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Violences conjugales et levée du secret médical : vécu et ressenti des médecins généralistes
Mémoire de Master / Thèse d'exercice   Open Access

Violences conjugales et levée du secret médical : vécu et ressenti des médecins généralistes

Marion Costille
Masters , Université de Montpellier
07/07/2023

Résumé

Medical secrecy Law of the 30 July 2020 Secret médical Loi du 30 juillet 2020 Intimate Partner Violence Domestic violence Spouse abuse General practice Confidentiality Violence conjugale Médecine générale Confidentialité
Domestic violence is a major public health issue. The French government took up the subject in 2019 by organizing the “Grenelle des violences conjugales”, which led to the promulgation of the law of July 30, 2020. Among various measures, this law allows healthcareprofessionals to file a judicial report without the consent of the victim if they are in immediate danger and under the control of the perpetrator of the violence. This change in the law sparked lively debate. The primary objective of this study was to gather general practitioners’ opinions on this change in the law. The second objective was to understand their experience of dealing with domestic violence in general.Method: we carried out a qualitative survey using individual, semi-directed interviews with general practitioners practicing in the Hérault region in France. After transcribing each interview, a thematic analysis of the verbatims was carried out. A triangulation of the data was obtained thanks to the reading of the verbatims by three researchers.Results: a total of 11 general practitioners were interviewed between September 2022 and May 2023. All agreed that they had little experience of domestic violence in their practice. Multiple factors limit their ability to detect and deal with domestic violence, but they recognize that they are helped by training courses and various professional networks. With regard to the lifting of medical confidentiality, made possible by the July 30, 2020, law, their opinions are nuanced. Overall, they welcome this measure, which they see as a way of ensuring that they are not powerless witnesses to the domestic violence their patients may suffer, but some are reluctant to go against the will of victims. In general, they are uncomfortable with the interpretation of the law, which is open to interpretation, particularly with the notions of “control” and “immediate danger”. Lastly, they feel that this does not really change their practice or the victim care.Conclusion: general practitioners are torn between the desire to help victims of domestic violence and the reluctance of going against their patients’ will. They don’t seem to be applying the law of July 30, 2020, very much so far, as it covers only rare situations, and they find it difficult to interpret. They would like to receive more training on the subject, and to be part of a network of professionals who help them care for victims.

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