From Advance Discussions to the Advance Directives. Or from Advance Directives to Advance Discussions?

Since the law Leonetti (2005) in France, at the end of life of a patient, it is necessary to know his former wishes in front of complex therapeutic decisions. In 2017, the law Claeys- Leonetti declares that the Advance Decisions (AD) can be opposable. This means that AD are mandatory (except in an emergency situation). A survey was conducted on a French representative population and showed that only 14% had written their AD. In this paper, we propose a discussion about the current issues in law application in practice: 1) AD are more relevant than medical advice; 2) AD are more relevant than the Support Person; 3) the principle of autonomy is more relevant than the benevolence/ paternalism principle; 4) the a priori confidence given to the medical community is the subject of a debate. Some outcomes will be proposed by the authors to facilitate the ties between the patient, his family care givers and medical professionals: 1) to use a template before writing the AD; 2) to write the AD on a white sheet; 3) to get helped with a mediation tool (as the card game Go Wish).