Responsabilité médicale et expertise : de la loi du Talion à la loi Kouchner

Despite the appearance from the Mesopotamian era of medical responsibility, an apparent impunity of the doctor will be in place until the 19th century. In France, it will be necessary to wait for the Napoleonic codes of 1804 and 1810 in order to clearly dissociate the civil and criminal responsibilities of the doctor. If liability for fault remains the rule in medical matters today, the concept of liability without fault introduced by the industrial revolution and the legislation on industrial accidents was taken up by the Kouchner law of 2002. It definitively opens the way to a statutory and legal compensation for non-faulty medical accidents under national solidarity via the National Office for Compensation for Medical Accidents (ONIAM) and the Conciliation and Compensation Commissions (CCI). Expertise in medical liability is now the backbone of the victim compensation process. It guides the magistrate in the recognition of faulty or non-faulty medical liability and helps him to set the amount of compensation allocated with regard to bodily injury.     

Sécurité des patients et développement des recherches : de la loi Bertrand à la loi Jardé

The legislator has successively adopted two laws amending deeply the legal framework of research. The first one is the law “Bertrand” no. 2011-2012 of 29 December 2011 on strengthening the safety of the drug and health products, which emphasizes the need for transparency of links of interest and opens wider opportunities for using post-marketing authorization trials. The second one is the law “Jardé” no. 2012-300 of March 5, 2012 on researches involving the human person, reforming all the rules governing researches and which establishes a national commission of researches involving the human person. If the first one is a clear move towards strengthening the protection of patients in research, it is possible to be more reserved about the effects of the latter, which seems more oriented towards an easing of constraints on researchers.     

Connaissances et contrôle exécutif : deux facteurs cognitifs de protection contre le vieillissement de la mémoire épisodique ?

In this study we refer to Craik and Bialystok's model distinguishing the “knowledge” (cultural learning experience that forms the basis for knowledge of the world) and the “executive control” (set of operations that control and regulate cognitive performance) as two main factors susceptible accounting for the age-related negative effects on the cognitive functioning, and for a possible age-related protective effect. Thus, the aim of the present study was to examine the possible protective effect of these two factors on the age-related decline in a cued-recall task. Four age groups of participants (20–39 years, 40–59 years, 60–74 years and 75–90 years) were administered with a word-stem cued-recall test to assess episodic memory, a “vocabulary” sub-test of the WAIS-R to assess knowledge and a reading span test to assess control. Results showed an age-related effect on the episodic memory, the control performance and the knowledge measure, indicating that performance decreases with age. A GLM analysis revealed a positive effect of the knowledge and the control factors on the cued-recall performance, and interaction between age and the knowledge factor resulting from a positive effect of the knowledge level only for the youngest group of participants (20–39 years). Furthermore, results revealed an interaction between age and the control factor, indicating a positive effect of the control level for the two oldest groups of participants (60–74 years and 75–90 years). These results suggest that, contrary to the knowledge, the control factor could be an effective protection against the age-related negative effects on the episodic memory.     

Le vaccin,un médicament devenu l’arme absolue promise contre la COVID-19 : une réglementation adaptée ?

As the first vaccines against COVID-19 arrive on the market, the question of the safety of these products arises in the public debate. The major concern is about the possible occurrence of adverse effects, particularly in the context of the use of novel pharmaceutical technologies such as mRNA. It is important to remind both patients and professionals that a vaccine is not only a medicinal product in its own right, but also a special medicinal product: biological and immunological. As a result, its supervision is draconian, and despite the urgency, no requirements have been lowered. The speed of marketing is the result both of adapted clinical trials and optimized evaluation procedures.     

Révision de la loi bioéthique : les dangers de l’autoconservation des ovocytes pour convenance personnelle

Legalization of self-conservation of ovocytes for personal convenience is considered by the second article of the bioethics legislative proposal, adopted by French National Assembly. This practice is aiming to allow men and women to keep their gametes for the purpose of a subsequent medically assisted procreation. Does this new liberty risks to take away a human's individual liberty and more specifically a women's one? Indeed, to legalize self-conservation of ovocytes for personal convenience means to extend the message whereby a woman could delay her maternity. The result would be an implicit pressure: as it becomes medically possible to privilege first of all a career and then to envisage maternity, woman seeking high performance must necessarily choose it. This technique could therefore hide a clear-cut decline for women's rights, again confronted with a cornelian choice, a family or a career.     

Psychologie de la santé et cancers : quels apports et quelles perspectives ?

How to adjust to the malignancy is an area that is widely explored by researchers in health psychology for over 35 years. A number of concepts and theories have been developed in an attempt to help people better cope with this particularly stressful life event. Two theoretical approaches are briefly presented: the transactional model of stress and the health belief model. Then, we discuss the interest of several concepts from these models (personality traits, social support, perceived control and coping), illustrating recent research. Finally, both theoretical and practical perspectives are discussed, with proposals that are supported to develop to help patients.     

