本文首先指出，法國現行法有關醫療糾紛損害賠償責任，係採取區分「國家賠償責任」與「民事賠償責任」的雙軌制責任體系。然而，無論是國家賠償責任或民事賠償責任，「醫療過錯」有無，仍是決定醫療損害賠償責任是否成立的關鍵因素。 本文接著強調，依法國損害賠償責任法上舉證責任分配的一般原則，加害人之過錯，由請求賠償損害的「被害人」負舉證責任。此項原則，在醫療損害賠償責任，自亦有其適用。然鑑於醫療過錯種類不一、證明對象複雜多樣、加上被害人收集證據能力有限，以致醫療過錯舉證責任分配原則，有必要依其種類型態之不同，區分為「醫療科學上的過錯」與「醫療倫理上的過錯」，再作更細膩的討論。 就「醫療科學上的過錯」而言，以下因素，仍然是決定舉證責任如何分配時的重要考量因素：一，醫療關係是一種「契約關係」，醫師的契約義務，不在於確保「疾病治癒」，而在於依其職業良知、注意及醫學既存知識採取各種措施，以盡力從事「疾病治療」的工作；二，醫療專業知識或技術水準的有限性，醫療行為的危險性、偶然性或不確定性；三，病患個人的特殊體質或主觀因素。從而，醫療契約上之義務，向來被定性為是一種「方法債務」。違反此一義務所造成之「醫療過錯」，原則上應由病患負擔舉證責任。只有在例外情況下，基於某些特殊考量，才完全免除病患的舉證責任負擔，或大幅減輕病患的舉證責任負擔。 反之，在「醫療倫理上的過錯」，無論是醫療資訊上的過錯或病患同意上的過錯，法國廢棄法院1997年2月25日裁判，具有指標性意義。該裁判變更向來見解，認為任何依法律規定或契約約定負有履行某種資訊義務者，應舉證證明其已履行此一義務，醫師對病患負有資訊義務，應負擔證明其已妥善履行此一義務的責任。此項見解，對向來的醫療過錯舉證責任分配原則產生關鍵性的逆轉作用，影響深遠。醫療過錯的舉證責任，不再是由病患負擔，轉而由醫療機構或醫事人員負擔。此項見解，其有高度共識，不僅為民事及行政法院所採納，亦於2002年立法明文規定。 本文最後指出，法國法上醫療過錯舉證責任的發展，已經成為該國醫療責任嚴格化發展趨勢之一環。此一趨勢，是否將導致醫療糾紛不斷增加，醫療責任過重，進而逼使醫界人士採取防禦性醫療措施，造成醫療品質大幅下降的結果？本文引用實證統計數據，對此問題持保留看法。

According to a general rule of evidence in French liability law, the plaintiff has to prove the fault of the defendant for the damage. This rule applies also in medical liability. However, the proof on medical fault is quite complicated and the victim’s capacity of collecting evidences is always limited. As it concerns the burden of proof for medical fault, it is necessary to distinguish two different faults : the fault on medical science and the fault on medical ethics. As far as the fault on medical science is concerned, many judgments indicate that the .doctor-patient relationship is one kind of “the contractual relationship”, and the doctor’s contractual obligation is not the cure of the disease itself but to cure the disease by medical conscience, professional attention and the advanced techniques. In account of the limited medical professional knowledge or technique standard, the very uncertainty for the cure of the disease and the patient's unique physical conditions, the obligation arising from the medical contract is since long time considered to be a method-obligation. Accordingly, the rule “victim needs to prove” still applies for the fault on medical science. Exceptionally, in some particular situation, the rule is going to change if this rule appears unfair for the victim. Otherwise, due to the judgment of French supreme court on February 25, 1997, the burden of proof for the fault on medical ethics falls on the doctor. The court’s opinion goes “Based on the law or the contract, any person who has a duty to inform others should prove that he has done it.” This opinion definitely puts a drastic and profound impact on the usual rules. Moreover, it is also accepted by both civil courts and administrative courts. Consequently, this rule has been adopted by a legislation in 2002.