[Ethics and the end of life]

Our responsibility toward others is the domain of ethics. To care particularly of a terminally ill patient, makes the relation asymmetrical. More, the doctor is exposed to unconscious trends like projections, desire of power, and anticipated grief of his/her patient. When warned against these psychological issues, the doctor will have at his/her disposal ethical landmarks that have been internationally accepted: principles such as autonomy and humanity of the patient, proportionality and futility, refusal of euthanasia and the principle of justice in palliative care. In front of the reality of a terminal patient care these principles enable the doctor to discuss the issue of disclosing a lethal prognosis. Stopping unproportionate treatments enables the doctor to avoid overtreatment. If a team consensus is helpful for a decision making, it does not exempt the doctor from his/her responsibility. The principle of beneficence makes for the doctor a duty to get educated and trained in palliative care with both their therapeutic and relational aspects. Lastly, a demand of euthanasia is a call for help; it justifies--instead of an act which must be refused--an unconditional listening and a commitment to do everything able to yield relief.