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France tightens disabled patients' rights to sue doctors
SCIENCE AND MEDICINE
NEWS France tightens disabled patients’ rights to sue doctors than €15 000. Third, many cliniwas enforced obstetricians could be he French National Assembly cians, especially those working in free made accountable for any disabilities has passed a bill that will prevent practice, reconsidered offering ultrathat were not detected during pregchildren born with disabilities from sound, because the price of their prenancy and noted that, for example, claiming compensation “for having miums had become so high that this current ultrasound techniques could been prejudiced by the simple fact of diagnostic tool was no longer a profonly detect 75% of Down’s syndrome their birth”. The Mattei bill, which itable procedure. cases. was almost unanimously adopted by Doctors’ leaders exthe Assembly on Jan 10, pressed satisfaction after the overruled a judgment in Mattei bill was passed by the November last year by the Rights were not granted to include this National Assembly, and Cour de Cassation, France’s image in electronic media. Please Nisand, together with the highest court, which ruled refer to the printed journal. French Gynaecologists that a teenager born with Association, asked colsevere physical and mental leagues to resume ultradisabilities, Nicolas sound investigations, which Perruche, could sue his have been offered only to mother’s doctors because women with high-risk pregthey failed to diagnose his nancies since Jan 1. condition while she was According to the bill, pregnant, therefore denying which will go to the Senate her the choice of an abortion on Jan 22 a child or his or (see Lancet 2001; 358: her family will no longer be 1972). entitled to claim any comIn July, 2001, judgments National Assembly agreed to limit landmark Perruche ruling pensation for being born in two similar cases, based with severe or mild disabilities. But Last year’s judgments had three on the Perruche ruling, were handed the draft still allows patients and their immediate consequences for patients, down by French courts who ordered families to sue doctors if they commit obstetricians, and gynaecologists, in a doctors to pay compensation for not a “professional fault” and fail to diagcountry where four million prenatal having detected disabilities. nose an obvious disability. ultrasound investigations are done According to the judgments, these Gynaecologists and obstetricians every year, the highest number of sentences were the only way to guarare still concerned by this clause in such investigations in the world. antee that the children had an approthe bill. And they fear that it will be First, in November last year a priate level of care for the rest of their extremely difficult to clarify the difgroup of senior gynaecologists led by lives. ference between a “professional Israël Nisand in Strasbourg and René However the cases raised serious fault” and an “unavoidable disabilFrydman in Paris called on the proethical questions, especially among ity”. Only in extreme cases, suggests fession to stop all ultrasound investirepresentatives of disabled people Nisand, could a doctor be made gations from Jan 1, 2002. Nisand told and the medical profession, who conresponsible for a patient’s disabilities. The Lancet that clinicians have to sidered that the courts had introBut for diseases such as Down’s synwork in the interest of the mother duced “the right to have never been drome the condition already exists and the unborn child, but cannot do born”. Many family organisations before the medical investigation, and so if they are threatened by lawsuits. also warned that these judgments therefore cannot be considered a “If we want to be fully protected, we could change society’s image of “medical fault” and should not be have to advise mothers to do an aborhandicapped people, and the new open to compensation, he added. tion if we suspect any possible small “right to have never been born” Nisand hopes that the Senate will risk, and this is not a way to solve the could be interpreted that people with modify this last aspect of the bill. problem.” Considering that a certain disabilities should not have been The new legislation was welcomed number of disabilities cannot be born, which in turn could lead to a by the president of the National detected by even the best practitionnew form of eugenics. Union of Parents and Friends of the ers and diagnostic tools, he said that The bill was introduced by JeanMentally Handicapped, Patrick the community not the doctors, may François Mattei, a geneticist at the Gohet, who said that what is needed have to cover the social and medical prenatal department of the Marseille now is for people to show “more solirisk of birth-related disabilities. University Hospital and a member of darity and awareness toward the Second, practitioners’ professional parliament, who announced his decihandicapped and respect their lives”. insurance premiums increased greatly sion to present a draft bill to stop the after the Perruche ruling from an Perruche ruling in November last average of €1500 (US$1337) to more year. Mattei warned that if the ruling Denis Durand de Bousingen AFP
T
THE LANCET • Vol 359 • January 19, 2002 • www.thelancet.com
233
For personal use. Only reproduce with permission from The Lancet Publishing Group.
