Il est intéressant de relever que les tribunaux éprouvent plus de facilité à retenir la responsabilité d'un avocat qui a manqué un délai de procédure
,
que celle d'un médecin qui a manqué de poser un diagnostic en temps utile. Dans le premier cas, le juge de l'action en responsabilité peut faire appel à son expérience pour apprécier les chances de succès (en soi beau-coup plus difficiles à établir statistiqùement) de la demande introduite tardivement. Ce n'est pas le cas pour les chances de succès d'un traite-ment médical, alors même que la littérature médicale comprend souvent d'importantes données statistiques, ce à quoi on ne trouve pas d'équi-valent dans la littérature juridique .
. Les juristes ont une riche expérience, pas toujours heureuse, des expertises établies par des professionnels ou des gens de l'art. Ce qui leur manque peut-être encore pour recevoir et admettre la notion de perte d'une chance, c'est une meilleure compréhension des bases conceptuelles du calcul des probabilités.
257
La perte d'une chance et sa réparation
Bibliographie
Brehm Roland, Berner Kornrnentar, t. VI. 1.3.1., 2e éd., 1998.
Chabas François, La perte d'une chance en droit français, in Guillod O.
(éd.), Développements récents du droit de la responsabilité civile, Zu-rich (Schulthess) 1991, 133 ss.
Engel Pierre, Traité des obligations en droit suisse, Dispositions générales du CO, 2e éd., Berne (Staempfli) 1997.
Heers Mireille, L'indemnisation de la perte d'une chance, Gazette du Palais 2000, 525 ss.
Le Tourneau Philippe/Cadiet Loïc, Droit de la responsabilité et des contrats, Paris (Dalloz) 2000.
Markesini Basil S./Deakin Simon F., Tort law, Oxford (Clarendon Press) 1999.
Mazeau Henri/Mazeau Léon/Tunc André, Traité théorique et pratique de la responsabilité civile délictuelle et contractuelle, Tome I, 6' éd., Pa-ris (Montchrestien) 1965. •
Müller Christophe, La perte d'une chance: Étude comparative en vue de son indemnisation en droit suisse, notamment dans la responsabilité médicale, Thèse, Berne 2002.
Petitpierre Gilles, Les fondements de la responsabilité civile, Revue de droit suisse 1997 I 273.
Roberto Vito, Schadensrecht, Bâle (Helbing & Lichtenhabm) 1997.
Smith Thomas A., A Capital Markets Approach ta Mass Tort Bankruptcy, 104 Yale Law Journal 367 (1994). '
Speaker Paul, The Application of the Loss of Chance Doctrine in Class Action, 21 The Review of Litigation 345 (2001),
Spier Jaap, (ed), Unification in Tort Law, Causation, Kluwer ( La Haye-Londres - Boston) 2000.
Stark Emil W" Die Perte d'une chance im schweizerischen Recht, in O.
Guillod (éd.), Développements récents du droit de la responsabilité ci-vile, Zurich (Schulthess) 1991, lOI ss.
Weir, Loss of a chance - Compensable in Tort: the Cornrnon Law, in Guillod O. (éd.), Neuere Entwicklungen im Haftpflichtrecht, Zurich
(Schulthess) 1991, 124 ss. ,
Werro Franz, Le mandat et ses effets: Etudes sur le contrat d'activité indépendante, Fribourg 1993.
259
Annexe 1
Annexe 1
Court of Appeal, SiKtb Distnc4 Califomia
ElaÎoe Damas, as Special Administrator, cIe., Plainritr a.nd RespoodeDt,
V.
David Coone)' et al., Defendants and AppelLants.
PREMO,J.
