Public hospital liability
PUBLIC HOSPITAL RESPONSIBILITY
A doctor practicing within a public hospital is not personally liable for harm caused to a patient due to their fault.
Indeed, the doctor acts as a public service agent, and the patient is considered a user of a public service. As such, only the public healthcare institution can be held liable.
If, however, the doctor commits a personal fault separate from their official duties, then civil liability may apply — but only in such cases.
A personal fault separate from official duties is defined by case law as a particularly serious fault that cannot reasonably be attributed to the normal functioning of the public service. This includes, for example, a fault committed with intent to harm, for personal gain, or a blatant breach of professional ethics.
Since the law of March 4, 2002, the administrative liability of public healthcare institutions can be invoked under Article L1142-1 of the Public Health Code, just like the liability of private healthcare professionals and institutions. Therefore, apart from the exceptional cases provided for in Article L1142-1, the administrative liability of a public healthcare institution can only be established if the patient provides proof of a fault, a damage, and a causal link between the two.
A medical expert assessment will be required to establish this fault. In principle, no judge will rule on medical liability without first obtaining the informed opinion of a qualified medical expert.
The competent courts for handling administrative liability of public healthcare institutions are:
• the Administrative Court at first instance,
• the Administrative Court of Appeal,
• and, if necessary, the Council of State (Conseil d’État).
PUBLIC HOSPITAL RESPONSIBILITY
PUBLIC HOSPITAL RESPONSIBILITY
A doctor practicing within a public hospital is not personally liable for harm caused to a patient due to their own fault.
Indeed, the doctor acts as a public service agent, while the patient is considered a public service user. Therefore, only the liability of the public healthcare institution can be engaged.
However, if the doctor commits what is known as a personal fault separable from their duties, they may then incur personal civil liability—but only under those specific circumstances.
A personal fault separable from official duties is defined by case law as a particularly serious fault that cannot reasonably be attributed to the functioning of the public service. Examples include misconduct committed with intent to harm, for personal gain, or a fault that is inexcusable under professional ethics.
Since the law of March 4, 2002, the administrative liability of public healthcare institutions may be invoked under Article L1142-1 of the Public Health Code, just like the liability of private professionals and institutions. Therefore, except in the exceptional cases mentioned in Article L1142-1, the administrative liability of a public healthcare institution can only be engaged if the patient proves the existence of a fault, a damage, and a causal link between the two.
A medical expert assessment will be required to establish such fault. In principle, no judge will rule on medical liability without first obtaining the opinion of a qualified expert.
The competent courts for hearing administrative liability cases involving public healthcare institutions are:
• the Administrative Court (first instance),
• the Administrative Court of Appeal,
• and, if necessary, the Council of State (Conseil d’État).
Public hospital liability
PUBLIC HOSPITAL RESPONSIBILITY
A doctor practicing within a public hospital is not personally liable for harm caused to a patient due to their own fault.
Indeed, the doctor acts as a public service agent, and the patient is considered a user of a public service. As a result, only the public institution’s liability may be engaged.
However, when the doctor commits what is known as a personal fault separable from their duties, they may then incur civil liability, but only in such cases.
Case law defines a personal fault separable from official duties as a particularly serious fault that cannot reasonably be attributed to the normal functioning of the service. This includes, for instance, a fault committed with intent to harm, for personal interest, or one that is inexcusable under professional ethics.
Since the law of March 4, 2002, the administrative liability of public healthcare institutions may be engaged under Article L1142-1 of the French Public Health Code, just like the liability of private professionals and institutions. Outside of exceptional circumstances provided for in Article L1142-1, the administrative liability of a public healthcare institution can only be established if the patient proves the existence of a fault, a damage, and a causal link between the two.
A medical expert assessment is required to demonstrate this fault. In principle, no judge will rule on medical liability without first obtaining the informed opinion of a qualified expert in the field.
The courts competent to hear cases involving the administrative liability of public healthcare institutions are:
• the Administrative Court at first instance,
• the Administrative Court of Appeal on appeal,
• and, if applicable, the Council of State (Conseil d’État).
Public hospital liability
Criminal and disciplinary sanctions
Most individuals instinctively turn to the police or the public prosecutor when faced with a dispute or disagreement involving a healthcare professional. However, criminal liability is rarely the most appropriate path. Like any citizen, a healthcare professional may indeed be held liable — but only if they have committed a criminal offense, which means an infraction, a misdemeanor, or a felony.
Moreover, unlike civil or administrative liability, it is not the victim who decides whether there will be a trial, but the public prosecutor.
Most of the time, victims are seeking either compensation or, in more serious cases, a form of punishment to prevent the professional from repeating the same mistake. While criminal courts are indeed meant to punish the perpetrators of crimes, misdemeanors, or infractions, in reality, few medical errors qualify as criminal offenses.
As a result, many victims who file complaints with the police, gendarmerie, or public prosecutor end up disappointed when no further action is taken. In truth, what they are often looking for — without realizing it — is either professional liability (disciplinary measures for professional misconduct) or civil/administrative liability (compensation for the harm suffered).
The criminal offenses most commonly associated with healthcare professionals include:
• unintentional harm to life or person,
• endangering the life of others,
• failure to assist a person in danger,
• breaches of rules governing clinical trials,
• violations of regulations regarding voluntary termination of pregnancy,
• breach of professional secrecy,
• gross professional misconduct,
• unauthorized practice of medicine,
• forgery and use of forgeries,
• and issuing fraudulent medical certificates.
To establish criminal liability in these cases, very specific conditions set out by the Penal Code and the Code of Criminal Procedure must be met.
If criminal liability is established, the professional may face penalties ranging from a fine to a suspended sentence, or even imprisonment.
Criminal liability is distinct from disciplinary or professional liability. Unlike civil or administrative liability, disciplinary liability does not aim to compensate victims.
It also differs from criminal liability in that it does not seek to punish a criminal offense, but rather the breach of professional duties imposed on healthcare professionals. Once a breach of ethical or professional obligations is identified, disciplinary action may be taken.
The process begins with a complaint filed with the Departmental Council of the Medical Board, which will attempt to organize a conciliation.
If conciliation fails, the complaint and a formal opinion will be forwarded to the Regional Council’s disciplinary chamber, which then acts as the first-instance disciplinary court. Sanctions may include a warning, reprimand, suspension, or removal from the profession.