Le traitement juridique spécial du chirurgien esthétique

The prominent place given to physical appearance in the current society qualified as the society of the “image”, has made cosmetic surgery, the most common surgical practice and claimed. This practice which was deemed illegal at one time and was then linked to the only therapeutic purposes has been recognized by the French courts following a change praetorian in 1936. The reasons supporting such a delay of recognition result from the specificity that distinguishes cosmetic surgery of the other surgical branches, it’s characterized by its very nature which is devoid of any curative purposes and is performed on a healthy person and its purpose is to achieve an improvement in the physical appearance and the morphology of the person concerned. This dual specificity also distinguishes cosmetic surgery from reconstructive and restorative surgeries. The specifications of cosmetic surgery required a special legal treatment of the cosmetic surgeon so it does not take advantage of the physical and mental fragility that has an obsession with beauty and physical development. Thus, we approached in this study the specific features of the legal treatment of the cosmetic surgeon in terms of obligations and responsibility.Regarding obligations, the specificity of cosmetic surgery requires a rigorous information obligation of the cosmetic surgeon to lead to a prior informed consent of the patient contained also on a written quotation. It requires a three-step process prior […] As for the cosmetic surgeon’s responsibility, it is also specific regarding its civil and criminal responsibilities : Specificity of its liability has led the French courts which made its approach towards the nature of the cosmetic surgeon’s obligation to conduct a process of «changing» the rules of common law in an attempt to adapt to specificity of cosmetic surgery and the resulting liability. However, the judicial process was not adapted to the specificity of cosmetic surgery, it led to a significantly wider confusion in the jurisprudence and doctrine, it is therefore questionable. Thus, we propose in this paper a specific regime for civil liability cosmetic surgeon three-sided : The contractual liability of the cosmetic surgeon linked to the specific contract cosmetic surgery that aims to improve morphology and has the objective of achieving the expected result which has justified the intervention. Thus, the cosmetic surgeon provides the aesthetic result of the intervention. Maintaining liability regarding damages that occur during the execution of the contractual obligation. The establishment of a special regime taking into account the case of damage due to therapeutic hazards and exceptional risks considering a compensation scheme automatically linked to specific cases that are placed outside the regime of civil liability. As to the criminal responsibility of the cosmetic surgeon, a special incrimination is strictly adapted to the nature of the surgery mainly applies in three situations : sexual remodeling, false advertising and scientific experimentation.La place primordiale accordée à l’apparence physique dans la société actuelle, qui est une société de «l’image», a fait de la chirurgie esthétique la pratique chirurgicale la plus répandue et réclamée. Cette pratique, d’abord considérée illicite, puis exclusivement liée à des fins thérapeutiques, fut reconnue par la jurisprudence française à la suite d’une évolution prétorienne en 1936. Les raisons d’un tel retard de reconnaissance résident dans la spécificité qui distingue la chirurgie esthétique des autres branches de la médecine chirurgicale : en effet, la chirurgie esthétique se caractérise d’une part par sa nature qui est dépourvue de toute finalité curative et qui est réalisée sur une personne jouissant d’une bonne santé et, d’autre part, par sa finalité puisqu’elle vise à réaliser une amélioration de l’apparence physique et de la morphologie de la personne concernée. Cette double spécificité distingue également la chirurgie esthétique de la chirurgie reconstructrice et réparatrice. Ces caractéristiques mêmes de la chirurgie esthétique ont exigé, de la jurisprudence, mais également du législateur français, un traitement juridique spécial du chirurgien esthétique en vue d’éviter que ce dernier ne profite de la fragilité, aussi bien physique que psychique, de la personne ayant une obsession de beauté et de perfectionnement physique dans un domaine non curatif. C’est ainsi que nous avons abordé, dans la présente étude, les points spécifiques du traitement juridique du chirurgien esthétique, tant au regard de ses obligations que de sa responsabilité. Relativement aux obligations, la spécificité de la chirurgie esthétique exige tout d’abord un devoir d’information rigoureuse de la part du praticien afin d’aboutir à un consentement préalable éclairé du patient, ce qui suppose un devis écrit contenant tous les renseignements relatifs à l’intervention. Elle exige, d’autre part, un processus préalable en trois étapes […] Pour ce qui est de la responsabilité du chirurgien esthétique, elle est également spécifique, et ce sur les plans civil et pénal : Sur le plan civil, sa spécificité a poussé la jurisprudence française, qui a réalisé son approche du point de vue de la nature de l’obligation du chirurgien esthétique, à procéder à une démarche de « mutation » des règles applicables en droit commun dans une tentative de les adapter à la spécificité de l’intervention chirurgicale esthétique et de la responsabilité du praticien qui en découle. Cependant, la démarche jurisprudentielle était inadaptée à la spécificité de la chirurgie esthétique, et a entrainé une large confusion au sein de la jurisprudence et de la doctrine ; elle est donc critiquable. C’est ainsi que la présente étude propose un régime spécifique à la responsabilité civile du chirurgien esthétique à trois facettes : La détermination du cadre juridique de la responsabilité contractuelle du chirurgien esthétique liée à la spécificité du contrat de chirurgie esthétique ayant pour objet unique l’amélioration de morphologie et pour objectif la réalisation du résultat attendu qui a justifié l’intervention esthétique ; ainsi le chirurgien garantit le résultat esthétique de l’intervention. Le maintien de la responsabilité extracontractuelle en ce qui concerne les dommages qui surviennent à l’occasion de l’exécution de l’obligation contractuelle. L’institution d’un régime spécifique prenant en considération l’éventualité des dommages survenus en raison des aléas thérapeutiques et des risques exceptionnels, en envisageant un régime d’indemnisation automatique lié à des cas spécifiques qui se place en dehors du régime de la responsabilité civile. Quant à la responsabilité pénale du chirurgien esthétique, une incrimination spéciale et strictement adaptée à la nature de la chirurgie esthétique s’applique essentiellement dans trois circonstances : le remodelage sexuel, la publicité mensongère et l’expérimentation scientifique

