Physician's civil responsibility: what's new in 2000?

In France, during the last year, important jurisprudence was established by the French Supreme Court of Appeal concerning the physician's civil respon sibility. On October 7, 1998, the Court decided that "the physician is not exempted for the obligation to provide information by the simple fact that these risks only materialize exceptionally". This means that from now, the physician must inform the patient of all risks that might influence the pat ient's decision, particularly information concerning life-threatening or se vere consequences, but also, as in the past, concerning frequent even benig n consequences. The limits of this jurisprudence and the completeness of th e information, as established in 1998, are emergency, patient refusal and i mpossibility to inform the patient. In the decree of May 23, 2000, the Cour t gave its definition of impossibility to inform the patient, thus establis hing the "therapeutic limits". But the judges recognized that the requireme nt for information delivery is independant of the necessary or unnecessary nature of the therapeutic act. However, in the decree of June 20, 2000, the Court established the conditions for awarding indemnities for defective in formation delivery. Defective information delivery is not sufficient in its elf to constitute a civil offense. Real damage is also necessary. To be awa rded with an indemnity, the patient must prove that the lack of information affected his/her decision to consent. If it appears that even if he/she ha d been well informed, the patient had consented to the care given, the phys ician would not be obliged to provide the patient with an indemnity. The ju dges want to find a compensation and make the proof easier for the patient. They accept the potential fault when an organ was injured in the course of an operation. But, these decisions concern the proof and they don't modify the medical responsibility. The physicians have got a duty to use reasonab le skill and care and they don't have any obligation to achieve a certain r esult. Sometimes, the physician has got an obligation to achieve a certain result but it isn't a general rule (November 08, 2000). (C) 2001 Editions s cientifiques et medicales Elsevier SAS.