De la dignité du défunt… et de la maintenance de la clim

Sources - FlickR - Creative Commons - squelette par Emma and KunleyLes décisions de justice passées inaperçues regorgent parfois de messages incontournables, en particulier lorsqu’ils ont trait à des questions délicates telles que la dignité due au corps d’un défunt et de la manière de « gérer » le décès d’un patient.

C’est le cas d’un arrêt de la Cour d’appel de Bourges en date du 20 mars 2008 ((CA Bourges, 20 mars 2008, n°07/00994.)) qui est porteur de plusieurs enseignements : l’obligation de surveillance pesant sur un établissement de santé en matière de décès imminent d’un patient en phase terminale d’un cancer généralisé (1) et l’obligation de l’établissement de conserver le corps du défunt dans un état satisfaisant jusqu’au jour des obsèques (2).

(1) Décès imminent d’un patient cancéreux en phase terminale, surveiller jusqu’à quand ?

Quoique l’issue était prévisible, les faits de l’espèce n’en demeurent pas moins douloureux. L’époux et les enfants d’une patiente atteinte d’un cancer en phase terminale s’attendaient à une fin proche. Ces derniers ont reproché à l’établissement de santé privé de ne pas les avoir prévenus de l’imminence du décès de la patiente.

Ils n’ont pu dès lors prendre leurs dispositions pour dire adieu à la patiente.

Les juges de première instance, comme les juges d’appel, sont unanimes à considérer :

  • d’une part, « qu’il appartient aux proches d’une personne dans sa dernière maladie sur le point de décéder, qui souhaitent être à ses côtés au moment de son décès, de prendre leurs dispositions pour être à son chevet jusqu’à cet instant ultime » ;
  • d’autre part, « qu’il ne peut raisonnablement pas être demandé à un établissement de soins d’assurer dans une telle hypothèse une surveillance de tous les instants, et surtout de prévoir avec précision le moment du décès. »

Sur ce point, la cour d’appel a donné tort aux appelants, aucune faute ne pouvant être reprochée à l’établissement de santé.

En matière de surveillance, à l’impossible nul n’est tenu, spécialement dans le contexte général de pénurie de personnel infirmier. Publics ou privés, les établissements de santé n’échappent pas à ce phénomène. En outre, vouloir prévoir le moment exact du décès d’un patient, fût-il en phase terminale d’un cancer généralisé, relève purement et simplement d’un vœu pieux.

Les juges ne s’y sont pas trompés et ont considéré que la responsabilité de la présence des proches du patient incombait directement à ces derniers et non au personnel soignant, même si bien évidemment on peut parfaitement comprendre la douleur de la famille qui vit un tel drame.

(2) De l’obligation de conserver le corps d’un défunt dans un état décent

Sur ce point, la cour d’appel a jugé :

« Attendu qu’en cause d’appel, la SARL Polyclinique du Val de Loire ne conteste pas sa responsabilité dans la dégradation prématurée du corps de la défunte, à la suite d’une panne du système de climatisation de la morgue non détectée pendant tout le week-end suivant le décès ;

Attendu que sans être contestée, la SARL Polyclinique du Val de Loire, expose qu’alors qu’habituellement, les familles des personnes décédées font enlever le corps par les pompes funèbres très rapidement après le décès et que les corps sont ensuite conservés dans un salon mortuaire des pompes funèbres, c’est à la demande insistante de M. X, pour lui éviter des frais liés à la conservation du corps de son épouse par les pompes funèbres, qu’elle a accepté de conserver le corps jusqu’au jour des obsèques, soit cinq jours après le décès ; »

En voulant « rendre service » au mari de la patiente, l’établissement de santé a commis une première illégalité en ce qu’il a consenti à conserver le corps au-delà d’un délai de dix heures. ((Art. R2223-76 du code général des collectivités territoriales.)) Le délai de cinq jours relevé par l’arrêt de la cour d’appel semble dès lors presque surréaliste.

Les faits nous permettent de présumer que l’établissement ne dispose pas d’une chambre mortuaire, mais d’une simple morgue dotée au minimum de tables réfrigérantes permettant d’accueillir les corps. En effet, en-deçà de 200 décès par an, un établissement n’a en principe pas l’obligation de disposer d’une chambre mortuaire, laquelle doit répondre à des spécifications techniques précises. 200 décès par an correspondent à moins d’un décès par jour en moyenne.

Une seconde illégalité qui résulte presque d’un malheureux concours de circonstance a été commise en ce que le système de climatisation est tombé en panne, ce qui a – il faut l’imaginer – accéléré la décomposition du corps, qui n’était dès lors plus visible et présentable.

On imagine sans peine le préjudice moral vécu par les proches, du fait de cette privation. La cour d’appel a confirmé la condamnation de la polyclinique par les juges de première instance au paiement de dommages-intérêts visant à dédommager ledit préjudice.

A vouloir « faire plaisir » aux proches éplorés en s’affranchissant de la rigueur des textes réglementaires en la matière, on aboutit à des situations délicates.

Omar YAHIA

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