Reflections on Judgment Cass. civ., Section III, No. 515 of 2020: Refusal of Transfusion and Civil Liability

Judgment No. 515 of 2020 by the Court of Cassation addresses a complex case of civil liability related to a road accident and the refusal of life-saving medical treatment. The subject of discussion is the causal link between the driving conduct of an individual and the subsequent death of the victim, who had refused to receive a blood transfusion for religious reasons. This judgment offers significant insights into liability and patient self-determination.

The Case and Previous Decisions

The context of the judgment unfolds around a fatal road accident that occurred in 1993. D.L.U., the victim, was involved in an accident and subsequently died in hospital, where he refused to receive a blood transfusion. The family members sought compensation for damages, arguing that the death was directly attributable to the reckless conduct of the driver of the vehicle involved.

The Court of Rome had initially recognized the exclusive liability of the driver, but the Court of Appeal subsequently held that the refusal of the transfusion had impacted the victim's chances of survival, introducing the concept of shared responsibility.

The Court of Appeal ruled that the driver's conduct and the refusal of the transfusion had both contributed to the death.

Causation and Refusal of Transfusion

A central aspect of the judgment is how the Court interpreted the causal link. The Court applied the principle of voluntary assumption of risk, arguing that D.L.U. had voluntarily exposed himself to the risks associated with road traffic, being aware that in the event of an accident he might require a transfusion. This reasoning led to a reduction in the tortfeasor's liability.

• The Court assessed that the chances of survival, had the transfusion been performed, were between 50% and 65%.
• The decision raised questions about the legitimacy of penalizing a personal and religious choice.

Conclusions: Self-Determination and Liability

Judgment No. 515 of 2020 highlights a conflict between the right to patient self-determination and civil liability. The Court reaffirmed D.L.U.'s right to refuse medical treatment, however, it also introduced an element of shared responsibility. This decision raises questions about the possibility of considering a refusal that can lead to fatal consequences as legitimate.

In conclusion, the judgment underscores the difficulty of balancing individual rights with civil responsibilities, a topic of increasing relevance in the current legal context.