Nov 19, 1991.
lJS Cal.App.3d 1593 1 Cal.Rptr.2d 584
[n 1 mcdical malpracrice action predkated upon
&:la)'ed diagnosis and tKalmCnt of Jung cancer, the jury rendered a verdict in favoT of plainliff Kenneth Dumas and ag3.wt defendant.s David Cooncy, M.D.
and Alfrt'd Spivadt:. M.D. Il Iwarde<! plainriff damages of 1321,400. The trial collrt cnlef(~d judgtncnt I((:olltingly. and defcndants appeal.
Derendants centend that the iii.! coun erred by insttucring the jwy 00 thr throry of IOSI chance. Wc agrec and conclude lhat 1be aror. WBS prejudkw. Wc therefore reverse the judgmc:nt and rernand for 1 ncw trial.
Blcqround
ln 1986, following an annuaL pbysical cxanUnation, Dr. Spivack diagnosed Jung cancer in plaintif[ A
$wgeon then removed a tumor and part ofplaintilfs righllung. Plaintiffwu:lerwent treaonent, but the disease recurred in May 1989. Plaîntiff died on Novmtber 26,1989, six days after the jury rendercd ilS verdicl. radiologisl n:poncd [0 dc:fendants that lheTe existe<!
somethlng Qf unknown signiftCance in p~intiff5 lung and rec~ fw1bc:r study in threc mooths' rime.
AccO'rdmg 10' plainrifT, defeodanls fsiled to communiutc the radiO'Wgisc's rewnunendation, and M lherefore did 001 undergo aoother X-ny unlil rus physieal examination in 1986.
Plaintiffs UJ!(n Witnc:S5 opine<! that plsinliffs tumor' W8S a -sra~ 3A ~ turnoJ in 1986 bul a ·stage 1-Iwnof in 1984. He explaîoed lhat a patiem having a WIDOr
rcsected al slage 1 US about Il 67 pcn::mt chance of beiDg aüve and free O'f discase in l'ive )'Cars. He continued tbat approximately 67 pereent of those patients who survive diseau-ftee for live yeaB will survive disease-Ûtt for tm years whicb wouJd be considele<! a cure for the fOIm of lung cuu::er suffercd by plaintifT.
Plainriffs expen also testified !ha! a parient having a tumOt resected at .. more advanccd condition known as stage 2 bas about a 33 percent chance of ·1598 being alive and disease-frce in five years. He estimated that plaintiffs cbl.flce of a five-year dîsease-free 5UfVivai MS 15 10 20 percent.
On cross-examination, the witness acknowledged thal only about 10 percent ofpalients diagnosed with the (onn of ~ tancer suffered by plaintiff arc dLa.gllosed Il stage 1. He agreed tbat tberc Ile relali\'ely few ("'e-year sl1l\'ivors bccause thc:re pre fcw stage 1 palienlS aDd 1he IMnality ralc of IllIl8 cancer is nurly idellrical 10 the incidence beausc of
!he LQW nlle Qf cure.
Oe~f1dants' priDCipal c"PCn wilnC:S5 testificd thal ail luni cancer is CS$eDtial1y incurable bcca\lSt il spreads before the ptitrwy rumor an he delected. He opined tbal plaiotifl's tumor began $pltading in 1974 and could nDt h'~'e bcen detectable until relarivc:ly laie in ilS biQlogiclllife.
[ ... J
The Instruction
The issue hefore us conums tbe propriety of giviog the jury the instruction assailed by defendants.
The trial cautt lold the jwy: "Damages for OC:jli2C11cc io pt'oviding medical care rnay bc based on evideDCt thal il is a rca=ble mcdical probability that the plaiotiff would bave bencfittcd by possible (ure, possible lengthening ofhis life, and/or UqJroved perS(Jnal comfon /Tom more prolJ1ll diagoosis and Q'eatn-=OI."
Defendants (ocus upon the Concepl of"possibility-and contend thal1he cbarge permiucd tht: jwy to fmd fQr plaintif( Qn!he tbeofy of!ou chance, a ·16411 thcoc-y lte(tlQfare unrecognizcd În Califomia that permits recQvecye\'cn tbougb. the evidcoce shows DO more than 1 bcrter_than_cvcnchance!hat Il defendant cllused a plaintiffs loss.
