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Background In early 2020, the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) published clinical ethics recommendations for the allocation of intensive care during COVID-19 pandemic emergency. Later the Italian National Institute of Health (ISS) invited SIAARTI and the Italian Society of Legal and Insurance Medicine to prepare a draft document for the definition of triage criteria for intensive care during the emergency, to be implemented in case of complete saturation of care resources. Methods Following formal methods, including two Delphi rounds, a multidisciplinary group with expertise in intensive care, legal medicine and law developed 12 statements addressing: (1) principles and responsibilities; (2) triage; (3) previously expressed wishes; (4) reassessment and shifting to palliative care; (5) collegiality and transparency of decisions. The draft of the statements, with their explanatory comments, underwent a public consultation opened to Italian scientific or technical-professional societies and other stakeholders (i.e., associations of citizens, patients and caregivers; religious communities; industry; public institutions; universities and research institutes). Individual healthcare providers, lay people, or other associations could address their comments by e-mail. Results Eight stakeholders (including scientific societies, ethics organizations, and a religious community), and 8 individuals (including medical experts, ethicists and an association) participated to the public consultation. The stakeholders’ agreement with statements was on average very high (ranging from 4.1 to 4.9, on a scale from 1—full disagreement to 5—full agreement). The 4 statements concerning triage stated that in case of saturation of care resources, the intensive care triage had to be oriented to ensuring life-sustaining treatments to as many patients as possible who could benefit from them. The decision should follow full assessment of each patient, taking into account comorbidities, previous functional status and frailty, current clinical condition, likely impact of intensive treatment, and the patient's wishes. Age should be considered as part of the global assessment of the patient. Conclusions Lacking national guidelines, the document is the reference standard for healthcare professionals in case of imbalance between care needs and available resources during a COVID-19 pandemic in Italy, and a point of reference for the medico-legal assessment in cases of dispute.

The valorization of scientific evidence provided by the expert as evidence in the trial framework has been revised, as well as the role of the judge, in light of the assumptions derived from the Daubert Judgment. The criterion of “general acceptance” of evidence obtained from the published literature in journals subjected to peer-review and the expert’s reputation can be helpful, particularly in cases where there is an open debate within the scientific community. It is the judge, however, who must take on the role of gatekeeper of the validity of evidence, to consent to its probatory admissibility, through a preliminary comprehension of the methods of science. The evaluation of reliability and admissibility of evidence is also reflected in the areas of medical malpractice and professional liability. Standards of care may be derived from an analysis not only of the guidelines, but also of other scientific sources to be subjected to the usual proof of admissibility, as well as new research paths that take account of personalized medicine and the application of guidelines to the individual.

International audience; This chapter describes the present situation concerning corporate criminal liability for acts of corruption in France, and especially the role of corporate anti-bribery rules within the French criminal system. It shows that although France does not now present a very welcoming prospect for the acknowledgment of the “doctrine” and correlative techniques of compliance within its criminal justice system, this does not entirely rule out the existence of possible relationships in the future. Although still rather limited and uncertain, it is possible to observe a tendency in France towards addressing corporate organizational failure more closely, and designing a more direct or autonomous system for corporate criminal liability. These could turn out to be first steps towards the positive acknowledgment of compliance programs. Parallel to this, another path could be taken, which consists of taking the avatars of corporate social responsibility (CSR) seriously, and using CSR as a tool against corporate practices that are inconsistent with it. Combined with the multiplication of incentives favoring compliance, these developments could also hasten their acknowledgment within the French criminal justice system.