Allowed to raise the emergency medical confidentiality in cases of abuse of minors or vulnerable people

The doctors are not bound by medical confidentiality and the duty to disclose cases of abuse of minors or vulnerable people, recalled medical and legal experts during the 11th consensus conference in Nantes by the French Society of Medicine of emergency (SFMU).
Organised as part of the annual Days SFMU, the consensus conference theme was "Abuse: Screening, to behave in emergencies." Was excluded sexual abuse.

In the absence of Jean-François Segard, Dr. Philippe Lestavel, chief of the emergency department of the hospital in Lille Salengro and member of the editorial board of the SFMU, recalled articles of law that doctors are subjected.

In Article 223-6 of the penal code, to assist a person in danger is mandatory under penalty of prosecution. Article 434-3 complements and requires persons to report cases of abuse and deprivation of children under the age of 15 or anyone who is not able to protect themselves.

Doctors are, however, subject to Article 226-13, which prohibits any person exercising a profession that can lead to the disclosure of wrongdoing lift the secrecy on pain of imprisonment (one year) and a fine (15,000 euros). They must also comply with the code of ethics of their profession.

"Here we have to deal with three contradictory texts," noted Dr. Lestavel, do not hesitate to speak of "paradoxical" ironically on the "abuse of emergency!"

However, there is a legal exception, mentioned in Articles 11 and 12 of the Criminal Code, which allows doctors to lift confidentiality in cases of physical and psychological harm to minors under 18 years of age or vulnerable people. Article 44 of the Code of Medical Ethics also leaves a certain margin of appreciation to the physician and allows it to be abuse cases.

Doctors are therefore not bound by medical secrecy, and in proven cases of abuse, refer to the administrative authorities or judicial authorities (prosecutor) when the protection of the victim is urgent. Only the doctor who initially found the lesions is authorized to write the certificate of wounding. This must include the number of days of total incapacity (ITT), which determines the jurisdiction (police court below 8 days or criminal court over eight days) to judge the respoansable .