Pub Date : 2025-08-01DOI: 10.1016/j.meddro.2024.11.001
Isabelle Poirot Mazères (Professeur de droit public, Présidente de l’Association française de droit de la santé, Présidente du collège de déontologie du CHU de Toulouse)
If the evaluation of the quality of health procedures and products as well as the measurement of the relevance of reimbursement by health insurance are constituent dimensions of the health system, they have only been acquired at the end of an evolution which has seen the gradual erasure of medical power and the parallel affirmation of expertise other than clinical, particularly medico-economic. Since 1986, several institutions responsible for evaluation have succeeded one another, with different statuses and increasingly broad missions, from the evaluation of professional acts or the formulation of clinical practices guidelines to the certification of health establishments, social and medico social. It is currently the High Health Authority which assumes this central role through which it contributes in this area of evaluation and standardization, to “the regulation of the health system through quality and efficiency”.
{"title":"De la fondation pour l’évaluation des techniques et pratiques médicales à la Haute Autorité de santé : l’évolution institutionnelle de l’évaluation des actes et des produits de santé","authors":"Isabelle Poirot Mazères (Professeur de droit public, Présidente de l’Association française de droit de la santé, Présidente du collège de déontologie du CHU de Toulouse)","doi":"10.1016/j.meddro.2024.11.001","DOIUrl":"10.1016/j.meddro.2024.11.001","url":null,"abstract":"<div><div>If the evaluation of the quality of health procedures and products as well as the measurement of the relevance of reimbursement by health insurance are constituent dimensions of the health system, they have only been acquired at the end of an evolution which has seen the gradual erasure of medical power and the parallel affirmation of expertise other than clinical, particularly medico-economic. Since 1986, several institutions responsible for evaluation have succeeded one another, with different statuses and increasingly broad missions, from the evaluation of professional acts or the formulation of clinical practices guidelines to the certification of health establishments, social and medico social. It is currently the High Health Authority which assumes this central role through which it contributes in this area of evaluation and standardization, to “the regulation of the health system through quality and efficiency”.</div></div>","PeriodicalId":41275,"journal":{"name":"Medecine & Droit","volume":"2025 193","pages":"Pages 101-105"},"PeriodicalIF":0.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.meddro.2024.12.004
Jacqueline Castany (Médecin)
{"title":"L’inceste, je te crois, je te soutiens","authors":"Jacqueline Castany (Médecin)","doi":"10.1016/j.meddro.2024.12.004","DOIUrl":"10.1016/j.meddro.2024.12.004","url":null,"abstract":"","PeriodicalId":41275,"journal":{"name":"Medecine & Droit","volume":"2025 192","pages":"Pages 63-64"},"PeriodicalIF":0.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.meddro.2025.03.001
François Vialla
As Parliament prepares to legislate on end-of-life issues, the author draws on philosophy and literature to shed light on a societal debate that extends far beyond the realm of medicine.
随着议会准备就临终问题立法，作者利用哲学和文学来阐明一场远远超出医学领域的社会辩论。
{"title":"Réflexions sur les métamorphoses de la fin de vie","authors":"François Vialla","doi":"10.1016/j.meddro.2025.03.001","DOIUrl":"10.1016/j.meddro.2025.03.001","url":null,"abstract":"<div><div>As Parliament prepares to legislate on end-of-life issues, the author draws on philosophy and literature to shed light on a societal debate that extends far beyond the realm of medicine.</div></div>","PeriodicalId":41275,"journal":{"name":"Medecine & Droit","volume":"2025 192","pages":"Pages 65-74"},"PeriodicalIF":0.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.meddro.2024.12.003
Caroline Lacroix (Maître de Conférences HDR)
The offence of causing risks to others was one of the major innovations of the Penal Code that came into force in 1994. According to article 223-1 of the Penal Code, the act of directly exposing others to an immediate risk of death or injury likely to result in mutilation or permanent disability through a manifestly deliberate violation of a particular obligation of prudence or safety imposed by law or regulation is punishable by one year of imprisonment and a fine of 15,000 euros. Thirty years of application of the offence provide an opportunity to question the application of the offence of causing risks to others in the field of health. The study of case law reveals that health is resistant to criminalization. Only limited hypotheses are likely to fall under the scope of criminal repression. Faced with this observation, the idea of a legislative evolution of the criminalization of endangerment, particularly in health, has been put forward. Should we then rethink repression and to what extent?
