Publications et travaux de recherche
2023
Rigaud, Jean-Philippe; Ecarnot, Fiona; Quenot, Jean-Pierre
Patient Information and Consent for Care in the Intensive Care Unit Article de journal
Dans: Healthcare (Basel), vol. 11, no. 5, p. 707, 2023.
Résumé | Liens | BibTeX | Étiquettes: Droit des patients, Information
@article{Rigaud2023,
title = {Patient Information and Consent for Care in the Intensive Care Unit},
author = {Jean-Philippe Rigaud and Fiona Ecarnot and Jean-Pierre Quenot},
url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10001104/},
doi = {10.3390/healthcare11050707},
year = {2023},
date = {2023-02-27},
journal = {Healthcare (Basel)},
volume = {11},
number = {5},
pages = {707},
abstract = {In this paper, we review the ethical issues involved in providing information to, and obtaining consent (for treatment and/or research) from patients in the intensive care unit. We first review the ethical obligations of the physician in treating patients, who are by definition, vulnerable, and often unable to assert their autonomy during situations of critical illness. Providing clear and transparent information to the patient about treatment options or research opportunities is an ethical and, in some cases, legal obligation for the physicians, but may be rendered difficult, not to say impossible in the intensive care unit by the patient’s health state. In this context, we review the specificities of intensive care with respect to information and consent. We discuss who the right contact person is in the ICU setting, with possible choices including a surrogate decision maker, or a member of the family, in the absence of an officially designated surrogate. We further review the specific considerations relating to the family of critically ill patients, and the amount and type of information that may be given to them without breaching the tenets of medical confidentiality. Finally, we discuss the specific cases of consent to research, and patients who refuse care.},
keywords = {Droit des patients, Information},
pubstate = {published},
tppubtype = {article}
}
In this paper, we review the ethical issues involved in providing information to, and obtaining consent (for treatment and/or research) from patients in the intensive care unit. We first review the ethical obligations of the physician in treating patients, who are by definition, vulnerable, and often unable to assert their autonomy during situations of critical illness. Providing clear and transparent information to the patient about treatment options or research opportunities is an ethical and, in some cases, legal obligation for the physicians, but may be rendered difficult, not to say impossible in the intensive care unit by the patient’s health state. In this context, we review the specificities of intensive care with respect to information and consent. We discuss who the right contact person is in the ICU setting, with possible choices including a surrogate decision maker, or a member of the family, in the absence of an officially designated surrogate. We further review the specific considerations relating to the family of critically ill patients, and the amount and type of information that may be given to them without breaching the tenets of medical confidentiality. Finally, we discuss the specific cases of consent to research, and patients who refuse care.
2022
Moutel, Grégoire; Goupille, Pauline; Suzat, Bertille; Rigaud, Jean-Philippe; Charvin, Maud; Grandazzi, Guillaume; Gouriot, Mylène; Gakuba, Clément; Gaberel, Thomas; Benoist, Guillaume
Interrompre une grossesse en réanimation sans recueil du consentement de la patiente : enjeux éthiques et médico-légaux Article de journal
Dans: Médecine Intensive Réanimation, vol. 31, no. 2, p. 77-84, 2022.
Résumé | Liens | BibTeX | Étiquettes: Collégialité, Droit des patients
@article{Moutel2022cc,
title = {Interrompre une grossesse en réanimation sans recueil du consentement de la patiente : enjeux éthiques et médico-légaux},
author = {Grégoire Moutel and Pauline Goupille and Bertille Suzat and Jean-Philippe Rigaud and Maud Charvin and Guillaume Grandazzi and Mylène Gouriot and Clément Gakuba and Thomas Gaberel and Guillaume Benoist},
doi = {10.37051/mir-00095},
year = {2022},
date = {2022-09-06},
urldate = {2022-09-06},
journal = {Médecine Intensive Réanimation},
volume = {31},
number = {2},
pages = {77-84},
abstract = {In France, the voluntary interruption of a pregnancy for medical reasons can be requested by the woman, whatever the term of the pregnancy, if it is attested that the continuation of the pregnancy seriously endangers her health. The termination of the pregnancy is then subject to the collegial opinion of a Pluridisciplinary Centre for Prenatal Diagnosis, which must give a favourable decision after analysing the situation. Following, it is the woman who takes the final decision. Respect for the autonomy of the pregnant woman is therefore a fundamental principle in prenatal diagnosis and termination of pregnancy in French law.