Luc Thévenoz
(··1
The Not·better-th'D~vtn Cbante Uability for medical malpractice is prerlicated upon :1 proximale causal connection between the ne&ligent tondue! illld the resulting înjury. (Budd v. Nixen (1971) 6Cal.3d 195, 200 [98 CaLRptr. 849.491 P.2d 4.n).) "[CJauSilion rOJSI be proven within a rnsoll3ble medieal probability Nied upon COJt1leIetlI expen II:Slimony. M~ plssibiliry :ltone is Insuftie.enl 10 esublish 1 prima fatlc case.
(Citations.) Thal lbere is 1 distincriOll beN.-een a reBSonable mc:dical 'probability' lJ'Id a medical 'possibility' oeeds liule discussion. There can be many possible '.;:auses,' indeed, an infinile nwœer of circUIDStaoces whkh can produce an injury or diseilSe. A possible cause OlÙy beCOTOClI 'proba.blc' owhen, in the absence of other reasoll3.ble causa]
explanalions, il becomc:s nwrt likely than DOt !hal the mjury was a result of ils a~tiOl1. This is the OUler limil or inrereocC' upon which an issue may he submined 10 the jury." (Jones v. Ortho PbarmaçeuhCIII Corp.
(1985) 163 CaLApp.3d 3%. 402-4031209 Cal.Rptr.
456J.)
"proo( of tausation is particularly difficul! in cases where the results compillined of are Iucb as might notmlllly he expccted 10 foHow ftom the original diseose Of injured condition. as is lhe case when a plaintiff complains of the defendant doctor's faiJUfe 10
cure. raIller than of any posirive effects of
JfUstJeatment. Plainliffi in such cases are faccd with the difficulty of obtaining and preseDting expert leslilllOfty Chat if proptT bcalment had betn given, bener restllts would bave foUowed." (Almal., Medical Malpraclitc.: ~Loss of Chance" CaUSfllity (1987) 54 A.L.RAth 10, (7.)
ln titis type of case where the tesrirnony ~tablisbes a probability of a better resul! (usually the patient's survival) absent a OOctor's negligence. a finding for lhe plainnff is consistent with existing principlcs of proximate cause. (Sec Haskovits v. Group Health Co· Op. (1983) 99 Wn.2d 609 (664 P.2d 474, 485]
(COIX. opo. of Pearson, J.); let ~.g., BUfford v. Baker (1942) n CaI.App.2d 301 1127 P.2:d ~I} (wbere fijlure to timc:ly diagnose hip in jury \"Wllted in booc dcfonnity, proximale cause wu estabLîsbod by lestirnony that prompt 1rcatrocn! would lave greatly e.nhancC'd the probability ofa good rcsuit].) hav~ produced results diffcrelll from thosc complaincd of, the courts have been faced with the question whcther the evidence is sufficienl JO establish the causation componenl e!senti.l to the plaintill's righl of action." (Annot., Medical Malpr.etice: "Loss of Cbance" Cau.sality, supra, 54 A.L.R.4tb Il pp. 17- 18.) ·1604
The masl fundamenlal argumenl IgaÎllSI the tndilionaJ mie-of causation as il operates in lhese typeS of cases i5 that il bars Ion leço~'ery "on behalf of the sUNivors of many potentially tenninal patients, no maner ho.,.,. blatant the health care provider's negligence. Through negligence, a physitian or other health care providcr could reduce a patiC.D(s cbanees of survivii from as hlgh as fifty percent 10, for example, ten percent, and )'et remain un.a.ruwerable in the l,w of ton: (Perez v. Las Vega!! Medical Qntcr (1991) _ Nev. _ [80S P.2d 589, 591).)