{"title":"L’application de l’article 223-1 du Code pénal en santé","authors":"Caroline Lacroix (Maître de Conférences HDR)","doi":"10.1016/j.meddro.2024.12.003","DOIUrl":"10.1016/j.meddro.2024.12.003","url":null,"abstract":"<div><div>The offence of causing risks to others was one of the major innovations of the Penal Code that came into force in 1994. According to article 223-1 of the Penal Code, the act of directly exposing others to an immediate risk of death or injury likely to result in mutilation or permanent disability through a manifestly deliberate violation of a particular obligation of prudence or safety imposed by law or regulation is punishable by one year of imprisonment and a fine of 15,000 euros. Thirty years of application of the offence provide an opportunity to question the application of the offence of causing risks to others in the field of health. The study of case law reveals that health is resistant to criminalization. Only limited hypotheses are likely to fall under the scope of criminal repression. Faced with this observation, the idea of a legislative evolution of the criminalization of endangerment, particularly in health, has been put forward. Should we then rethink repression and to what extent?</div></div>","PeriodicalId":41275,"journal":{"name":"Medecine & Droit","volume":"2025 192","pages":"Pages 75-80"},"PeriodicalIF":0.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.meddro.2024.11.002
Marion Girer (Professeure des Universités en droit)
The Health High Authority has produced numerous publications on users’ rights, which we will analyse to see whether they contribute to the development of these rights. The first area is respect for fundamental human rights. In the healthcare sector, this mainly concerns dignity, privacy and confidentiality, freedom of movement and the promotion of good treatment: the HAS deals with almost all the fundamental rights recognised to patients, making it possible to check, at least in theory, that these rights are respected during care. In the medico-social and social sector, the fundamental rights of users are satisfactorily taken into account, but the wording is sometimes vague and abstract, which could prevent these rights from being applied in practice. The second priority is to make users real players in their own care. In the healthcare sector, the HAS has drawn up a detailed overview of rights, with patient information, involvement and consent occupying a central place. In the medico-social and social sector, the HAS promotes the empowerment of supported persons, in particular through the involvement of users in the construction of their support project. The HAS appears to be more of a player in disseminating knowledge of rights, and will have to take care to erase the impression of a ‘catalogue’ of rights by referring to values and ethical principles.
{"title":"La Haute Autorité de santé, un acteur du développement des droits des usagers ?","authors":"Marion Girer (Professeure des Universités en droit)","doi":"10.1016/j.meddro.2024.11.002","DOIUrl":"10.1016/j.meddro.2024.11.002","url":null,"abstract":"<div><div>The Health High Authority has produced numerous publications on users’ rights, which we will analyse to see whether they contribute to the development of these rights. The first area is respect for fundamental human rights. In the healthcare sector, this mainly concerns dignity, privacy and confidentiality, freedom of movement and the promotion of good treatment: the HAS deals with almost all the fundamental rights recognised to patients, making it possible to check, at least in theory, that these rights are respected during care. In the medico-social and social sector, the fundamental rights of users are satisfactorily taken into account, but the wording is sometimes vague and abstract, which could prevent these rights from being applied in practice. The second priority is to make users real players in their own care. In the healthcare sector, the HAS has drawn up a detailed overview of rights, with patient information, involvement and consent occupying a central place. In the medico-social and social sector, the HAS promotes the empowerment of supported persons, in particular through the involvement of users in the construction of their support project. The HAS appears to be more of a player in disseminating knowledge of rights, and will have to take care to erase the impression of a ‘catalogue’ of rights by referring to values and ethical principles.</div></div>","PeriodicalId":41275,"journal":{"name":"Medecine & Droit","volume":"2025 192","pages":"Pages 81-84"},"PeriodicalIF":0.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.meddro.2024.12.002
Paul Véron (Maître de conférences en droit)
As an independent public authority with scientific status, the French Haute Autorité de santé does not have regulatory powers. It mainly provides recommendations or opinions, which are soft law standards. Its authority is therefore based above all on the compliance of the recipients of these standards, which can only be achieved on a dual condition: the probity of the experts and the quality of the expertise.
