{"id":10271,"date":"2023-10-11T09:30:00","date_gmt":"2023-10-11T07:30:00","guid":{"rendered":"https:\/\/institutrobertbadinter.fr\/fr\/?post_type=publications&p=10271"},"modified":"2025-07-09T16:06:45","modified_gmt":"2025-07-09T14:06:45","slug":"autonomie-personnes-ages","status":"publish","type":"publications","link":"https:\/\/institutrobertbadinter.fr\/fr\/publications\/autonomie-personnes-ages\/","title":{"rendered":"Autonomie des personnes \u00e2g\u00e9es et mesures de protection juridique. Quelle place dans le champ m\u00e9dical pour la volont\u00e9 des personnes \u00e2g\u00e9es juridiquement prot\u00e9g\u00e9es ?"},"content":{"rendered":"\n

L\u2019autonomie individuelle \u2013 m\u00eame avec sa part d\u2019illusion \u2013 occupe une place centrale en droit puisque c\u2019est l\u2019expression de la volont\u00e9 qui engage. Ainsi, dans le champ m\u00e9dical, recueillir le consentement du patient est une exigence \u00e9thique mais \u00e9galement l\u00e9gale. Cela \u00e9tant pos\u00e9, il peut s\u2019av\u00e9rer difficile dans certaines
situation s de vuln\u00e9rabilit\u00e9 d\u2019obtenir un consentement libre et \u00e9clair\u00e9 de la part d\u2019un patient et m\u00eame de sonder sa volont\u00e9. Le droit identifie ainsi des personnes en situation de vuln\u00e9rabilit\u00e9 en raison de leur \u00e2ge (les mineurs) ou de l\u2019alt\u00e9ration de leurs facult\u00e9s (les majeurs prot\u00e9g\u00e9s). Dans le premier cas la volont\u00e9 est
per\u00e7ue comme immature quand elle appara\u00eet dans la seconde hypoth\u00e8se trop vacillante. Le droit contemporain de la protection juridique cherche cependant \u00e0 concilier protection et autonomie, privil\u00e9giant l\u2019accompagnement \u00e0 la substitution.
L\u2019ambition du pr\u00e9sent travail scientifique (2021-2023) r\u00e9unissant une \u00e9quipe de chercheurs venus de diff\u00e9rentes disciplines (droit sociologie, philosophie) et de praticiens (professionnels de sant\u00e9, mandataires judiciaires et magistrats) a consist\u00e9 \u00e0 rechercher comment ce double mouvement d\u2019autonomisation \u2013 de la
protection juridique et du droit de la sant\u00e9 \u2013 se concr\u00e9tise ou non s\u2019agissant des d\u00e9cisions m\u00e9dicales concernant des personnes \u00e2g\u00e9es b\u00e9n\u00e9ficiant d\u2019une mesure de protection.
Au regard de la complexit\u00e9 des r\u00e8gles applicables (en particulier l\u2019article 459 du Code civil sur les d\u00e9cisions personnelles du majeur b\u00e9n\u00e9ficiant d\u2019une mesure de repr\u00e9sentation \u00e0 la personne et l\u2019article L1111-4 du Code de la sant\u00e9 publique sur le consentement aux soins et le refus), l\u2019hypoth\u00e8se a \u00e9t\u00e9 formul\u00e9e d\u2019une
difficult\u00e9 pour le m\u00e9decin \u00e0 prendre en compte la volont\u00e9 d\u2019un patient pour lequel il pourrait se tourner plus volontiers vers le protecteur.
Pour v\u00e9rifier l\u2019hypoth\u00e8se, une enqu\u00eate de terrain a \u00e9t\u00e9 men\u00e9e aupr\u00e8s des diff\u00e9rents acteurs de la mesure \u2013 juges, professionnels de sant\u00e9 et mandataires judiciaires \u00e0 la protection des majeurs \u2013 mais aussi des prot\u00e9g\u00e9s, par des questionnaires et des entretiens.
