[Medical civil responsibility in the year 2000].

In France, during the last year, important jurisprudence was established by the French Supreme Court of Appeal concerning the physician's civil responsibility. 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 patient's decision, particularly information concerning life-threatening or severe consequences, but also, as in the past, concerning frequent even benign consequences. The limits of this jurisprudence and the completeness of the information, as established in 1998, are emergency, patient refusal and impossibility to inform the patient. In the decree of May 23, 2000, the Court gave its definition of impossibility to inform the patient, thus establishing the "therapeutic limits". But the judges recognized that the requirement for information delivery is independent 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 information delivery. Defective information delivery is not sufficient in itself to constitute a civil offense. Real damage is also necessary. To be awarded 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 had been well informed, the patient had consented to the care given, the physician would not be obliged to provide the patient with an indemnity. The judges 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 reasonable skill and care and they don't have any obligation to achieve a certain result. Sometimes, the physician has got an obligation to achieve a certain result but it isn't a general rule (November 08, 2000).