法国高等自治机构（Haute autorit de sant）作为具有科学地位的独立公共机构，并不具有监管权力。它主要提供建议或意见，这是软法律标准。因此，它的权威首先取决于这些标准的接受者是否遵守这些标准，而这些标准只有在双重条件下才能实现：专家的正直和专业知识的质量。
{"title":"Les ressorts de l’autorité de la HAS : indépendance et expertise","authors":"Paul Véron (Maître de conférences en droit)","doi":"10.1016/j.meddro.2024.12.002","DOIUrl":"10.1016/j.meddro.2024.12.002","url":null,"abstract":"<div><div>As an independent public authority with scientific status, the French Haute Autorité de santé does not have regulatory powers. It mainly provides recommendations or opinions, which are soft law standards. Its authority is therefore based above all on the compliance of the recipients of these standards, which can only be achieved on a dual condition: the probity of the experts and the quality of the expertise.</div></div>","PeriodicalId":41275,"journal":{"name":"Medecine & Droit","volume":"2025 192","pages":"Pages 85-88"},"PeriodicalIF":0.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.meddro.2025.01.008
Stéphanie Rabiller (Maître de conférences, HDR)
The active participation of users in the healthcare system, although widely proclaimed, is struggling to be fully in practice. Despite the 2002 laws instituting bodies such as the CDU such as the CDU and CVS, there are still obstacles to involving people in decision-making. The HAS, which is endeavouring to improve this situation by activating a number of levers, will have to ensure that it goes beyond organisational issues to make the right to participation a concrete and effective reality, a real issue of political freedom and citizenship.
{"title":"La Haute Autorité de santé et la participation des usagers aux instances institutionnelles","authors":"Stéphanie Rabiller (Maître de conférences, HDR)","doi":"10.1016/j.meddro.2025.01.008","DOIUrl":"10.1016/j.meddro.2025.01.008","url":null,"abstract":"<div><div>The active participation of users in the healthcare system, although widely proclaimed, is struggling to be fully in practice. Despite the 2002 laws instituting bodies such as the CDU such as the CDU and CVS, there are still obstacles to involving people in decision-making. The HAS, which is endeavouring to improve this situation by activating a number of levers, will have to ensure that it goes beyond organisational issues to make the right to participation a concrete and effective reality, a real issue of political freedom and citizenship.</div></div>","PeriodicalId":41275,"journal":{"name":"Medecine & Droit","volume":"2025 191","pages":"Pages 37-41"},"PeriodicalIF":0.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.meddro.2024.09.001
Francis Megerlin , Gilles Bouvenot , Patrice Queneau
Deprescribing aim to improve the clinical condition of patients, through progressively reducing and/or discontinuing certain drug treatments. This paper reports its conceptual genesis and gradual diffusion, the dynamics of practitioners/healthcare insurer agreements in France, and medical liability. Irrespective of any incentive agreement, consideration of the advisability of de-prescribing has become mandatory in situations where iatrogenic risks are well established – particularly in the case of multi-medication treatments: as knowledge grows, failure to deprescribe (or to consider the advisability of doing so) could be considered a fault. However, de-prescribing is not a quantitative approach, due to its clinical purpose and consequences: it requires gathering scattered data, prioritizing treatments, planning, and sometimes arbitrating between therapeutic intentions. Interprofessional collaboration is then served by new tools and informed by experience-sharing: they alone can meet the clinical and societal challenge of deprescribing, while dedicated algorithms and AI are coming.
