Embolie gazeuse cérébrale lors d’une séance d’hémodialyse : aspects médico-légaux : à propos d’une affaire judiciaire

Air embolism is a serious iatrogenic event, concerning many invasive medical therapies. It is a rare but life-threatening adverse event. We report a case of a cerebral air embolism occurring during a renal replacement therapy. We report the case of a court case analyzed in the Department of Legal Medicine of Farhat Hached University Hospital in Sousse, Tunisia, related to a cerebral gas embolism occurring during a session of renal replacement therapy. Then we discuss the medical liability of the medical team involved in this act. Through a draft organic law (law No. 41/2019 on patients’ rights and medical liability), Tunisian jurisprudence aims at resolving legal claims in the field of medical liability by providing more opportunities for an amicable solution and by guaranteeing an adequate and quick compensation of the damage suffered.     

Contamination transfusionnelle et relations sexuelles non protégées : les limites du droit à indemnisation du transfusé au titre de la solidarité nationale (Civ., 1re, 22 janvier 2014, no 12-35023, FS P+B+I)

A patient victim of HIV infection by transfusion who knowingly maintained sexual relation with his spouse cannot receive compensation for moral prejudice in the case of his spouse and daughter's contamination. The request for compensation addressed to the ONIAM on the grounds of the articles L. 1142-22 and L. 3122-1 of the Public Health Code must therefore be rejected.     

The Needle in the Haystack

Summary

Despite the significant damages in sexual abuse cases, the plaintiff's ability to collect the money awarded in settlement or judgment is often precluded by the limited financial resources of the defendant(s). In this chapter, practicing attorney Julian Hubbard introduces the basics of individual and corporate insurance coverage and reviews the development of very limited coverage in sexual abuse cases in statutory and case law. While direct coverage for sexual abuse injuries is as rare as a “needle in a haystack,” indirect coverage can be found in some cases, especially those in which the acts of negligent individuals other than the perpetrator facilitated the abuse and thus the plaintiff's injuries. After an overview of relevant insurance issues and law, Mr. Hubbard delineates a practical model for research and legal strategies to ensure reaching any available insurance coverage, and explores the benefits and drawbacks of drawing on administrative resources to help pay for survivors' medical and mental health care.     

Ethical and Legal Considerations for Internet-Based Psychotherapy

The provision of mental health services over the Internet is becoming increasingly commonplace as new technologies continue to develop. Evidence in support of the efficacy of many such interventions is accumulating. Given the potential global reach of Internet-based psychological services, the authors examine ethical issues relating to this growing area of practice through the lens of the Universal Declaration of Ethical Principles for Psychologists (International Union of Psychological Science, 2008). They also raise issues relating to potential liability risks and offer recommendations intended to guide mental health practitioners who are considering involvement in the provision of Internet-based services.     

论医疗违约行为的认定及其标准

医疗违约以医师在诊疗过程中不履行或不完全履行其医疗债务为表现形式。然而,医疗债务属于手段债务,对其不完全履行无法从结果上判断,而只能从履行过程上判断是否违反诊疗义务。因此,医疗违约的认定首先应明确医疗合同中诊疗义务的具体内容,并在此基础上采取一定的标准和方法判定医师的诊疗行为是否构成违约。鉴于合同法上传统的违约认定方法并不适用于医疗合同,应考虑将医疗水平确立为违约的认定标准,并谨慎应对其适用中可能存在的问题。     

Disciplinary sanctioning of students with intellectual disabilities: revisiting the status liability hypothesis

We examined the impact of disability status on disciplinary sanctioning of a student committing a minor versus severe behavioral infraction. We used the status liability hypothesis as a framework. This hypothesis suggests that individuals with a higher personal status receive sanctioning differentially based on the severity of offense. Specifically, individuals of high status are predicted to be sanctioned less severely than persons with lower status given a minor offense. The hypothesis also predicts that individuals accorded high status will receive more punitive sanctioning when the act of deviance from social norms is perceived as severe. Pre-service teachers were randomly assigned to judge the behavior of a student with or without an intellectual disability committing a behavioral offense. A student with an intellectual disability was seen as influenced by dispositional factors, regardless of the offense, while a student without a disability who committed a minor offense was seen as influenced by situational factors. The behavior of a student with an intellectual disability was judged as less severe, and the student was 50% less likely to incur an in-school suspension. When a student with an intellectual disability was sanctioned, the length of suspension was equal to that of a student without a disability.

How should citizens’ collective liability for state action be grounded?

This paper assesses one type of justification for collective liability – the democratic authorization account – according to which citizens can be held liable for what their state does, because they collectively authorize the state’s actions. I argue that the democratic authorization view, properly understood, has an implausibly narrow scope, which risks leaving many victims of injustice without compensation. Hence, I propose a subsidiary account that is wider in scope, and which applies to most cases of state-inflicted harm. This view picks out liable agents on the basis of (a) their ability to bear the compensatory burdens, (b) the incentives that the prospect of liability give citizens to hold their states in check, and (c) distributive concerns. Lastly, I address the relationship between citizens who are (merely) collectively liable for some harm, and citizens who are to some extent morally responsible (for instance in virtue of having endorsed the state-inflicted harm).     

Poly Implant Prothèse : en l’absence de responsabilité de l’État,quelle indemnisation possible ?

With two decisions dated November 16th 2020, the French administrative Highest court (“Conseil d’État”) has compromised the possibility for PIP's victims to demonstrate the deficiency of the National medicines agency (ANSM) in its duty of health control. Those decisions transpose to medical devices already well-established principles, used for other healthcare products. There are of interested because they give the Highest court the opportunity to precisely detail the qualification of the facts. Although the consequences for the victims seem to be only of symbolic value, the scope of the solution is not limited to the liability of the State. By reducing the number of potential liable persons, those decisions also seem to jeopardize the compensation of the victims by the national solidarity funds.     

L’anormalité du dommage : une notion juridique stabilisée ?

Medical liability, in accordance with liability law, is traditionally based on the triad of operative event, causal link and damage. The emergence of systems of no-fault liability gave rise to the concept of abnormal damage, which is a necessary condition for liability. In terms of medical liability, in 1958 the administrative courts ruled that this criterion was necessary in order to compensate medical damage in situations of liability for alleged misconduct, then from 1990 in situations of no-fault liability. This condition was extended to compensate medical hazard from 1993. The Court of Cassation refused to adopt a no-fault liability system, leading to unequal treatment. Thus, the law of March 4, 2002 created a system which, in situations of no-fault liability, allowed national solidarity to be engaged in the event of abnormal damage. However, the legislation did not clearly set out the character of this abnormality, and jurisprudential hesitation over this criterion has made compensation uncertain. In 2014, the administrative and judicial courts clarified their jurisprudence by adopting a more specific definition of this criterion of abnormality. However, a very restrictive view taken of this criterion means that many victims now risk being excluded from the scope of compensation. As such, this jurisprudential stability is perhaps but temporary.