[The surrogate for inpatients]

The French legal framework of the surrogate has been defined by a law passed in 2002 concerning the patients' rights, in response to the absence of prior rights of the incompetent patient. The surrogate is designated only by a competent major patient. In the case of competent patient, the surrogate may support the patient throughout the course of care, including during the hospitalizations or consultations. In the case of incompetent patient, the surrogate must be involved in the decision-making process. A poor designation and a lack of the surrogate's involvement emerge from different French studies since 2002, especially in the end-of-life decisions, despite a specific law passed in 2005, which reinforced the surrogate's role in this context. The evolution of the patients' rights, in France as in most of the industrialized countries, should lead to specific actions to improve the surrogate's involvement, in the respect of the ethical principles of autonomy, beneficence and non-maleficence.