What is the doctor’s right to say?

In turn, they were distinguished by their skeptical observations, often full of errors. Accusative act and divisive rhetoric, many doctors have contributed fat to persistent news channels and have been pitched as spokesmen for the field of anti-hygienic action.

For several weeks, health authorities have now been targeted by a complaint from the National Council of the Medical Syndicate (Cnom), the medical news agency EBM said on July 10. Among them are Deputy Haut-Rhin and psychiatrist Martin Wonner, publicly anti-vaccine and Covidio skeptic or anesthetist and resuscitator Louis Foucher, and severe anti-vaccine and Nobel Prize medicine laureate Luc Montagnier, who was recently distinguished by these observations of vaccine misinformation. Create variables from Covid-19. Several general practitioners are also involved, according to the Medical Press Agency: Drs Peter L. Pease, Vincent Reliquet, Denis Agrett and François-Xavier Riches, and two Reunion practitioners, Drs Antoine Vino and Helen Bouscal.

In an extraordinary hearing at the end of June, Cnom decided to file a complaint with the Trial Disciplinary Chambers or join already existing complaints, in particular against Martine Wonner, who filed the Nofakemed collective on June 7. The last time. The authority criticizes them in part for comments they have made since the beginning of the health crisis, in stark contrast to the articles of the Code of Medical Ethics.

The approach is not new. Last December, doctors Christian Peron and Didier Raoult were the target of complaints from the National Council of the Medical Syndicate. Subsequently, AP-HP, the employer of Dr. Perronne also decided to terminate his duties as Head of Department at Raymond Poincaré Hospital in Garches. ” For several months, in the context of the health crisis, Professor Christian Peron made comments deemed unworthy of the job he does AP-HP explained in a press release. Evidence that the doctor cannot say everything, or rather, say everything. What is it really? to Marian Dr. Jean-Marcel Morges, Vice-President of the National Council of the Medical Syndicate (CNOM), discusses the necessary precautions that doctors should follow, especially in times of crisis. Interview.

Marian: How do you rule the word doctors?

Jean-Marcel Morge: There is a set of rules that have general application, and which are related to the individual’s freedom of expression. The doctor has the freedom to express himself like all citizens. However, the word doctor is governed by the Code of Ethics, which is itself incorporated into the Code of Public Health. The physician’s communication should be accompanied by clear, fair and appropriate information. And if there are any doubts, as is the case right now in the context of the pandemic, it is clear that we must put things in perspective and remember that the facts we are talking about today are not fully supported by science and not necessarily consensus.

There is no paradox there, just two levels. First, freedom of expression, then obligations related to the obligations of the medical and scientific community that require rigor and the importance of the comments provided are essential. Because in our society, doctors are a trusted third party towards the population and the patients they treat.

In fact, when you are a doctor, a professor of medicine, what do you have the right to say? Not to say?

There is no actual prohibition on expression, but there are several levels of precaution. We can take without precaution for language what is duly supported ancient scientific and medical facts for which reasons are not ascribed. On the other hand, when talking about very new topics such as Covid, where the realities of the day are sometimes called into question very quickly, it is necessary to add caution to the message and thus to the clause.

“In the context of the epidemic, the unbridled expression of doctors has taken on completely unusual proportions.”

One may wonder, of course, but it is essential that the notes, on a case-by-case basis, be accompanied by cautionary messages warning of the fact that the facts on the subject are not stable, not permanent and still alive by consensus. way.scientific community.

Because doctors are responsible for public health?

The doctors are knowledgeable. They are custodians of medical knowledge. They must fully play their role as healthcare professionals by validating the information they have knowledge of, before disclosing it in an informed manner to their patients. They have a very basic and fundamental responsibility.

To return to Dr. Peron, he was fired from his position at AP-HP for making “statements unworthy of the position he holds”. Is it frequent in the profession?

In the context of the epidemic, the unbridled expression of doctors has taken on completely unusual proportions. why ? First, because we are in an unprecedented situation, we are facing an unprecedented disease that we knew nothing about a year ago.

Second, because the epidemic by definition affects the entire population, because it is particularly dangerous, and because its social and economic health consequences are significant. The suffering it generates is important.

Thus, doctors are invited to express their opinions. The media is the first to ask for its analysis, and not only. Some are solicited for their rhetoric and selected for the controversial discourse they support. And we can regret that doctors do not always have the wisdom, in the philosophical sense of the term, to have the necessary perspective of what ought to be a valid expression. The necessary hindsight, the recognition that an important piece of information does not arise from consensus but from data that will be questioned tomorrow. This is the nature of science. Scientific fact has never been proven. It is the relativity of truth. It is Descartes … but in an unprecedented situation, unusual behavior. We are in a situation where a large number of expressions deviate from the norms of standardized communication expected of clinicians. We’ve never seen this before, except on a very occasional basis.

In the Peron case, the District Board of the Medical Syndicate was taken over. Do its decisions have legal value?

Of course. But it is not the council that makes the decision. Whether it’s the National Council or the county council, it simply decides to refer the doctor to the Disciplinary Room. In particular because it is considered that there is a violation of the rules of morality.

In addition, the board can: either take over a matter, or receive a complaint and bring the doctor to the disciplinary room. At this point, since these professions are regulated with an ethical code, when there is a penalty for radiation, that penalty is applied. A doctor practicing during the sentence will be evidence of an illegal practice of the profession.

What is the danger of these stalking doctors?

It will be the prejudgment to answer you. I can only say that the range of punishment is from warning to write-off.

Does the Covid-19 pandemic, a vehicle of uncertainty, make you think about developing new ethical rules?

There must be a contribution to the correct expression in the public space of the physician. It is not a matter of banning the expression but of getting feedback from the experience from a completely new situation, so that lessons can be learned and the distractions do not reproduce symmetrically. Again, we do not question the doctor’s expression, but in our society it is necessary to be enlightened in the face of opinion.

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