{"title":"Déprescription et responsabilité médicale","authors":"Francis Megerlin , Gilles Bouvenot , Patrice Queneau","doi":"10.1016/j.meddro.2024.09.001","DOIUrl":"10.1016/j.meddro.2024.09.001","url":null,"abstract":"<div><div>Deprescribing aim to improve the clinical condition of patients, through progressively reducing and/or discontinuing certain drug treatments. This paper reports its conceptual genesis and gradual diffusion, the dynamics of practitioners/healthcare insurer agreements in France, and medical liability. Irrespective of any incentive agreement, consideration of the advisability of de-prescribing has become mandatory in situations where iatrogenic risks are well established – particularly in the case of multi-medication treatments: as knowledge grows, failure to deprescribe (or to consider the advisability of doing so) could be considered a fault. However, de-prescribing is not a quantitative approach, due to its clinical purpose and consequences: it requires gathering scattered data, prioritizing treatments, planning, and sometimes arbitrating between therapeutic intentions. Interprofessional collaboration is then served by new tools and informed by experience-sharing: they alone can meet the clinical and societal challenge of deprescribing, while dedicated algorithms and AI are coming.</div></div>","PeriodicalId":41275,"journal":{"name":"Medecine & Droit","volume":"2025 191","pages":"Pages 46-52"},"PeriodicalIF":0.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.meddro.2024.10.003
Amandine Cayol (Maître de conférences en droit privé, Codirectrice du Master Droit des assurances, Codirectrice de la Clinique juridique de Normandie, Membre de l’Institut Caennais de Recherche Juridique – ICReJ (UR 967), Membre associée du LexFEIM, Le Havre (UR 1013))
The growing use of artificial intelligence systems in the field of mental health is not without consequences for patient care and the medical relationship. It influences both the role of the doctor and the place of the patient.
{"title":"Repenser la prise en charge de la santé mentale à l’ère de l’IA","authors":"Amandine Cayol (Maître de conférences en droit privé, Codirectrice du Master Droit des assurances, Codirectrice de la Clinique juridique de Normandie, Membre de l’Institut Caennais de Recherche Juridique – ICReJ (UR 967), Membre associée du LexFEIM, Le Havre (UR 1013))","doi":"10.1016/j.meddro.2024.10.003","DOIUrl":"10.1016/j.meddro.2024.10.003","url":null,"abstract":"<div><div>The growing use of artificial intelligence systems in the field of mental health is not without consequences for patient care and the medical relationship. It influences both the role of the doctor and the place of the patient.</div></div>","PeriodicalId":41275,"journal":{"name":"Medecine & Droit","volume":"2025 191","pages":"Pages 53-55"},"PeriodicalIF":0.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.meddro.2024.11.004
Arnaud Lami (Maître de conférences HDR)
Established for several decades, the certification of healthcare establishments has continued to grow. Having become an essential element of healthcare system governance, certification has led to many innovations. As a result, healthcare establishments have had to develop strategies to best appropriate this approach.
{"title":"Stratégie et certification des établissements de santé","authors":"Arnaud Lami (Maître de conférences HDR)","doi":"10.1016/j.meddro.2024.11.004","DOIUrl":"10.1016/j.meddro.2024.11.004","url":null,"abstract":"<div><div>Established for several decades, the certification of healthcare establishments has continued to grow. Having become an essential element of healthcare system governance, certification has led to many innovations. As a result, healthcare establishments have had to develop strategies to best appropriate this approach.</div></div>","PeriodicalId":41275,"journal":{"name":"Medecine & Droit","volume":"2025 191","pages":"Pages 42-45"},"PeriodicalIF":0.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号