When faced with a los! chance and the ll'aditiooal
~all or ooiliing." prospect, sorne courts bave allo .... 'Cd reeo"C'f)' by adopting a relaxed standard or causatioo permitting recovery when the p1ainriff mablisbes a
"subsWltial possibility" ()fcausation. (Ste Fennell v.
Swthern Maryland Hosp. (1990) 320 Md. 776 [580 A.2d 206, 210·211]. and cases citcd theKin at rn. 4.) This approach effectively creales a new tort with 1 more lenieru tbresbold of causation as i15 distin&uîshing (eature. (Ibid.) ~Courts adopling the t'elaJled cauution/new cause of actino approacb continue to a .... 'afd 'al1 or nothing' dIltruoges, and wben the plaintiff establisbcs a 'mb:JllIntiaJ possibility' WI the doctor's oegligence caused the death. Ibere is fuit rccovcry. 1be resull ls that relaxing the Nies of causation mcrely ilqlrove$ the plaintill's odds of receiving ail ratber!han nothing." (Id .• t p. 210i On
"The rdaxed causarion approach in mcdical malpracticc cases has ()ften been attributed te dictwn in Hicks v. United States, 368 F.2d 626 (4th Cir.1966), where Judgc Sobcloffwritifli; for the coun stated; [§ ] 'When a deferxlant's negligeot action or inaction bas cffectivdy tcrminated .. person's cb.a.oc:e of SUlViv.l, il does nOClie in the defendanl's mouth to raise conjectures as to the melRlJe of the chances dull he bas put beyond the pos:sibility of reali:talion. If there WIlS any substanlial possibility of survival and the defendanl has destroyed. il, he i5 answenble.
Rarely is il possible JO demonsll1lte to ln absolute certaioty what would bave happened in circWl'l$taoces
!hat the wrongdoer did not allow to come to pus. The law dots not in the eKisting circwnstances requite the
the other hand, couru ha ... e also exprcssly rdllinrd the uaditional role of causarion in medical malpracDct cases whtn confronted with the lost chance argumenl.
(Sec Fennell v. Southem Maryland Hosp., supra, 580 A.2d al p. 215; sce cases citcd in Falcon v. Memorial Hosp. (1990) 436 Mich. 443. fn. 11 [462 N.W.2d44, 64] (dis. opO. of Riley, C. 1.).)
Other couru addressing the issue have adopltd Ihe losl chance thtory fusl suggesttd by Professoc King in King.. CausariOfl, Valuation. and Chance in Personal ln jury Tons Involviog Prccx~ting CorxJitions and fUlure *Hi05 Consequences (1981) 90 Yak LJ. I3Sl (Sec e.g., Perez .... las Vegas TradilMxiaI principles of l'w re[aling to duty, bTtllcb, causation, and burdm of proofremain the samc-wh.al changes is the IIcceptance orthe concept!hal daJœges may be recon:red for the loss of a chance of survival where that chance is substantial and can he idcnlified and quantified (and thus valued) without resort to conjecture or speculation.' " (FellJlell v. SQtJthcm Maryl3nd Hosp., supra, 580 A.2d at p. 212, dring Weimcr .... Hetrick (1981) 309 Md. 536 [525 A.2d 643,653) (cone. optl. or McAlIliffe, J.).)
Prokssor King nplains the eoncepc as follov.'$:
'Causation bas for the n'lOSt part been lJealCd a5 an 3ll-or-nothing proposition. Eithtr a Ioss was caused by the defendant or il was 001. Inexplicably, the .11·
OHlOthing approacb of the c3usalion inquiry bas been allowed to slip ÎIS analytical moorings, influencing plaintifflo show 10 a cenainty Ih.at the patient would have lived had she bctn hospi~lized and operated on promptly.' ... [Citalion.t (Fenntll v. Sootbem Maryland H05p., supu, S80 A.2d at pp. 210-211, fil.
omitted.) ln Hicks, the UlK'Ontradictcd evideoce was
!NI the parieD1 v.~u.ld bve survived bad the doclor optn.led pr~ly. (Hicks ". United Sutes (4th Ciro 1966) 368 F.2d 626, 632.) Thus., the issue wbether
1-relaxed standard of eausation should he adopted was not presented in Hi<:ks .nd the case i5 consistent wilb the traditional role of causation. Hicks is thcrefore questionabJe authority for modifying the traditional mie of causation.
