Les droits des patients en France : bilan et perspectives

For many years, patients' rights have been claimed on courts. Since Mercier's case in 1936, judges have defined more precisely the perimeter of these rights. In 2002 most of these decisions were implemented in a French law adopted on March the 4th (Loi Kouchner). This law will celebrate its ten years of application in 2012. This law does not operate a revolution regarding the previous jurisprudence decisions but reinforces the fundamental principles to protect people and clarifies the solutions adopted by judges. As a consequence of the human dignity envisaged as a core principle, three major issues will be discussed in this paper. First, rules for patients or for their family in order to access their medical record have been clarified. Second, procedures for informed consent in healthcare have been reinforced. Finally, rules to disclose information covered by professional secrecy to third parties have been precised. Autonomy of patients has also been emphasized in the law related to patients' rights at the end of life adopted in 2005. Even though these new rights are quite unknown (see Leonetti, evaluation report, December 2008), and are limited to persons who are at the end of their life, they exist and permit to people to express their will. This new law allows people to anticipate on what care they want at the end of their life and allows medical doctors to refuse to enter in “unreasonable obstinacy”. Based on a strong recognition of patients' autonomy, the adoption of this law seems to be in accordance with contemporary social expectations.