title: [Safety and accuracy of surgical procedures: case law evolution].
abstract: Surgeons, like other doctors, practice their profession within a framework of contractual liability defined by statute in 1936. This established that the doctor was subject to a contractual obligation to provide appropriate and diligent care. Care and technical acts should conform to those which would have been provided by a prudent doctor within the standards of knowledge and practice of his field; care which deviates from this standard would be considered medical error or fault. This standard of care is referred to as "sound professional conduct". However, while not calling this basic principle into question, civil jurisdictions have progressively held surgeons liable whenever injury has occurred following surgical acts, without considering whether care deviates from sound professional conduct. Since 2000, judges have begun to attribute a requirement for absolute safety of results in cases where the surgeon had injured an organ unrelated to the planned operation. However it seems that the rare judgments given on this topic in the last 2-3 years have become less frequent. The creation of a compensation regime for medical accidents, via the law dated March 4, 2002, has contributed to this evolution. It is to be hoped that the flaws described in this system do not encourage jurisdictions to reconsider previous case law decisions.
authors.affiliation: Université d'Angers, IFR 132, laboratoire INSERM (U 922 LHEA); service de médecine légale, CHU d'Angers - Angers. CIRouge-Maillart@chu-angers.fr
authors.forename: C
authors.initials: C
authors.lastname: Rougé-Maillart
authors.forename: A
authors.initials: A
authors.lastname: Gaudin
authors.forename: E
authors.initials: E
authors.lastname: Lermite
authors.forename: J-P
authors.initials: JP
authors.lastname: Arnaud
authors.forename: M
authors.initials: M
authors.lastname: Penneau
mesh_terms: D005602:France; D006801:Humans; D007603:Jurisprudence; D016365:Liability, Legal; D008318:Malpractice / Q000331:legislation & jurisprudence; D019300:Medical Errors / Q000331:legislation & jurisprudence* / Q000517:prevention & control*; D012449:Safety / Q000331:legislation & jurisprudence; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000331:legislation & jurisprudence / Q000592:standards*