IMOC et justice. Les limites à ne pas dépasser (à propos des discussions sur l’imputation d’une IMOC à une hypoxie intrapartum)

Abstract

If most of the Cerebral Palsy (CP) are bound to diverse antepartum pathologies, it appears nevertheless that a percentage, of the order of 20 %, is bound directly and exclusively to acute accidents (uterine rupture, placental abruption, cord accidents, etc.) or to medical faults (bad practices) committed by the obstetric team during childbirth. Furthermore, this “official” percentage concerns only the severe forms of the CP, pathology the spectrum of which we know better, now. In front of the inflation of obstetrical malpractice claims, a consensus was established around the criteria defined, in 1999, then in 2003, by the “International Task Force on Cerebral Palsy” clustering main American professionals’ syndicates. Literally applied, these criteria allow certain experts and/or certain insurances’ lawyers to eliminate any intrapartum cause of CP. The suggestion of a pathological antenatal cause becomes too often an automatic reflex of the defense. This unbearable situation for the victims launched a strong counter-attack of their defenders. Some recent court cases compel us to ring the alarm bell and to remind firmly that there are ethical limits not to be transgressed so that the financial component do not dominate the debates, to the detriment of the truth of the obstetrical facts and the just compensation of the victims.