[Medical risk and liability in stomatology in the year 2000].

Rev Stomatol Chir Maxillofac

Service de Stomatologie et Chirurgie Maxillo-Faciale, CHU, Angers.

Published: June 2000

In the current context of scientific progress, the evolution of medical liability is directly related to the increasing potential danger of medical procedures, the widening field of medical intervention, the growing concern about becoming a victim, and the changing notions about responsibility. We present here recent changes in administrative and legal jurisprudence. As administrative instances have progressively acquired more and more freedom of action, they have successively accepted hypotheses of presumed misconduct, abandoned the prerequisite of major misconduct, and allowed cases of liability without misconduct. The attitudes of legal instances remained unchanged for a long period before developing the concept of lost opportunity, then the presumption of misconduct in the case of nosocomial infections, and more recently, the notions of prejudice resulting from lack of information and the obligation for safe outcome accessory to the obligation to use available means. The future remains quite uncertain. One can expect a convergence between administrative and judiciary judges. For many, this unification will lead to a desirable "block of competency". We are probably moving towards the notion of objective responsibility which would allow indemnities to be awarded for medical accidents, but leaving open the possibility of court action for misconduct. The question remains open concerning the modalities of implementation: legislation or jurisprudence with its inherent risks.

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