French Medical Law
Sources of French Medical Law
French medical law (droit médical) is primarily codified. The Public Health Code (Code de la santé publique) contains provisions on the organisation of the health system, the practice of medicine, patient rights, and public health. The Medical Ethics Code (Code de déontologie médicale), incorporated into the Public Health Code, sets professional obligations for physicians. The Social Security Code (Code de la sécurité sociale) governs the health insurance system. The Bioethics Laws (Lois de bioéthique), revised every seven years, regulate assisted reproduction, genetic testing, organ transplantation, and research involving human embryos.
Medical Professional Liability
The 2002 Kouchner Law (Loi du 4 mars 2002 relative aux droits des malades et à la qualité du système de santé) fundamentally reformed medical liability. It reversed the burden of proof previously established by the Cour de cassation in 2001 and created a comprehensive compensation framework. The law recognises the right to compensation for nosocomial infections (infections contracted in health care establishments), with the burden on the health care facility to prove that the infection originated outside its premises.
ONIAM and CCI
The National Office for Compensation for Medical Accidents (Office National d’Indemnisation des Accidents Médicaux, ONIAM) administers compensation for medical accidents that do not involve fault, particularly for accidents of exceptional severity and nosocomial infections meeting certain thresholds. Regional Commissions for Conciliation and Compensation (Commissions de Conciliation et d’Indemnisation, CCI) provide a non-judicial mechanism for dispute resolution. The CCI issues opinions on the merits of claims and recommends compensation amounts, which the insurer must pay within specified deadlines.
Patient Rights
The 2002 Law established fundamental patient rights, including the right to information and informed consent. Patients must receive clear, appropriate information about their health status, proposed investigations and treatments, their urgency, risks, and alternatives. The right to access medical records (dossier médical) is guaranteed. The Claeys-Leonetti Law of 2016 on the end of life strengthens patient autonomy by recognising the right to deep and continuous sedation until death for patients with a life-threatening prognosis. Euthanasia and physician-assisted suicide remain prohibited.
Health Insurance System
The French health insurance system (Sécurité Sociale) operates on the principle of solidarity. Universal health protection (Protection Universelle Maladie, PUMA), established in 2016, guarantees all persons legally residing in France stable access to health care. The system covers a percentage of medical costs, with patients typically paying the remainder. Complementary health insurance (mutuelles) covers additional costs. The system is financed through social security contributions and the CSG (Contribution Sociale Généralisée).
Hospital Law and Quality
The 2009 Hospital, Patients, Health and Territories Reform (Loi HPST) restructured the governance of public hospitals, introduced regional health agencies (Agences Régionales de Santé, ARS), and promoted the coordination of care. The Haute Autorité de Santé (HAS) is the independent public authority responsible for the accreditation of health care organisations, the evaluation of medical practices, the assessment of health technologies, and the publication of clinical practice guidelines.
Bioethics
The bioethics laws, revised every seven years, address evolving ethical and social questions. The 2021 revision extended assisted reproduction (PMA) to single women and female couples, expanded the storage period for gametes, and modified the rules on preimplantation genetic diagnosis. The laws also regulate organ transplantation, genetic testing, and research on embryonic stem cells, balancing scientific progress with respect for human dignity.