Entre fauter et ne pas informer…

Ayant subi une intervention chirurgicale jugée mutilante, inutile et inadaptée à sa pathologie ((Illustration, s’il en était encore besoin, de la nécessité de juger de la pertinence des actes.)), une femme a recherché la responsabilité de son médecin. Dans son arrêt du 24 avril 2008, la Cour d’appel de Bourges avait limité l’indemnisation à laquelle pouvait prétendre la victime en retenant qu’ « en raison de la violation de son devoir d’information par le médecin, celle-ci avait perdu une chance d’éviter l’opération chirurgicale incriminée ».

Dans un arrêt lapidaire et pédagogique, rendu au visa des articles L. 1142-1 du code de la santé publique, ensemble l’article 16-3 du code civil, la Cour de cassation a censuré cette décision ((Cass. Civ. 1ère, 28 janvier 2010, n°09-10.992.)).

Son attendu de principe est le suivant :

« Attendu qu’en vertu du premier de ces textes, le médecin répond, en cas de faute, des conséquences dommageables des actes de prévention, de diagnostic ou de soins qu’il accomplit et, en vertu du second, qu’il ne peut être porté atteinte à l’intégrité du corps humain qu’en cas de nécessité médicale pour la personne ou à titre exceptionnel dans l’intérêt thérapeutique d’autrui ; »

Sur le fondement du défaut d’information, la cour d’appel avait alloué à la victime une certaine somme. Son raisonnement était simple : puisque le médecin attaqué n’avait pas démontré avoir informé sa patiente des risques de l’opération pratiquée, la violation de son devoir d’information a causé un préjudice à la plaignante, lequel ne peut s’analyser qu’en une perte de chance d’éviter l’opération chirurgicale.

Silencieuse sur ce point, la Cour de cassation a acquiescé.

En revanche, et toujours selon la cour d’appel, le tribunal de grande instance  avait mal jugé car il avait procédé, selon elle, à une double indemnisation en allouant à la fois à la victime la somme de 5.000 euros en réparation de la perte de chance liée au défaut d’information et celle de 10.600 euros au titre de la réparation intégrale de son préjudice corporel.

Il importait, selon les juges d’appel, de reconstituer le préjudice en tous ses éléments et d’y affecter la proportion de perte de chance d’en éviter la réalisation. Au vu des circonstances, la réparation de la perte de chance devait être fixée à 16.000 euros.

C’est sur ce point que la Cour de cassation a censuré l’arrêt. Elle a considéré que l’intervention mutilante, injustifiée et inadaptée s’analysait juridiquement en une faute distincte de celle tirée du manquement au devoir d’information. Plus précisément, la faute consistait en l’atteinte à l’intégrité physique du patient sans nécessité médicale, en violation des conditions de licéité des actes médicaux déterminées par l’article 16-3 du code civil.

Le raisonnement tombe comme un couperet :

« Qu’en statuant ainsi alors qu’elle avait retenu que les préjudices dont Mme X avait été victime découlaient de façon directe, certaine et exclusive d’une intervention chirurgicale mutilante, non justifiée et non adaptée, de sorte qu’ils ouvraient droit à réparation, la cour d’appel a violé les textes susvisés. »

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