De l’interdiction de la recherche sur l’embryon et les cellules souches au régime d’autorisation sous condition : brèves remarques sur la protection de la vie humaine dans la loi no 2013-715 du 6 août 2013

The publication in the Official Journal of Law No. 2013-715 of August 6th 2013 which authorizes under conditions embryos and embryonic stem cells research is a milestone in the legal and ethical field in France. Indeed, the new Article L. 2151-5 of the Public Health Code replaces the prohibition regime of embryos and embryonic stem cells research by an authorization regime, which raises the question of the value and the protection of embryonic life in French law.     

2004–2009 : révision de la loi de bioéthique en France,quels enjeux,quels débats ? Assistance médicale à la procréation,gestation pour autrui,transplantation

The bioethics law, adopted for the first time in 1994 and revised in 2004, is under revision again. This process has raised numerous debates at various institutional, professional and social levels. The government also organised a unique type of citizens’ consultation: the General Estates in Bioethics (GEB). Several panels of citizens had the opportunity to express their informed opinion on a selected set of topics concerning the law revision, after having received a special training by an expert committee. We have analysed the contributions of six public bodies – the Parliament Office for Scientific and Technological Choices Evaluation (OPECST), the National Consultative Ethics Committee, (CCNE), the State Council, (CE), the Biomedical Agency, (ABM), the Senate and the Parliamentary Information Mission for this bioethics law revision – as well as the final GEB's report. In this article, we present and compare their proposals on three themes: Medically assisted procreation (MAP), surrogacy and transplantation. Whereas a consensus emerged from the debates on certain issues – apart from the Senate, all institutions seem to be in favour of maintaining the current banning of surrogacy – other points are still under debate – how to open the access to MAP technologies, under what conditions should we grant access to selected data concerning gamete donors, how is death defined in the difficult conditions of a potential non heart beating donor, should the presumed consent regime for post mortem donation be revised, and if so how, – The parliament should discuss the law during 2010's first semester, and will have the difficult responsibility to take measures on issues raising medical, scientific, social, philosophical and moral questions.     

Interface travail–hors travail : la satisfaction et la perception des politiques d’aide à la conciliation,des variables déterminantes ?

Documentation refers to (work–life balance) conciliation politics either as a strategic tool, an obligation or an act of social responsibility. By means of a multiple-choice questionnaire, we questioned 331 nurses about their perception pertaining to conflict and corporate support, the role they expected employers to play with regards to work–life balance conciliation support as well as their degree of satisfaction of supportive programmes. We also analyzed commitment and job satisfaction attitudes. Results show that the perceived organizational support plays a mediatory role between work-life conciliation programmes, on the one-hand, and the commitment and satisfaction attitudes, on the other hand. However, giving a more or less important role to the employer does not influence this relationship.     

Évolution du contrôle religieux la première année suivant l’annonce d’un cancer du sein : quels liens avec les stratégies de coping,l’anxiété, la dépression et la qualité de vie ?

The aim of this study was to examine the evolution of perception of religious control during the first year after breast cancer diagnosis and to establish how this evolution could have an effect on coping strategies, psychological distress and quality of life. One hundred and seventeen patients completed four self-reports questionnaires at surgery time and 1, 4, 7, 10, 13 months after the first assessment. Findings showed that religious control declined during the first 4 months treatment, although it is stable after. Furthermore, maintenance of religious control was associated with lower helplessness-hopelessness, denial, anxious preoccupations and avoidance and with better emotional and physical quality of life at all times of the study. We found no association with anxiety or depression.     

L’addiction au travail : quels effets de la charge de travail,de la dissonance émotionnelle et du surinvestissement ?

The present study aimed to assess workaholism in the light of job demands (psychological demands, efforts, emotional dissonance) and job resources (control, social support, rewards). The study was conducted among 342 employment counselors. The results revealed that the employment counselors would have all the more workaholism behaviors that the organizational context expose them to high levels of psychological demands and efforts, high levels of over-commitment and emotional dissonance and low levels of social support and rewards. Multiple regressions highlighted the central role of psychological demands, over-investment and emotional dissonance to reveal workaholism.     

Approche historique de la lutte contre les épidémies et les pandémies par les « pouvoirs publics »

Omnipresent in the history of humanity, the epidemic risk seemed to spare us, we stored it in the history of medical thought and health law. The alerts of the past few years have not been enough to raise awareness, we are helpless in the face of an unknown scourge. A dive into history allows us, without further pretension, to recall the major stages in the fight against epidemics and pandemic.