In this article, we analyse a situation that raises complex ethical and decision-making issues where the termination of pregnancy is required when the patient is neither able to formulate a request nor to consent, due to her pathology requiring hospitalization in intensive care.
If the continuation of the pregnancy poses a serious threat to the patient's health, urgency may be an acceptable argument for acting without the patient's consent. This urgency is understood here as the fact that, without a rapid decision, the clinical situation has little chance of improving or even deteriorating. In this context, we discuss the arguments for terminating the pregnancy and the importance of consulting the parents and spouse, so as not to exclude relatives from the decision-making process. Finally, our analysis questions the limits of medical secrecy in intensive care when a dialogue and an exchange of information with relatives appears essential, in particular when the patient cannot participate in the decision and when there are complex decisions to be made.},
keywords = {Collégialité, Droit des patients},
pubstate = {published},
tppubtype = {article}
}
In France, the voluntary interruption of a pregnancy for medical reasons can be requested by the woman, whatever the term of the pregnancy, if it is attested that the continuation of the pregnancy seriously endangers her health. The termination of the pregnancy is then subject to the collegial opinion of a Pluridisciplinary Centre for Prenatal Diagnosis, which must give a favourable decision after analysing the situation. Following, it is the woman who takes the final decision. Respect for the autonomy of the pregnant woman is therefore a fundamental principle in prenatal diagnosis and termination of pregnancy in French law.
In this article, we analyse a situation that raises complex ethical and decision-making issues where the termination of pregnancy is required when the patient is neither able to formulate a request nor to consent, due to her pathology requiring hospitalization in intensive care.
If the continuation of the pregnancy poses a serious threat to the patient's health, urgency may be an acceptable argument for acting without the patient's consent. This urgency is understood here as the fact that, without a rapid decision, the clinical situation has little chance of improving or even deteriorating. In this context, we discuss the arguments for terminating the pregnancy and the importance of consulting the parents and spouse, so as not to exclude relatives from the decision-making process. Finally, our analysis questions the limits of medical secrecy in intensive care when a dialogue and an exchange of information with relatives appears essential, in particular when the patient cannot participate in the decision and when there are complex decisions to be made.
In this article, we analyse a situation that raises complex ethical and decision-making issues where the termination of pregnancy is required when the patient is neither able to formulate a request nor to consent, due to her pathology requiring hospitalization in intensive care.
If the continuation of the pregnancy poses a serious threat to the patient's health, urgency may be an acceptable argument for acting without the patient's consent. This urgency is understood here as the fact that, without a rapid decision, the clinical situation has little chance of improving or even deteriorating. In this context, we discuss the arguments for terminating the pregnancy and the importance of consulting the parents and spouse, so as not to exclude relatives from the decision-making process. Finally, our analysis questions the limits of medical secrecy in intensive care when a dialogue and an exchange of information with relatives appears essential, in particular when the patient cannot participate in the decision and when there are complex decisions to be made.
Huck, Joséphine; Moutel, Grégoire; Baumann, Sophie
Information et consentement sur l’épisiotomie : comment améliorer les pratiques ? Article de journal
Dans: Santé Publique, vol. 34, no. 2, p. 243-253, 2022.
Résumé | Liens | BibTeX | Étiquettes: Droit des patients
@article{Huck2022,
title = {Information et consentement sur l’épisiotomie : comment améliorer les pratiques ?},
author = {Joséphine Huck and Grégoire Moutel and Sophie Baumann},
doi = {10.3917/spub.222.0243},
year = {2022},
date = {2022-06-01},
urldate = {2022-06-01},
journal = {Santé Publique},
volume = {34},
number = {2},
pages = {243-253},
abstract = {Intro Context and subject of the study: While women are increasingly demanding to be actors of their birth and to participate in the choices concerning their care, a study showed in 2013 that the information they received concerning episiotomy had improved, but that consent was very rarely sought. The interest of our study was therefore to explore the practices of midwives a few years later, and to highlight the factors that may encourage or hinder them in the delivery room to inform women and obtain their consent.
Method: We conducted 12 semi-structured interviews with midwives working in the delivery room in several maternity hospitals in the Ile-de-France region. A manual content analysis was carried out independently by two researchers who then compared their results. A complementary analysis using NVivo software confirmed the validity of the manual analysis.
