Vayre P
Service de Chirurgie Générale et Digestive, Groupe Hospitalier Pitié Salpêtrière, Paris.
Bull Acad Natl Med. 1996 Dec;180(9):2149-58; discussion 2158-61.
A study of 125 medico-legal opinions and evaluation of the literature allows for: an appreciation of the evolution in the concept in the jurisprudence pertaining to the responsibility of the surgeon in France in present practice conditions, a definition of the role of the legal expert, an explanation of the development of paths outside the procedural setting. In the present state of our knowledge the responsibility related to a prejudicial error has a frequency of 25-30% all jurisdictions and disciplines considered together. In 66% of cases the error is the absence of a timely treatment decision or a defective postoperative follow up. A mishap without proven error is present 50% of the cases which justifies a decision of coverage outside the civil responsibility of the surgeon. The modern conditions of surgical practice, the implications of the new technologies, the evolution of economic and socio-cultural ideas must lead the political decision makers and health-professionals to rapidly define a clear line of conduct. In the absence of comprehensive statistics from the courts, the qualitative and quantitative information contained in the national database "Remedhos France", now available, will be useful to inform the surgical community on the risk and its prevention, as well as to orient a homogenous doctrine and its applications in view of a common European approach.
一项对125份法医学意见书的研究以及对文献的评估得出以下结论：了解在当前实践条件下法国外科医生责任相关法学概念的演变，界定法律专家的角色，解释程序框架之外途径的发展。就我们目前的知识状况而言，与有害错误相关的责任在综合考虑所有司法管辖区和学科的情况下发生率为25%至30%。在66%的案例中，错误是未及时做出治疗决定或术后随访存在缺陷。50%的案例存在无过错的医疗事故，这证明了在外科医生民事责任范围之外做出承保决定的合理性。现代外科手术实践条件、新技术的影响、经济和社会文化观念的演变，必须促使政治决策者和卫生专业人员迅速确定明确的行为准则。由于缺乏来自法院的全面统计数据，目前可用的国家数据库“法国医疗补救措施”中包含的定性和定量信息，将有助于告知外科界相关风险及其预防措施，并鉴于欧洲的共同方法，为统一的学说及其应用提供指导。
