Standards, Options and Recommendations (SOR): consequences of the SOR guidelines project in terms of liability for French Cancer Centers

Context. The "Standards, Options and Recommendations" (SOR" project, starte d in 1993, is a collaboration between the Federation of the French Cancer C enters (FNCLCC), the 20 French comprehensive Cancer Centers and specialists from French Public Universities, Genera Hospitals nad Private Clinics. The main health care outcome for cancer patients. The methodology is based on literature review and critical appraisal by a multidisciplinary group of ex perts, with feedback from specialists in cancer care delivery. Objectives. To identify consequences in terms of liability of the development of SOR gu idelines and to formulate recommendations for the FNCLCC and medical doctor s using SOR. Methods. Data have been identified by literatures search on le gal matters by CNWH's Legal Center JuriSante, then submitted to a group of 8 experts. Results. The main conclusions of the present study are 1) The SO R attest high level of quality and methodological rigor; 2) according to le gal considerations and in comparison to the available scientific data, the SOR guidelines can be considered as the state of the art in oncology at tim e of release; 3) the study identified six quality properties of Standards, Options and Recommendations (SOR): information contained in the SOR must be serious, accurate reliable, complete, up-to-date and secure. The respect o f these quality criteria is essential in the matter of liability; 4) when g athered, they can prevent the actors from being implicated on questions of liability. Specialists who use the SOR may avoid problems if liability, nev ertheless evidence and the state of the art may evolve with time; 5) clinic ians who do not use the SOR, may appear to be responsible for disasters, ex cept if they can justify their medical decision (evolution of scientific kn owledge or specific clinical circumstances, etc.); 6) therefore, SOR develo pers need to keep in mind these essential properties when SOR are prepared; 7) the SOR steering committee (COSOR) analysed the conclusions of the pres ent legal study and defined a series of actions and procedures to guarantee the respect of the above quality criteria.