Special legal treatment of the cosmetic surgeon

La place primordiale accordée à l’apparence physique dans la société actuelle, qui est une société de «l’image», a fait de la chirurgie esthétique la pratique chirurgicale la plus répandue et réclamée. Cette pratique, d’abord considérée illicite, puis exclusivement liée à des fins thérapeutiques, fut reconnue par la jurisprudence française à la suite d’une évolution prétorienne en 1936. Les raisons d’un tel retard de reconnaissance résident dans la spécificité qui distingue la chirurgie esthétique des autres branches de la médecine chirurgicale : en effet, la chirurgie esthétique se caractérise d’une part par sa nature qui est dépourvue de toute finalité curative et qui est réalisée sur une personne jouissant d’une bonne santé et, d’autre part, par sa finalité puisqu’elle vise à réaliser une amélioration de l’apparence physique et de la morphologie de la personne concernée. Cette double spécificité distingue également la chirurgie esthétique de la chirurgie reconstructrice et réparatrice. Ces caractéristiques mêmes de la chirurgie esthétique ont exigé, de la jurisprudence, mais également du législateur français, un traitement juridique spécial du chirurgien esthétique en vue d’éviter que ce dernier ne profite de la fragilité, aussi bien physique que psychique, de la personne ayant une obsession de beauté et de perfectionnement physique dans un domaine non curatif. C’est ainsi que nous avons abordé, dans la présente étude, les points spécifiques du traitement juridique du chirurgien esthétique, tant au regard de ses obligations que de sa responsabilité. Relativement aux obligations, la spécificité de la chirurgie esthétique exige tout d’abord un devoir d’information rigoureuse de la part du praticien afin d’aboutir à un consentement préalable éclairé du patient, ce qui suppose un devis écrit contenant tous les renseignements relatifs à l’intervention. Elle exige, d’autre part, un processus préalable en trois étapes […] Pour ce qui est de la responsabilité du chirurgien esthétique, elle est également spécifique, et ce sur les plans civil et pénal : Sur le plan civil, sa spécificité a poussé la jurisprudence française, qui a réalisé son approche du point de vue de la nature de l’obligation du chirurgien esthétique, à procéder à une démarche de « mutation » des règles applicables en droit commun dans une tentative de les adapter à la spécificité de l’intervention chirurgicale esthétique et de la responsabilité du praticien qui en découle. Cependant, la démarche jurisprudentielle était inadaptée à la spécificité de la chirurgie esthétique, et a entrainé une large confusion au sein de la jurisprudence et de la doctrine ; elle est donc critiquable. C’est ainsi que la présente étude propose un régime spécifique à la responsabilité civile du chirurgien esthétique à trois facettes : La détermination du cadre juridique de la responsabilité contractuelle du chirurgien esthétique liée à la spécificité du contrat de chirurgie esthétique ayant pour objet unique l’amélioration de morphologie et pour objectif la réalisation du résultat attendu qui a justifié l’intervention esthétique ; ainsi le chirurgien garantit le résultat esthétique de l’intervention. Le maintien de la responsabilité extracontractuelle en ce qui concerne les dommages qui surviennent à l’occasion de l’exécution de l’obligation contractuelle. L’institution d’un régime spécifique prenant en considération l’éventualité des dommages survenus en raison des aléas thérapeutiques et des risques exceptionnels, en envisageant un régime d’indemnisation automatique lié à des cas spécifiques qui se place en dehors du régime de la responsabilité civile. Quant à la responsabilité pénale du chirurgien esthétique, une incrimination spéciale et strictement adaptée à la nature de la chirurgie esthétique s’applique essentiellement dans trois circonstances : le remodelage sexuel, la publicité mensongère et l’expérimentation scientifique.The prominent place given to physical appearance in the current society qualified as the society of the “image”, has made cosmetic surgery, the most common surgical practice and claimed. This practice which was deemed illegal at one time and was then linked to the only therapeutic purposes has been recognized by the French courts following a change praetorian in 1936. The reasons supporting such a delay of recognition result from the specificity that distinguishes cosmetic surgery of the other surgical branches, it’s characterized by its very nature which is devoid of any curative purposes and is performed on a healthy person and its purpose is to achieve an improvement in the physical appearance and the morphology of the person concerned. This dual specificity also distinguishes cosmetic surgery from reconstructive and restorative surgeries. The specifications of cosmetic surgery required a special legal treatment of the cosmetic surgeon so it does not take advantage of the physical and mental fragility that has an obsession with beauty and physical development. Thus, we approached in this study the specific features of the legal treatment of the cosmetic surgeon in terms of obligations and responsibility.Regarding obligations, the specificity of cosmetic surgery requires a rigorous information obligation of the cosmetic surgeon to lead to a prior informed consent of the patient contained also on a written quotation. It requires a three-step process prior […] As for the cosmetic surgeon’s responsibility, it is also specific regarding its civil and criminal responsibilities : Specificity of its liability has led the French courts which made its approach towards the nature of the cosmetic surgeon’s obligation to conduct a process of «changing» the rules of common law in an attempt to adapt to specificity of cosmetic surgery and the resulting liability. However, the judicial process was not adapted to the specificity of cosmetic surgery, it led to a significantly wider confusion in the jurisprudence and doctrine, it is therefore questionable. Thus, we propose in this paper a specific regime for civil liability cosmetic surgeon three-sided : The contractual liability of the cosmetic surgeon linked to the specific contract cosmetic surgery that aims to improve morphology and has the objective of achieving the expected result which has justified the intervention. Thus, the cosmetic surgeon provides the aesthetic result of the intervention. Maintaining liability regarding damages that occur during the execution of the contractual obligation. The establishment of a special regime taking into account the case of damage due to therapeutic hazards and exceptional risks considering a compensation scheme automatically linked to specific cases that are placed outside the regime of civil liability. As to the criminal responsibility of the cosmetic surgeon, a special incrimination is strictly adapted to the nature of the surgery mainly applies in three situations : sexual remodeling, false advertising and scientific experimentation