Annexe 1
the identificalÎOO and valuation of Jasses in CI$CS invol ... ing preelListing condilaons Url claÎml fur future
co~equences. A plaintiff ordinarily should be
required to prove by the applicable: standard of proof .tW.t the defendant caused the Ioss in question.. What caused a loss, howcver, should be a sCpMIte question from wba' the nature and eJ>;lcnl of tbc Ioss art. This distinction setmi to ha ... e e1uded the courts, with the r($.Ult liaI 1051 chances in rnany respects are CO~led cither as cenainti" or IlOt al ail.
"To ilJu5tJale, co!Wda the case in which a doctor ncgligc:ntly &ils 10 diagnooe a patimt's caru:erous condition \lntil il MS become inopetable. Anumc further that even with a timely diagnosis the patient would ha ... e had only a 30% cllllllce of recovering from the disease and surviving over the long Ierm.
There are tv.'O ways of handling $uch a case. Unrler the lJaditional approach, this Ion of Il not-better-than·
even cnance of reeovering from the callCcr would 00\
be c~ble because it did no! appeu more lilely
ÙIIII (sie) not !hat the patienl would havc sucvivcd with proper care. Recoverable damages. if any, wouId dcpend 00 lbe exletlllO v.'hich il appeared that cancer killed the parienl sonner than il ""'Ouid have v.ith Iimc:ly diagoosis aoel lJe.atment, and on !he extent 10 which the dcby in diagnosis aggr.avated the patÎcnt's condition, such as hy causing addilional pain. A rIlOJt
rational approach., howc:ver, \Io:ould allow rccovcry for the loss of the chance ofcure evcn though the chance wu not better than cven. The probability of long.tenD survival would he rcflected in the amount of damages awmled foc Ille *1606 }oss of the chance. Whik !he Conditions and Funue CONequences, supra, 90 Yale U. 3t pp. 1363·1364.)
Professor Kint criticius the lJaditional mIe of causation as il operate5 in the area of lost chance. He flfSl claims 1bc .11 or nothing concept 15 arbitrary beçause it treaœ the bertcr·than-even chance as 1
cen.ainty and gives 00 credillO the coucqJrually nlgh eveD dance. Sc:cood, he belie ... es the ruJc is conlT.lry to the dcterrent objectives of lOri law beçause it rlenies recovery rOT the effecu of condue! that causes statistically demoostrable 1055eS. Third, he considers the ruJe a catalyst fot distoning othc:r IUles affecting causation and damages in an 3ttcmpl 10 mitigate perceived injustices. And founh, he deems the ruJe is wûair becausc: the imponden.bles of chance must he
Luc Thévenoz
grappled with on[y because of lhe· defendant's conduct. (King, Causalion, Valuation, and Cbancein Persona! ln jury Torts Invo!ving Preexisting Conditions aoo Future Consequences, supra, 90 Yale L.J. at pp. 1376-1378.) He lîkens a 1051 chance to the loss of a lotteT)' rid.:et, an asset he accepts as having some value notwithstanding the prospect of winnîng with it is not better!han even. (Id. al p. 1378.)
Rell1ed Callsation ror 1 Lost Chanee The iS:'lue whether a relned standard of causation should he adopted in CalifoflÙa was addressed in Simmons v. Wesl Covina Medical Oinic (1989) 212 Cal.App.3d 696 [260 Cal.Rptr. 772].
