care of patients by improving cooperation, coordination and the continuity of care. When applied to palliative care in the home, they facilitate overall care including medical, social and psychological aspects. French legislation in 2002 required that an information document explaining the functioning of the network should be given to patients when they enter a healthcare network. The law requires that this document be signed. Ethical issues arise from this legislation with regard to the validity of the signature of dying patients. Signature of the consent form by a guardian or trustee, a designated person—the Person of Trust—transforms the doctor–patient relationship into a triangular doctor–patient–third-party relationship.


  • Competing interests: None declared.