Signed, not Ratified
   Patient Rights in France

Right to Informed Consent

     Minors
    Incapacitated Adults
Right to Information about his or her Health
Rights regarding the Medical File
Right to Privacy
Right to Complain and to Compensation
 
Rights of Users of Genetic Services
 

 



Several legal provisions protect the physical integrity of the patient and his right to informed consent. Art. 16-1 of the Civil Code (the “Code Civil”) recognizes for everyone the right to respect for his or her body and declares the body inviolable. According to art. 16-3 violation on the integrity of the human body is only possible when there is a medical need for the person concerned or, exceptional, in the therapeutic need of another person. The same article requires the preceding consent of the person concerned except when his situation makes a medical intervention necessary and he is not able to give his consent.
Art. 11 of the patient right law 2002 has inserted a number of provisions  in the Code of Public Health (Code de la Santé Publique): Art. L.1111. - 4, third paragraph of the Code of Public Health stipulates that no medical operation or no treatment can be carried out without the free and informed consent of the person concerned. The information which must be given to the patient, focuses on the medical tests, treatments or preventive acts that are presented to the patient, their purpose, their necessity, their consequences, the risks that frequently appear or that are serious, normally foreseeable risks, possible alternatives en the foreseeable consequences in case of a refusal.
When after a certain treatments new risks appear, the patient has to be informed about these risks, except when it is not possible to reach him (art. L.1111-2, section 1).
At the request of the patient public and private health services must give him information concerning the cost of preventive, diagnostic and therapeutic treatments which he needs. Physicians who are not related to any health services must, before the start of any medical treatment, inform the patient concerning the cost of the treatments and the conditions among which the obligatory health-insurance intervention (art. L. 1111-3). In case of a conflict, the physician or the hospital has the obligation to prove that the information was given in accordance with the legal provisions. The physician or the hospital is free to choose how to give this proof (art. L.1111-2, last paragraph).
The consent can be withdrawn anytime (art. L.1111-4, third paragraph, last words). Nowhere the form of the consent and the refusal of treatment are regulated. Also art. 36 of the French deontological Code of medical duty (legally binding since the Decree no. 95 - 1000 of 6 September 1995) in which a provision is stipulated concerning the consent of the patient is silent concerning the form. In the comments on the Deontological Code of the National Council of the French Order of Physicians and more specifically the comment on art. 36, the use of a written consent is advised against, except in the cases described by law (e.g. in case of medical experiments). In case of a refusal of treatment the physician is on the other hand advised to have this refusal confirmed in writing by the patient.

Art. L.1111-4, second paragraph, as modified by art. 4 of the Law of 22 April 2005, regulates the refusal of lifesaving treatment by a patient who is not terminal ill. When such a patient refuses every lifesaving treatment (before the modification it was stipulated as “one lifesaving treatment”), the physician must do everything to persuade him to accept the necessary care. To do so, he can call in a colleague. In any case the patient must confirm his decision within a reasonable period of time. This will be noted in the medical file. The physician watches over the dignity of the patient and guarantees the quality of his end of life. Since the modification it has become more clear that the physician must respect the refusal of the patient. Moreover art have. 6 of the law of 22 April 2005 has inserted a new article L.1111-10 in Code of Public Health which explicitly recognizes the right of a terminal ill patient to refuse a treatment or end it.

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