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Patients in France may get end-of-life drug at home

A powerful sedative used in palliative end-of-life care is to be available on prescription in all pharmacies in France within four months.

Until now, the sedative Midazolam has only been available for use in hospitals. Under the new rules, GPs will be able to prescribe it through normal pharmacies, to allow patients to receive end-of-life care at home, with less pain, instead of being admitted to hospital.

The health ministry has said that the drug will only be prescribed under strict conditions, and only with a prescription from a mobile GP team or a hospital service. The prescription will also require a second opinion from another doctor.

Some GPs have said this latter rule will put unnecessarily-complex barriers in place.

Dr Jean-Paul Hamon, president of doctors' union La Fédération des Médecins de France told public news service FranceInfo: "The doctor, the nurse, the patient, and the patient's family...that is who is concerned, no-one else. They shouldn't impose someone else who is 'supposed to know more' et cetera, and add complexity to a situation that is [already] particularly heavy and distressing to take care of."

But other GPs have said this extra protection is needed.

Dr Pierre Robin, GP in Marseille, said: "It's not easy. You can get it wrong. You might have demands that do not correspond to the real situation."

Pharmacists have welcomed the move.

Dr Gilles Bonnefond, president of pharmacist union l’Union des Syndicats de Pharmaciens d'Officine, said: “We have a medicine that is suitable, with fewer side-effects [and that is] easier to use, under very specific conditions. We are going to be helping many town pharmacy teams, and patients.”

The decision to change the rules comes just two months after a GP in Normandy was investigated for giving Midazolam to five patients without the correct authorisation. He has since been struck off.

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