Les donn\u00e9es recueillies ont invalid\u00e9 partiellement l\u2019hypoth\u00e8se initiale. Il est apparu en effet que les professionnels de sant\u00e9 interrog\u00e9s restaient attentifs \u00e0 la volont\u00e9 de leurs patients \u00e2g\u00e9s juridiquement prot\u00e9g\u00e9s, y compris lorsque la mesure est la plus forte, \u00e0 savoir une repr\u00e9sentation \u00e0 la personne. L\u2019enqu\u00eate a n\u00e9anmoins r\u00e9v\u00e9l\u00e9 que le cadre juridique \u00e9tait m\u00e9connu, sous exploit\u00e9 et mal ma\u00eetris\u00e9 de sorte que le sujet \u00e2g\u00e9 juridiquement prot\u00e9g\u00e9 ne semble devoir le respect de son autonomie qu\u2019aux r\u00e9flexes et pr\u00e9occupations \u00e9thiques des diff\u00e9rents acteurs. Dans ces conditions, la position du patient \u00e2g\u00e9 b\u00e9n\u00e9ficiant d\u2019une mesure de protection appara\u00eet fragile et menac\u00e9e. Elle d\u00e9pend du niveau de r\u00e9flexion et d\u2019engagement \u00e9thiques des professionnels, tr\u00e8s variables d\u2019une personne \u00e0 l\u2019autre (\u00e0 cet \u00e9gard, il convient de relever que les praticiens ayant accept\u00e9 de participer \u00e0 l\u2019enqu\u00eate sont des personnes a priori enclines \u00e0 s\u2019interroger sur leurs pratiques et donc vraisemblablement sensibilis\u00e9es aux enjeux \u00e9thiques) et risque dans un proche avenir de souffrir de la d\u00e9gradation des conditions d\u2019exercice qui n\u2019\u00e9pargne aucun des corps de m\u00e9tiers consid\u00e9r\u00e9s. Ces constats \u00e9tay\u00e9s ont conduit \u00e0 proposer, d\u2019une part, une clarification des textes juridiques afin de les rendre intelligibles pour que l\u2019ensemble des acteurs \u2013 juristes ou non \u2013 puissent pleinement s\u2019en emparer et, d\u2019autre part, un projet de formation pluridisciplinaire et continue au profit des diff\u00e9rents professionnels intervenant aupr\u00e8s du patient \u00e2g\u00e9 juridiquement prot\u00e9g\u00e9. C\u2019est toute l\u2019ambition prospective de cette recherche.<\/p>\n\n\n\n

20.16_AUTONOMIE_PERSONNES_AGEES_synthese<\/a>T\u00e9l\u00e9charger<\/a><\/div>\n\n\n\n
20.16_AUTONOMIE_PERSONNES_AGEES_rapport<\/a>T\u00e9l\u00e9charger<\/a><\/div>\n\n\n\n
20.16_Annexes rapport final<\/a><\/div>\n\n\n\n
R\u00e9sum\u00e9 en anglais \/ English version <\/summary>\n

Individual autonomy, even with its share of illusion, occupies a central place in law since it is the expression of the will that binds. Thus, in the medical field, obtaining the patient\u2019s consent is not only an ethical but also a legal requirement. That being said, it can be difficult in some situations of vulnerability to obtain free and informed consent from a patient and even to gauge his will. The law thus identifies people in a situation of vulnerability due to their age (minors) or the alteration of their faculties (protected adults). In the first case, the will is perceived as immature when it appears too vacillating in the second hypothesis. However, contemporary legal protection law seeks to reconcile protection and autonomy, favouring support over substitution. The ambition of this scientific work (2021-2023), bringing together a team of researchers from different disciplines (law, sociology, philosophy) and practitioners (health professionals, legal representatives and magistrates), consisted of researching how this double empowerment movement \u2013 of legal protection and health law \u2013 materialises or not with regard to medical decisions concerning elderly people benefiting from a protective measure. In view of the complexity of the applicable rules (in particular article 459 of the French Civil Code on the personal decisions of adults benefiting from a personal representation measure and article L1111-4 of the Public Health Code on consent to care and refusal), the hypothesis was formulated that it would be difficult for health professionals to take into account the wishes of a patient for whom he could turn more readily to the legal protector. To verify the hypothesis, a field survey was conducted with the various actors in the measure \u2013 judges, health professionals, and legal representatives for the protection of adults \u2013 as well as protected persons, through questionnaires and interviews. The data collected partially invalidated the initial hypothesis. It appeared, in fact, that the health professionals remained attentive to the wishes of their legally protected elderly patients, including when the measure was the strongest, namely when the patient was