NEWS France tightens disabled patients’ rights to sue doctors than €15 000. Third, many cliniwas enforced obstetricians could be he French National Assembly cians, especially those working in free made accountable for any disabilities has passed a bill that will prevent practice, reconsidered offering ultrathat were not detected during pregchildren born with disabilities from sound, because the price of their prenancy and noted that, for example, claiming compensation “for having miums had become so high that this current ultrasound techniques could been prejudiced by the simple fact of diagnostic tool was no longer a profonly detect 75% of Down’s syndrome their birth”. The Mattei bill, which itable procedure. cases. was almost unanimously adopted by Doctors’ leaders exthe Assembly on Jan 10, pressed satisfaction after the overruled a judgment in Mattei bill was passed by the November last year by the Rights were not granted to include this National Assembly, and Cour de Cassation, France’s image in electronic media. Please Nisand, together with the highest court, which ruled refer to the printed journal. French Gynaecologists that a teenager born with Association, asked colsevere physical and mental leagues to resume ultradisabilities, Nicolas sound investigations, which Perruche, could sue his have been offered only to mother’s doctors because women with high-risk pregthey failed to diagnose his nancies since Jan 1. condition while she was According to the bill, pregnant, therefore denying which will go to the Senate her the choice of an abortion on Jan 22 a child or his or (see Lancet 2001; 358: her family will no longer be 1972). entitled to claim any comIn July, 2001, judgments National Assembly agreed to limit landmark Perruche ruling pensation for being born in two similar cases, based with severe or mild disabilities. But Last year’s judgments had three on the Perruche ruling, were handed the draft still allows patients and their immediate consequences for patients, down by French courts who ordered families to sue doctors if they commit obstetricians, and gynaecologists, in a doctors to pay compensation for not a “professional fault” and fail to diagcountry where four million prenatal having detected disabilities. nose an obvious disability. ultrasound investigations are done According to the judgments, these Gynaecologists and obstetricians every year, the highest number of sentences were the only way to guarare still concerned by this clause in such investigations in the world. antee that the children had an approthe bill. And they fear that it will be First, in November last year a priate level of care for the rest of their extremely difficult to clarify the difgroup of senior gynaecologists led by lives. ference between a “professional Israël Nisand in Strasbourg and René However the cases raised serious fault” and an “unavoidable disabilFrydman in Paris called on the proethical questions, especially among ity”. Only in extreme cases, suggests fession to stop all ultrasound investirepresentatives of disabled people Nisand, could a doctor be made gations from Jan 1, 2002. Nisand told and the medical profession, who conresponsible for a patient’s disabilities. The Lancet that clinicians have to sidered that the courts had introBut for diseases such as Down’s synwork in the interest of the mother duced “the right to have never been drome the condition already exists and the unborn child, but cannot do born”. Many family organisations before the medical investigation, and so if they are threatened by lawsuits. also warned that these judgments therefore cannot be considered a “If we want to be fully protected, we could change society’s image of “medical fault” and should not be have to advise mothers to do an aborhandicapped people, and the new open to compensation, he added. tion if we suspect any possible small “right to have never been born” Nisand hopes that the Senate will risk, and this is not a way to solve the could be interpreted that people with modify this last aspect of the bill. problem.” Considering that a certain disabilities should not have been The new legislation was welcomed number of disabilities cannot be born, which in turn could lead to a by the president of the National detected by even the best practitionnew form of eugenics. Union of Parents and Friends of the ers and diagnostic tools, he said that The bill was introduced by JeanMentally Handicapped, Patrick the community not the doctors, may François Mattei, a geneticist at the Gohet, who said that what is needed have to cover the social and medical prenatal department of the Marseille now is for people to show “more solirisk of birth-related disabilities. University Hospital and a member of darity and awareness toward the Second, practitioners’ professional parliament, who announced his decihandicapped and respect their lives”. insurance premiums increased greatly sion to present a draft bill to stop the after the Perruche ruling from an Perruche ruling in November last average of €1500 (US$1337) to more year. Mattei warned that if the ruling Denis Durand de Bousingen AFP
T
THE LANCET • Vol 359 • January 19, 2002 • www.thelancet.com
233
For personal use. Only reproduce with permission from The Lancet Publishing Group.