Results: Information on episiotomy and collection of consent in the delivery room were respectively limited by the anxiety-inducing nature of the information and its temporality (labour and delivery are not appropriate times for information according to the professionals), and by the fear of refusal. Information given beforehand during pregnancy and the drafting of a birth plan would facilitate the collection of consent in the delivery room.
Conclusion: A time dedicated to information and the distribution of an information leaflet on episiotomy to patients could help improve the practices of health professionals.},
keywords = {Droit des patients},
pubstate = {published},
tppubtype = {article}
}
Intro Context and subject of the study: While women are increasingly demanding to be actors of their birth and to participate in the choices concerning their care, a study showed in 2013 that the information they received concerning episiotomy had improved, but that consent was very rarely sought. The interest of our study was therefore to explore the practices of midwives a few years later, and to highlight the factors that may encourage or hinder them in the delivery room to inform women and obtain their consent.
Method: We conducted 12 semi-structured interviews with midwives working in the delivery room in several maternity hospitals in the Ile-de-France region. A manual content analysis was carried out independently by two researchers who then compared their results. A complementary analysis using NVivo software confirmed the validity of the manual analysis.
Results: Information on episiotomy and collection of consent in the delivery room were respectively limited by the anxiety-inducing nature of the information and its temporality (labour and delivery are not appropriate times for information according to the professionals), and by the fear of refusal. Information given beforehand during pregnancy and the drafting of a birth plan would facilitate the collection of consent in the delivery room.
Conclusion: A time dedicated to information and the distribution of an information leaflet on episiotomy to patients could help improve the practices of health professionals.
Method: We conducted 12 semi-structured interviews with midwives working in the delivery room in several maternity hospitals in the Ile-de-France region. A manual content analysis was carried out independently by two researchers who then compared their results. A complementary analysis using NVivo software confirmed the validity of the manual analysis.
Results: Information on episiotomy and collection of consent in the delivery room were respectively limited by the anxiety-inducing nature of the information and its temporality (labour and delivery are not appropriate times for information according to the professionals), and by the fear of refusal. Information given beforehand during pregnancy and the drafting of a birth plan would facilitate the collection of consent in the delivery room.
Conclusion: A time dedicated to information and the distribution of an information leaflet on episiotomy to patients could help improve the practices of health professionals.
Moutel, Grégoire
L'accès aux traitements pour tous de manière égalitaire restera-t-il la règle ? Article de journal
Dans: La Lettre du Neurologue, vol. 26, no. 5, p. 165-166, 2022.
Liens | BibTeX | Étiquettes: Accès aux soins, Droit des patients, Régulation de l'accès à l'innovation, Traitements onéreux
@article{Moutel2022c,
title = {L'accès aux traitements pour tous de manière égalitaire restera-t-il la règle ?},
author = {Grégoire Moutel},
url = {https://www.edimark.fr/lettre-neurologue/acces-traitements-tous-maniere-egalitaire-restera-t-il-regle},
year = {2022},
date = {2022-05-01},
urldate = {2022-05-01},
journal = {La Lettre du Neurologue},
volume = {26},
number = {5},
pages = {165-166},
keywords = {Accès aux soins, Droit des patients, Régulation de l'accès à l'innovation, Traitements onéreux},
pubstate = {published},
tppubtype = {article}
}
2021
Raoul-Cormeil, Gilles
Mandataire judiciaire à la protection des majeurs : une profession méconnue au statut incertain Chapitre d'ouvrage
Dans: Regards humanistes sur le droit. Mélanges en l’honneur de la Professeure Annick Batteur, p. 463-500, LGDJ, 2021, ISBN: 978-2-275-09163-1.
Liens | BibTeX | Étiquettes: Droit des patients
@inbook{Raoul-Cormeil2021c,
title = {Mandataire judiciaire à la protection des majeurs : une profession méconnue au statut incertain},
author = {Gilles Raoul-Cormeil},
url = {https://www.lgdj.fr/melanges-en-l-honneur-de-la-professeure-annick-batteur-9782275091631.html},
isbn = {978-2-275-09163-1},
year = {2021},
date = {2021-11-01},
urldate = {2021-11-01},
booktitle = {Regards humanistes sur le droit. Mélanges en l’honneur de la Professeure Annick Batteur},
pages = {463-500},
edition = {LGDJ},
keywords = {Droit des patients},
pubstate = {published},
tppubtype = {inbook}
}
Rogue, Fanny
Le parrainage bénévole d'enfant, un outil d'accompagnement des mineurs Chapitre d'ouvrage
Dans: Regards humanistes sur le droit. Mélanges en l’honneur de la Professeure Annick Batteur, p. 351-378, LGDJ, 2021, ISBN: 978-2-275-09163-1.