Impact of Consanguinity on Cancer in a Highly Endogamous Population

Background: Many epidemiological studies have indicated that inbreeding has little or no effect on the incidence of cancer. Due to the high prevalence of consanguinity in Qatar (54%), its influence may nevertheless be of special importance. Aim: The aim of this study was to examine whether parental consanguinity affects the risk of cancer in a local Arab highly inbred population. Design: Matched case-control study. Setting : The study was carried out in Al-Amal cancer hospital and primary health care centers in Qatar over a period from August 2008 to February 2009. Subjects and Methods: The study included 370 Qataris and other Arab expatriates with various types of cancers and 635 controls matched by age and ethnicity. A questionnaire that included sociodemographic information, type of consanguinity, medical history, and tumor grade was designed to collect the information of cases and controls. Results: The study revealed that the rate of parental consanguinity was similar in both cases (29.5%) and controls (29.9%) with a higher inbreeding coefficient in controls (0.017 +/- 0.03), compared to cancer patients (0.0155 +/- 0.03). Other Arab expatriates had a higher incidence of cancer (61.1%) than Qataris (38.9%). The inbreeding coefficient was higher in male cancer patients (0.0189 +/- 0.03), but lower in female cancer patients (0.014 +/- 0.03) as compared to controls. Controls were more inbred in the overall studied subjects (23.6%) and women (23.8%) than cases. The coefficient of inbreeding was lower in patients with breast (0.014), skin (0.012), thyroid (0.008) and female genital (0.014) cancers, whereas it was higher in cases for leukemia and lymphoma (0.018), colorectal (0.025) and prostate (0.017), with no significant difference between cases and controls. No significant differences were observed between cases and controls in the parental consanguinity, mean coefficient of inbreeding and proportion of more inbred subjects. Conclusions: The study findings revealed that although the consanguinity rate is high in our Arab population, it has no effect on the incidence of cancers overall. However, there was an increased risk found for leukemia and lymphoma, colorectal and prostate cancer groups, but a reduced risk in breast, skin, thyroid and female genital cancer groups

