Doctors Stop Violence: a group of doctors dismayed by the position of their professional order in the fight against violence against children

Protecting doctors who report it is better to protect abused children. ODM needs to change its practices to help protect children better.

The report of the commission, chaired by Judge Durand, observes the particular situation of doctors with regard to violence against children:

Under the law, a doctor who makes a complaint in favor of a child who is a victim or who may be a victim of sexual violence may be subject to disciplinary proceedings on the orders of doctors.CIIVISE is attentive to the situation of these professionals who have been the subject of these proceedings, including sanctions up to the temporary ban on exercising their profession …

The CIIVISE therefore logically recommends the suspension of the ordinal proceedings against doctors in the context of reports of minors in danger or probable, remembering that the protection of the minor must take precedence. It also recommends clarifying the reporting physician’s position vis-à-vis the law and supports a reporting obligation for physicians clearly inscribed in the law.

In the days following the publication of the report, the Order of Doctors (ODM) launched a press release widely reported by the press, openly expressing its opposition to the recommendations of the CIIVISE.

On behalf of the Stop Violence Doctors Collective (established in April 2021 and made up of about fifty practitioners of all specialties) we show our dismay at the position taken publicly by the ODM. This position can be summarized in four points which should be examined:

isDoctors should report child abuse to the prosecutor only “if they are sure of the existence of the abuse as stated by the ODM” ?

The Collective stresses that the doctor is neither an investigator nor a magistrate and that it is not his job to be sure of the facts. The doctor can only assume and pass on to justice or social services the elements of which he becomes aware and which lead him to assume that the child may be in danger. The investigation and possible implementation of the protection are the responsibility of the socio-judicial services responsible for this purpose.

Having to be sure of the facts to report to the Public Prosecutor would mean for a doctor never to be able to report him.

isDoctors already have a “protection obligation” according to the medical code of ethics, would it not be necessary for the ODM to have an obligation to report?

We believe that a doctor cannot implement the protection himselfof one child subjected to abuse. It has neither the means nor the prerogatives. The only means available to the doctor to protect a child in danger is to report it to the judicial or administrative authorities as required by law 2007-293 of 5 March 2007 so that effective protection measures can be put in place as soon as possible. . To protect a child for a doctor, this can only be reported.

isCould the reporting obligation “keep children out of care” as feared by the ODM?

Collective de Médecins Stop Violences reminds that children have a basic need for emotional and physical security on a daily basis, described as a Meta need by the scientific community. This means that a child’s need for safety is the primary condition of her physical and mental health.

Also, abuse in childhood it is the main risk factor for suicide in children and adolescents. This abuse originates in childhood and later in adulthood from physical and psychiatric diseases. Abuse is therefore a major public health problem that cannot be ignored by doctors.

Finally, it shows regular clinical practice with abused childrenthat access to assistance for the abused child becomes regular and effective only once the protection measures have been implemented by justice and social services. Obligation for doctors to report will not hinder access to care for abused children, quite the opposite.

isWhy is ODM against mandatory reporting for doctors when countries that have implemented it are seeing better child protection?

This reporting obligation for doctors exists elsewhere: present for 50 years in the United States, it also exists in Canada and in many European countries. In Canada, a large study has shown that this obligation leads to better protection of children.

In France some doctors already aresubject to this reporting obligation: school doctors as well as SME doctors (maternal and child protection); it would therefore only be a question of extending this obligation to all doctors without distinction.

The World Psychiatric Association, the Council of Europe Committee of Ministers, the Committee on the Rights of the Child and two UN Special Rapporteurs have also supported this duty to report, believing that it ensures better detection of child abuse and protection of reporting doctors.

The Haute Autorité de Santé (HAS) in its 2011 report on domestic violence notes that doctors “they are among the local actors best able to recognize evocative signs of abuse In its 2014 press release, the HAS regrets that less than 5% of reports of child abuse come from doctors.

Should we delve into the reasons for keeping an extremely low number of reports from doctors? How is it possible for a doctor to follow the recommendations of the HAS, carry out his human and ethical duty of protecting child victims if he has to fear judicial proceedings and ordinal convictions in the aftermath of his complaint?

On behalf of the Médecins Stop Violences collective, we are in favor of the inclusion in the law of the duty to report recommended by CIIVISE. Practitioners of the collective, regularly confronted with the problems of violence against children, believe that it is in the best interests of the child and thatthis concern must prevail over all other considerations as a child’s health and sometimes life is at stake.

Having acknowledged that the complaints against doctors in situations of child abuse come most often from the alleged abusers of the child, the group also argues in favor of inadmissibility by the Department Councils and disciplinary chambers of the ODM of any complaint within the framework of the suspicion of child abuse.

Protecting doctors who report it is better to protect abused children. ODM needs to change its practices to help protect children better.

To find the website of the Médecins Stop Violences collective: click HERE

For the collective Doctors Stop Violence:

Dr. Maurice BERGER child psychiatristformer associate professor of child psychology at Lyon2 University, dean of the university degree “Legal skills in child psychiatry and clinical child psychology”.

Doctor Françoise FERICELLI child psychiatristformer hospital doctor, department head, legal expert.

Doctor Eugénie IZARD child psychiatristPresident of REPPEA, a network of professionals for the protection of children and adolescents.

Professor Yann MIKAELOFF pediatricianUniversity professor-hospital professional Faculty of Medicine Paris-Saclay, legal expert.

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