Liens | BibTeX | Étiquettes: Droit des patients
@inbook{Rogue2021,
title = {Le parrainage bénévole d'enfant, un outil d'accompagnement des mineurs},
author = {Fanny Rogue},
url = {https://www.lgdj.fr/melanges-en-l-honneur-de-la-professeure-annick-batteur-9782275091631.html},
isbn = {978-2-275-09163-1},
year = {2021},
date = {2021-11-01},
urldate = {2021-11-01},
booktitle = {Regards humanistes sur le droit. Mélanges en l’honneur de la Professeure Annick Batteur},
pages = {351-378},
edition = {LGDJ},
keywords = {Droit des patients},
pubstate = {published},
tppubtype = {inbook}
}
Raoul-Cormeil, Gilles
Médiator : première condamnation pénale. Les leçons d'un scandale sanitaire Article de journal
Dans: Revue Générale de Droit Médical, no. 79, p. 93-110, 2021.
Résumé | Liens | BibTeX | Étiquettes: Droit des patients
@article{Raoul-Cormeil2021b,
title = {Médiator : première condamnation pénale. Les leçons d'un scandale sanitaire},
author = {Gilles Raoul-Cormeil},
url = {https://www.bnds.fr/edition-numerique/revue/rgdm/rgdm-79/mediator-premiere-condamnation-penale-les-lecons-d-un-scandale-sanitaire-10683.html},
year = {2021},
date = {2021-06-01},
urldate = {2021-06-01},
journal = {Revue Générale de Droit Médical},
number = {79},
pages = {93-110},
abstract = {La culpabilité des Laboratoires Servier dans le scandale sanitaire du Mediator a été établie pour la première fois. De nombreuses victimes ayant consommé ce médicament ont obtenu réparation. Elles ont subi des déformations cardiaques. Et leurs souffrances ont été aggravées par un préjudice d’anxiété. Le jugement a été frappé d’appel. En attendant que la condamnation des Laboratoires Servier soit définitive, ce jugement nous invite à raisonner sur les autres décisions prises par les juges administratifs et les juges civils, ainsi que sur la loi ayant modifié le statut de l’Agence nationale de sécurité dumédicament (ANSM).},
keywords = {Droit des patients},
pubstate = {published},
tppubtype = {article}
}
La culpabilité des Laboratoires Servier dans le scandale sanitaire du Mediator a été établie pour la première fois. De nombreuses victimes ayant consommé ce médicament ont obtenu réparation. Elles ont subi des déformations cardiaques. Et leurs souffrances ont été aggravées par un préjudice d’anxiété. Le jugement a été frappé d’appel. En attendant que la condamnation des Laboratoires Servier soit définitive, ce jugement nous invite à raisonner sur les autres décisions prises par les juges administratifs et les juges civils, ainsi que sur la loi ayant modifié le statut de l’Agence nationale de sécurité dumédicament (ANSM).
Raoul-Cormeil, Gilles
Cent ans de droit des patients, à l'aune de la fin de vie Article de journal
Dans: Revue Droit & Santé, no. 100, p. 121-131, 2021.
Résumé | Liens | BibTeX | Étiquettes: Droit des patients, Fin de vie
@article{Raoul-Cormeil2021,
title = {Cent ans de droit des patients, à l'aune de la fin de vie},
author = {Gilles Raoul-Cormeil},
url = {https://www.bnds.fr/edition-numerique/revue/rds/rds-100/cent-ans-de-droit-des-patients-a-l-aune-de-la-fin-de-vie-10600.html},
year = {2021},
date = {2021-03-01},
urldate = {2021-03-01},
journal = {Revue Droit & Santé},
number = {100},
pages = {121-131},
abstract = {Le consentement du patient en fin de vie doit toujours être recherché, mais, pour s'assurer qu'il puisse exprimer sa volonté lorsque son état ne le permet plus, la loi a développé des modes d'expression anticipée.},
keywords = {Droit des patients, Fin de vie},
pubstate = {published},
tppubtype = {article}
}
Le consentement du patient en fin de vie doit toujours être recherché, mais, pour s'assurer qu'il puisse exprimer sa volonté lorsque son état ne le permet plus, la loi a développé des modes d'expression anticipée.
