Medecine & Droit最新文献

The long-awaited judgment issued about the Mediator case by the 31st criminal court of the Tribunal de grande instance de Paris will not be the last one. The public prosecutor, as well as Servier and some of the victims have called for the appeal. Nevertheless, the number of victims reflects the extent of damage caused by this medicine. The complexity of the procedure highlights the specificities of the civil and administrative jurisdictions, as well as the transactional process. The purpose is to study the main points related to this articulation.

A patient suffers of a genetical disease. He does not wish to inform his family. Is he responsible for a lost of chances of his parents, chances to prevent the disease, or to receive care? Is there a second class of patients?

We offer a reflection around a clinical case of nosocomial infection allowing us to address the difficulties faced by experts and lawyers and other jurists in matters of medical liability. This case is the result of an exercise proposed within the framework of the national DIU (interuniversity diploma) in medical accidents for which the two authors are responsible in Amiens and Bordeaux. The writing was enriched with the responses of the students. This clinical case makes it possible to approach the compensation for nosocomial infections, to compare the amicable procedure before the conciliation and compensation commission for medical accidents and the procedure before a judicial or administrative jurisdiction. Finally, the reflection focuses on patient information, especially protected adult, and access to the medical file. It is not a question here of detailing the medical care but of discussing medical responsibility and the rights of the patients.

Medico-legal autopsy sometimes requires the use of the Parasitology-Mycology specialty. Two recent medico-legal clinical cases, involving this specialty, have questioned us. First of all, may a non-conformity biological analytical (compared to accepted and accredited standards by COFRAC) fail the whole biological expertise, and thereafter, the medico-legal expertise of the file? The answer must consider that the raw result obtained as a result of a medical biology technique must be interpreted and discussed by the expert in the discipline (in this case by the parasitologist) before being included in the medical discussion and discussed by the medical examiner. The judgment is secondarily delivered by the judge according to his intimate conviction and without determining the probative value of the examination. Should a post-mortem biological examination be part of an expertise in medical biology or is it a technical and scientific examination? This answer is based on the previous one, considering the significant contribution of the expert who will bring his knowledge, interpreting and discussing the raw result. A simple technical and scientific examination would only provide the raw result without any assessment of the context and circumstances of the biological sample.

Dental implants are medical devices designed to create stable, strong, non-iatrogenic and durable anchors in the maxilla or mandible to which a removable or fixed dental prothesis fits, to replace one or more missing teeth. From the 1970s to 2000, these medical devices experienced changes in shape and materials before a consensus was reached on a type of implant that responded to the standard of care. This raises the question of the medical liability of healthcare professionals who use different implant systems in their practices. The present article proposes to highlight the choice of the dental implant by dental practitioner, its design and the materials used, on the field of the medical liability, through a retrospective study of judicial decisions in France. The “Brånemark-type” endosseous cylindrical-conical screw implant is considered as standard of care in France. The dental surgeon has the possibility to use other types of dental implants when the clinical situation strictly contraindicates the use of cylindrical-conical screw implants. In case of litigation, he must be able to justify his choices.

Forensic expertise becomes dominant in our society. Several reports questioned the competence of medical experts. We analysed the scientific competence of the 136 experts in Anaesthesia, Intensive Care and Emergency Medicine from senior courts in France. For that purpose, we made the choice of the H-Index and the number of scientific publications as markers of quality, using Google Scholar and PubMed databases. Thirty-five percent of experts have an H-Index equal to zero and 27 % never published. Out of the 104 experts who published at least one scientific article, 27 (26 %) did not publish for at least 10 years. The present study illustrates the great heterogeneity of the medical expert population regarding our criterions of judgement. This questions the selection and the operating mode of legal experts. There is a major difference with the selection process performed by the French Conciliation and Compensation Commissions. We propose that the official scholarly societies should be consulted during the appointment process.

As the first vaccines against COVID-19 arrive on the market, the question of the safety of these products arises in the public debate. The major concern is about the possible occurrence of adverse effects, particularly in the context of the use of novel pharmaceutical technologies such as mRNA. It is important to remind both patients and professionals that a vaccine is not only a medicinal product in its own right, but also a special medicinal product: biological and immunological. As a result, its supervision is draconian, and despite the urgency, no requirements have been lowered. The speed of marketing is the result both of adapted clinical trials and optimized evaluation procedures.

Torture and ill treatment constitute a serious violation of basic human rights. Health professionals are actors capable of acting, in addition to caring for the victims, for the advent of a world without torture. Thorough investigation and substantiated documentation of allegations of torture can help victims to tell the truth about what has happened to them and support them in their quest for justice and reparation. They help victims to obtain credible evidence that torture has taken place, allowing them to assert their rights. Trained health professionals can document the physical and psychological trauma resulting from torture, and link them to specific torture practices with a very high level of credibility, using the Istanbul protocol, a manual on documentation of torture approved by the United Nations. Victims can use this evidence to formally file a complaint to substantiate allegations in civil or criminal cases, as a basis for their request for rehabilitation assistance, and as an official acknowledgment of the harm they have suffered. This work aims to point out the important role of the doctor in the process of documenting the allegations of torture and other ill treatment and the need for training on the ethical, legal and practical aspects of this intervention in order to participate in prevention, and fight against this crime.

When a suicidal act is attributed to work, in addition to the qualification of a work accident, the employer's inexcusable fault, based on his obligation of safety, can be retained if the latter was aware of the danger incurred by his subordinate and did not take the necessary measures to protect him. Two points stand out. On the one hand, the risk of suicide is not always predictable, which leads to a more general thinking on its prevention. On the other hand, since 2015, two conceptions regarding the obligation of security have coexisted, new in labour law and, constant in social security law, with litigation falling under two separate chambers of the High Court. Three judgments from October 8, issued by the second civil chamber of the High Court appear to be moving towards a harmonization of case law. Consequently, their scope should be assessed, in particular regarding the preventive measures expected from the employer.