Secret médical en santé au travail

The occupational physicians are obliged, like any doctor, to respect the ethical obligations imposed on their profession, including in the exercise of the missions specific to occupational medicine and contained in the Labor Code. The occupational physician is not isolated and works in a multidisciplinary team of a health service at work. He must communicate with other health professionals, but also with employers, representative bodies of staff. Medical confidentiality holds a special place in the triangular relationship between the occupational physician, the employee and the employer. The medical practice in the field of occupational health requires that many provisions of the Labor Code be followed, including the respect of the secret of manufacture and the position of advising employers and employees. The occupational physician must communicate with the employer in order to best achieve his mission, but in practice, it may be difficult for the occupational doctor to make his recommendations heard to improve the working conditions of employees without power, when he cannot argue his opinions on medical information.     

Le consentement en droit médical

Medical law, which derogates from ordinary law, interests and questions by its particularities. However, the Mercier decision of 1936 seems to have denied this by forcing an ordinary “medical contract” between the doctor and his patient. But the medical relationship, far beyond a contractual logic, seems to be unable to blend into the civil law elements of contract law. As such, consent, keystone of this medical matter, does not meet the standards of contract law yet imposed by the Court of Cassation. This article aims to unravel and clarify the scope and regime of this consent not quite like the others.     

Expertise du comité d’hygiène sécurité et conditions de travail : une conception si extensive du secret médical qu’elle pourrait entraîner la négation du droit du travail

Paid medical institutions which are entitled to work conditions corresponding to the respect of their basic right with which it must be articulated. Which is the exact extent of the medical secret? Can it go until allowing the neutralization of the right of the workers organisms?     

Responsabilité médicale et « option »

Medical liability is, in civil law, the suit of a breach of the contract. But, sometimes, it depends of the law of torts (that is the reference in common law). The patient cannot choose between the two systems. If the damage proceeds of a contractual negligence, there is only a conctractual liability. Two projects of law ((ministry of justice) are in another way; they will offer the option. Is it a good solution for the patient?     

Under what conditions do lay people and health professionals accept a breach of doctor-patient confidentiality regarding a patient with signs of terrorist radicalization?

IntroductionConfidentiality is crucial to the establishment of a strong patient-physician relationship. However, certain situations create a dilemma for the physician who is faced with the choice of either respecting medical confidentiality or protecting others from a serious risk of violence.ObjectiveThis study aimed to observe how lay people and health professionals assessed the acceptability of breaching confidentiality when a physician is confronted to a patient showing signs of terrorist radicalization.MethodA total of 228 participants (174 from the general population and 54 health professionals) judged the acceptability of 54 scenarios which were constructed through the orthogonal combination of 4 factors frequently mentioned in the literature: presence of a “Psychiatric disorder”; “Signs of radicalization”; “Projects of violence”; “Collegiality”. Variance and cluster analyses were performed on all the raw data.ResultsResults showed that all factors influenced the judgment of participants but that “Psychiatric disorders” had a weaker impact. Five clusters were identified: “Favorable if collegiality” (n = 23); “Favorable to breach confidentiality” (n = 77); “Unfavorable to breach confidentiality” (n = 26); “Sensitive to all factors” (n = 71); “Favorable if violence” (n = 31), respectively with mean ratings of 5.87, 8.42, 3.64, 6.30 and 7.16, on an acceptability scale of 0–10.ConclusionThe importance that the great majority of participants attribute to these factors indicates that they influence their judgments in this specific context.