protected. Results nevertheless revealed that the legal framework was unknown, under-exploited, and poorly controlled, so that the elderly patient benefiting from a protective measure appears fragile and threatened. It depends on the level of reflection and ethical commitment of professionals, which vary greatly from one person to another (in this respect, it should be noted that the practitioners who agreed to take part in the survey are people who are a priori inclined to question their practices and therefore probably aware of ethical issues), and risks suffering in the near future from the deterioration of the conditions of exercise, which do not spare any of the trades considered. These substantiated findings have led to the proposal, on the one hand, of a clarification of the legal texts in order to make them intelligible so that all the actors, lawyers or not, can fully grasp them, and, on the other hand, of a multidisciplinary and continuous training project for the benefit of the various professionals, working with the legally protected elderly patient. This is the prospective ambition of this research.<\/em><\/p>\n<\/details>\n","protected":false},"featured_media":0,"template":"","disciplines":[114,111,115],"collections":[119],"publication_tag":[1640,2846,2849,2848,2847],"auteurs":[2844,2845],"class_list":["post-10271","publications","type-publications","status-publish","hentry","disciplines-droit","disciplines-philosophie","disciplines-sociologie","collections-rapports-de-recherche","publication_tag-autonomie","publication_tag-decisions-medicales","publication_tag-patient-age","publication_tag-protection-juridique","publication_tag-volonte","auteurs-camille-bourdaire-mignot","auteurs-tatiana-grundler-2"],"acf":[],"yoast_head":"\nAutonomie des personnes \u00e2g\u00e9es<\/title>\n<meta name=\"description\" content=\"Comment le double mouvement d\u2019autonomisation \u2013 protection juridique et droit de la sant\u00e9 \u2013 se concr\u00e9tise ou non en ce qui concerne les d\u00e9cisions m\u00e9dicales touchant des personnes \u00e2g\u00e9es b\u00e9n\u00e9ficiant d\u2019une mesure de protection\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/institutrobertbadinter.fr\/fr\/publications\/autonomie-personnes-ages\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Autonomie des personnes \u00e2g\u00e9es\" \/>\n<meta property=\"og:description\" content=\"Comment le double mouvement d\u2019autonomisation \u2013 protection juridique et droit de la sant\u00e9 \u2013 se concr\u00e9tise ou non en ce qui concerne les d\u00e9cisions m\u00e9dicales touchant des personnes \u00e2g\u00e9es b\u00e9n\u00e9ficiant d\u2019une mesure de protection\" \/>\n<meta property=\"og:url\" content=\"https:\/\/institutrobertbadinter.fr\/fr\/publications\/autonomie-personnes-ages\/\" \/>\n<meta property=\"og:site_name\" content=\"INSTITUT ROBERT BADINTER\" \/>\n<meta property=\"article:modified_time\" content=\"2025-07-09T14:06:45+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/institutrobertbadinter.fr\\\/fr\\\/publications\\\/autonomie-personnes-ages\\\/\",\"url\":\"https:\\\/\\\/institutrobertbadinter.fr\\\/fr\\\/publications\\\/autonomie-personnes-ages\\\/\",\"name\":\"Autonomie des personnes \u00e2g\u00e9es\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/institutrobertbadinter.fr\\\/fr\\\/#website\"},\"datePublished\":\"2023-10-11T07:30:00+00:00\",\"dateModified\":\"2025-07-09T14:06:45+00:00\",\"description\":\"Comment le double mouvement d\u2019autonomisation \u2013 protection juridique et droit de la sant\u00e9 \u2013 se concr\u00e9tise ou non en ce qui concerne les d\u00e9cisions m\u00e9dicales touchant des personnes \u00e2g\u00e9es b\u00e9n\u00e9ficiant d\u2019une mesure de protection\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/institutrobertbadinter.fr\\\/fr\\\/publications\\\/autonomie-personnes-ages\\\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/institutrobertbadinter.fr\\\/fr\\\/publications\\\/autonomie-personnes-ages\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/institutrobertbadinter.fr\\\/fr\\\/publications\\\/autonomie-personnes-ages\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\\\/\\\/institutrobertbadinter.fr\\\/fr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Publications\",\"item\":\"https:\\\/\\\/institutrobertbadinter.fr\\\/fr\\\/publications\\\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Autonomie des personnes \u00e2g\u00e9es et mesures de protection juridique. 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