France adopts new code of medical ethics

BMJ 1995; 311 doi: (Published 23 September 1995) Cite this as: BMJ 1995;311:769
  1. ALEXANDER DOROZYNSKI, medical journalist
  1. Paris

    The French government has adopted a new code of medical ethics, which was first proposed by the Ordre National des Medecins, the French medical association, two years ago. The 114 article code was approved by Elizabeth Hubert, the minister of public health, and published last week. Major changes since the last code, which was published in 1979, cover patients' rights, particularly their right to receive “clear, and appropriate” information about their illnesses and about the tests, investigations, and treatments that are prescribed for them.

    The association says that the demand for better information has been highlighted by complaints that many doctors do not fully explain what diagnoses mean, or the rationale for the prescribed treatments. If doctors believe, however, that they have “legitimate reasons” to do so they may choose not to tell patients about the diagnosis of a serious disease or a poor prognosis, except when the illness may expose others to the risk.

    The code says that doctors must alleviate their patients' suffering and not pursue treatment or clinical investigations unnecessarily. They should support terminally ill patients, but they do not have the right to hasten death deliberately. To comply with new laws about clinical trials the code says that doctors must ensure that scientific objective do not interfere with the doctor-patient relationship and the need to safeguard confidentiality. The code reaffirms confidentiality of information. Only doctors on the staff of the social security's health insurance branch or of other public bodies that provide special benefits to patients can ask a doctor for information about a patient.

    Every doctor practising in France must belong to the national medical association, which has a legal responsibility to enforce the code. Any violations are judged by its regional councils, and appeals may be made to the association's national council in Paris. Sanctions range from warnings to temporary suspension and expulsion, which is rare and would bar a doctor from practising medicine.

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