Act of April 22, 2005 called Bill "Leonetti''. Analysis of a questionnaire sent to the persons involved in the health care field

France introduced new legislation on patients and end-of-life care (the so-called "Leonetti Act'') in 2005. It prompts caregivers and the cared-for to initiate a truly ethical approach to dramatic medical situations in general and the end of life in particular. In 2008, a commission was set up to see how the legislation was being implemented. In order to know the understanding of this law in our region, we send a questionnaire to all the caregivers of the universitary hospital and all the people who are in connection with our regional ethical committee. Methodology. - The questionnaire comprised seven short, open questions, in order to assess the level of knowledge of this legislation by caregivers and administrative staff. We e-mailed the questionnaire (twice, with a two-week interval) to the members of the Regional Ethics Forum (n = 300) and all the staff at our University Hospital with a personnel e-mail address (n = 1500). The recipients were invited to return one questionnaire per care team. Results. - We received 152 questionnaires (corresponding to 383 individuals). Overall, only 16% of the answers explain what the Leonetti Act covered, 14% knew which patients were concerned, 8% explicitly mentioned the collegial approach, 46% said that withdrawal of care did not mean the withdrawal of basic medical care or nursing, 66% stated that palliative care is not synonymous with the end of life, 33% explicitly mentioned the usual definition of palliative care and 68% said that the role of the person of trust had been strengthened by the legislation. Conclusion. - This study confirmed the clear need to implement all the provisions suggested by the commission in 2008, in order to raise awareness of this legislation and promote its uptake by caregivers and, indeed, the main people concerned - the patients. One can only hope that the new Regional Ethics Forums will commit to promoting this legislative support for consideration of ethical issues. (C) 2011 Elsevier Masson SAS. All rights reserved.