Thermal Energy Storage and Heat Transfer of Nano-Enhanced Phase Change Material (NePCM) in a Shell and Tube Thermal Energy Storage (TES) Unit with a Partial Layer of Eccentric Copper Foam

Thermal energy storage units conventionally have the drawback of slow charging response. Thus, heat transfer enhancement techniques are required to reduce charging time. Using nanoadditives is a promising approach to enhance the heat transfer and energy storage response time of materials that store heat by undergoing a reversible phase change, so-called phase change materials. In the present study, a combination of such materials enhanced with the addition of nanometer-scale graphene oxide particles (called nano-enhanced phase change materials) and a layer of a copper foam is proposed to improve the thermal performance of a shell-and-tube latent heat thermal energy storage (LHTES) unit filled with capric acid. Both graphene oxide and copper nanoparticles were tested as the nanometer-scale additives. A geometrically nonuniform layer of copper foam was placed over the hot tube inside the unit. The metal foam layer can improve heat transfer with an increase of the composite thermal conductivity. However, it suppressed the natural convection flows and could reduce heat transfer in the molten regions. Thus, a metal foam layer with a nonuniform shape can maximize thermal conductivity in conduction-dominant regions and minimize its adverse impacts on natural convection flows. The heat transfer was modeled using partial differential equations for conservations of momentum and heat. The finite element method was used to solve the partial differential equations. A backward differential formula was used to control the accuracy and convergence of the solution automatically. Mesh adaptation was applied to increase the mesh resolution at the interface between phases and improve the quality and stability of the solution. The impact of the eccentricity and porosity of the metal foam layer and the volume fraction of nanoparticles on the energy storage and the thermal performance of the LHTES unit was addressed. The layer of the metal foam notably improves the response time of the LHTES unit, and a 10% eccentricity of the porous layer toward the bottom improved the response time of the LHTES unit by 50%. The presence of nanoadditives could reduce the response time (melting time) of the LHTES unit by 12%, and copper nanoparticles were slightly better than graphene oxide particles in terms of heat transfer enhancement. The design parameters of the eccentricity, porosity, and volume fraction of nanoparticles had minimal impact on the thermal energy storage capacity of the LHTES unit, while their impact on the melting time (response time) was significant. Thus, a combination of the enhancement method could practically reduce the thermal charging time of an LHTES unit without a significant increase in its size.QC 20210907</p

Synergism between IL7R and CXCR4 drives BCR-ABL induced transformation in Philadelphia chromosome-positive acute lymphoblastic leukemia

Emergence of ABL1 kinase inhibitor resistant clones may cause disease relapse in Philadelphia chromosome-positive acute lymphoblastic leukemia. Here, the authors show interleukin 7 receptor (IL7R) signaling to contribute to this resistance mechanism, and that targeting the IL7R pathway may suppress incurable drug-resistant leukemia forms

The Small GTPase RHOA Links SLP65 Activation to PTEN Function in Pre B Cells and Is Essential for the Generation and Survival of Normal and Malignant B Cells

The generation, differentiation, survival and activation of B cells are coordinated by signals emerging from the B cell antigen receptor (BCR) or its precursor, the pre-BCR. The adaptor protein SLP65 (also known as BLNK) is an important signaling factor that controls pre-B cell differentiation by down-regulation of PI3K signaling. Here, we investigated the mechanism by which SLP65 interferes with PI3K signaling. We found that SLP65 induces the activity of the small GTPase RHOA, which activates PTEN, a negative regulator of PI3K signaling, by enabling its translocation to the plasma membrane. The essential role of RHOA is confirmed by the complete block in early B cell development in conditional RhoA-deficient mice. The RhoA-deficient progenitor B cells showed defects in activation of immunoglobulin gene rearrangement and fail to survive both in vitro and in vivo. Reconstituting the RhoA-deficient cells with RhoA or Foxo1, a transcription factor repressed by PI3K signaling and activated by PTEN, completely restores the survival defect. However, the defect in differentiation can only be restored by RhoA suggesting a unique role for RHOA in B cell generation and selection. In full agreement, conditional RhoA-deficient mice develop increased amounts of autoreactive antibodies with age. RHOA function is also required at later stage, as inactivation of RhoA in peripheral B cells or in a transformed mature B cell line resulted in cell loss. Together, these data show that RHOA is the key signaling factor for B cell development and function by providing a crucial SLP65-activated link between BCR signaling and activation of PTEN. Moreover, the identified essential role of RHOA for the survival of transformed B cells offers the opportunity for targeting B cell malignancies by blocking RHOA function