Homicide et enfant à naître : une occasion manquée

The ruling of June 30, 1999 was one of the first significant rulings given by the French Supreme Court with regard to the criminalization of unintentional feticide. The question posed essentially asked whether a physician who committed a fault leading to the death of a fetus could be accused of manslaughter, which is a criminal offense under Article 221-6 of the French Criminal Code? The Court ruled not to describe this as feticide. It upheld this position in several subsequent rulings, considering that the unborn child, even when viable, was not a human being equipped with a legal personality. Early on, the French doctrine displayed shock at the fact that no criminal offense was recognized and, in its majority, it condemned the Supreme Court\u27s position, both on legal arguments and extra-legal arguments. Case law was stable until February 4, 2014, when a criminal court sentenced a motorist for the manslaughter of a six-month old fetus, following its death in utero. On appeal, one year later, the Court ultimately upheld the position of the French Supreme Court

The problem with medical research on tissue and organ samples taken in connection with forensic autopsies in France

Currently, in France, it is legally impossible to conduct scientific research on tissue and organ samples taken from forensic autopsies. In fact, the law schedules the destruction of such samples at the end of the judicial investigation, and the common law rules governing cadaver research cannot be applied to the forensic context. However, nothing seems in itself to stand in the way of such research since, despite their specific nature, these samples from forensic autopsies could be subject, following legislative amendments, to common law relating to medical research on samples taken from deceased persons. But an essential legislative amendment, firstly to allow the Biomedicine Agency to become authorized to issue a research permit and secondly, to change the research conditions in terms of the non-opposition of the deceased to said research. Such an amendment would be a true breakthrough because it would allow teams to continue to move forward calmly in research, and allow this research to be placed within a legal framework, which would promote international exchanges

Le préjudice moral né du défaut d’information du patient

Le défaut d’information du patient sur les risques d’un acte médical pourrait-il être constitutif d’un préjudice moral dit « préjudice d’impréparation » alors qu’aucune perte de chance ne peut être retenue 

L’immunité indemnitaire du médecin salarié ne profite pas à son assureur. À propos de Civ. 1, 12 juillet 2007

Selon un arrêt du 12 juillet 2007 de la Cour de cassation, l’assureur de responsabilité civile de l’établissement de soins, tenu, en sa qualité de commettant, pour responsable du dommage causé par son préposé, peut exercer un recours subrogatoire contre l’assureur du salarié

Gravity “steps” at Mt. Etna volcano (Italy). Instrumental effects or evidences of earthquake-triggered magma density changes?

On two occasions, sudden gravity changes occurred simultaneously at two summit Etna’s stations, during local low-magnitude earthquakes. A systematic coupling between earthquakes inducing comparable maximum acceleration and displacement at the observation points and gravity steps is missing, implying (a) the non-instrumental nature of the steps and (b) the need for particular underlying conditions for the triggering mechanism(s) to activate. We review some of the volcanological processes that could induce fast underground mass redistributions, resulting in gravity changes at the surface. These processes involve bubbles and crystals present in the magma and require particular conditions in order to be effective as mass-redistributing processes. The gravity steps could be a geophysical evidence of the dynamical stress transfer between tectonic and magmatic systems at a local scale. Given the implications that these transfers may have on the volcanic activity, routine volcano monitoring should include the observation of fast gravity changes

Faut-il reconnaître l’« aléa chirurgical » ?

Depuis plusieurs années, la jurisprudence considère de manière distincte la faute de technique opératoire. L’obligation d’exactitude du geste opératoire s’est vue renforcée et depuis 1997, il semblait acquis que la faute technique puisse être retenue dès lors que le praticien « porte atteinte à un organe ou à un tissu qu’il n’était pas nécessaire de toucher pour réaliser l’intervention ». Pourtant, dans certaines situations, le dommage n’est pas en rapport avec un manquement aux règles de l’art, mais lié à une complication inhérente à la technique. La Cour de cassation avait toujours refusé l’idée d’un « aléa chirurgical » et reconnu que toute atteinte d’un organe, autre que ceux visés lors de l’intervention, révélait obligatoirement une imprudence du chirurgien. Pourtant, en reconnaissant comme fautif un chirurgien qui a respecté les règles de l’art, le juge risque de s’éloigner des principes de la responsabilité médicale. Des arrêts rendus ces trois dernières années nous amènent à rediscuter l’opportunité de reconnaître l’existence d’un aléa chirurgical

Updated review of postmortem biochemical exploration of hypothermia with a presentation of standard strategy of sampling and analyses.

Hypothermia is defined as a core body temperature below 35°C and can be caused by environmental exposure, drug intoxication, metabolic or nervous system dysfunction. This lethal pathology with medico-legal implications is complex to diagnose because macroscopic and microscopic lesions observed at the autopsy and the histological analysis are suggestive but not pathognomonic. Postmortem biochemical explorations have been progressively developed through the study of several biomarkers to improve the diagnosis decision cluster. Here, we present an updated review with novel biomarkers (such as catecholamines O-methylated metabolites, thrombomodulin and the cardiac oxyhemoglobin ratio) as well as some propositional interpretative postmortem thresholds and, to the best of our knowledge, for the first time, we present the most adapted strategy of sampling and analyses to identify biomarkers of hypothermia. For our consideration, the most relevant identified biomarkers are urinary catecholamines and their O-methylated metabolites, urinary free cortisol, blood cortisol, as well as blood, vitreous humor and pericardial fluid for ketone bodies and blood free fatty acids. These biomarkers are increased in response either to cold-mediated stress or to bioenergetics ketogenesis crisis and significantly contribute to the diagnosis by exclusion of death by hypothermia

La recherche juridique sur les prélèvements biologiques réalisés dans le cadre des autopsies et objets de scellés judiciaires. Nécessité d'une adaptation législative

Currently, it is legally impossible to conduct scientific research on tissue and organ samples taken from forensic autopsies. In fact, the law schedules the destruction of such samples at the end of the judicial investigation, and the common law rules governing cadaver research cannot be applied to the forensic context. However, nothing seems in itself to stand in the way of such research since, despite their specific nature, these samples from forensic autopsies could be subject, following legislative amendments, to common law relating to medical research on samples taken from deceased persons. But an essential legislative amendment will have the goal firstly to allow the Biomedicine Agency to become authorized to issue a research permit and secondly, to change the research conditions in terms of the non-opposition of the deceased to the said research. Such an amendment would be a true breakthrough because it would allow teams to continue to move forward calmly in research, and allow this research to be placed within a legal framework, which would promote international exchanges

Organ donation in France: legislation, epidemiology and ethical comments

The Bioethics Laws revised in 2004 have defined rules concerning organ donation and transplantation. They have also permitted the creation of the French Biomedicine Agency which guarantees the right of enforcement. In France there are three situations in which organs may be harvested: from cadaveric donors, from living donors and, since 2005, from non heart beating donors.Organ harvesting from cadaveric donors is permissible if the deceased did not make known his refusal during his lifetime (this may be recorded in the national registry set up for this purpose). The rule of presumed consent also applies in the case of organs taken after cardiac arrest. With regard to organ harvesting from living persons, a panel of experts is required to give approval. The recipient\u27s spouse, brothers or sisters, sons or daughters, grandparents, uncles or aunts and first cousins may be authorised to donate organs, as well as the spouse of the recipient\u27s father or mother. The donor may be any person who provides proof of having lived with the recipient for at least two years. Some ethical questions will need to be resolved; for example the relevance of maintaining the EEG for brain death diagnosis, enforcement of the law on presumed consent, the real nature of the will of living donors and the definition of death