Simmons WlIS an action for wrongful birth and wrongfullife brought by a mother and child afier the child was born with Down's Syndrome. The action was predicated upon a physician's negligence in failing 10 test for the risk ofDown's Syndrome in rime to aOOrt the pregnancy. The trial court granted the defendants' motÎon for swnmary judgmenl on the basis IhlIt the evidence as to causation established that there was only a 20 perçent chance thal the lest would have delected a risk of Down's Syndrome. The court afflI1lled on the basÎs tbal the tradirional role of causalion negated recovery.
The plainriffs in Simmons raised the specter of lost chançe as follows: "Plainriffs oonlend their low statisrical proba.bility of avoiding the hann sbou1d nol prevent tbem from recovering damages for tbeir lost chance of terminating the pregnancy. PlaintiID; assert a jury cou1d consider their low statistical probability of avoiding the harm, bUl onIy for the purpose of
The court acknowledged the authorities in foreign jurisdictions !hat had adopted the lost chance tbeory in medical malpraclice aClions. II then distinguished hetween actions for uegligently reducing a patient's chaoce of survivaJ and depriving a woman of the chaoce 10 abort a geneticaUy defeçtive child. (1 Yiew~d the former type of case as one where the palienl's condition could he attnbutable to a host of factors in addition to the physicim's negligeoce with the attendant difficulries in proof and the latter type of case as one wbc:Ie the hereditary condition WlIS not would unwîsely encourage costly and unreasonable overtesting and overtreatment for defensive purposes.
Physicians wou1d find il necessary 10 place the requirements of the Jegal system before the needs and the finances of the patient. In addition, the physicians' increased exposure to liability would adversely impact already high medical malpracrice premimns, Tt.'lu1ting in an upward spiral of consumer costs. The uncertainty fostered by such a ruling would undoubledly open the proverbial floodgates of our overburdened judicial system. [§ ] We refuse to eJtpand the ciccle of liability by abandoning establisbed tort law principles of cauntion where there is only a mere possibility of detecting the genetic defecl We do not wish 10 intrude upon the Legislature's task of weÎghing such matters of public poliey, and leave to it the functioo of dedding whether 10 provide a remedy for those genetically defectÎve children and their parents who are Wlable 10 prove to 1 reasonable medical eertainty that medical negtigence deprived the mother of the chance to lenninale her pregnancy." (Sirnmons v. West Covina Medical Oinic, supra, 212 Cal.App.3d at pp. 705-706.)
Plaintif( eonstrues the opinion of the Sinunons court on lost chance as dictum because it was unnecessary given the threshold conclusion that the rationale for relaxed causation did not apply 10 wrongful birth and life cases.
The court's remarks, however, specificaUy addressed an issue raised by the plaintiffs in !hat case. "" 1608
In any Ç1,'ent, we agree with Simmons and helieve il is equally applicable to the preexisting condition arena of medical malpracrice as recognized by Gooding v. University Hosp. Bldg., IDe. (Fla. 1984) 445 So.2d 1015. Gooding was a wrongful death case alleging medical malpractice predieated üpOn a negligenl diagnosis. In conc1uding that the theory of Joss of chance to slIn'ive is inconsistenl with the concept of proximate cause, the court observed:
"Relaxing the causalion requirement might correct a perceived unfairneS:'l to some plaintiffs who could praye the pO.'lsibîlîty !hat the medical malpractiee
caused an injury but could nO! prove the probability of causalioo, but at the !.ame lime coold creale an injusltce. Helllw care ptOviders coold fmd tbemselves defendiog OISCS siroply becausc a patienl fails 10 Îf!1JWvc or wbeJe saioll$ disease processes arc DOl
atTested because anolhcr c~ of lU;Ôon eould possibly bring 1 bener result No olher professioolJ malprKtice defend.aol curies this burdtn of liabi!ity
atTested because anolhcr c~ of lU;Ôon eould possibly bring 1 bener result No olher professioolJ malprKtice defend.aol curies this burdtn of liabi!ity