Est-ce que le secret médical est la clé de voûte du respect de l'éthique médicale en prison ?

Practicing medicine in strict compliance with the rules of deontology is a difficult or even impossible task in the prison setting. Although the French law no. 94-43 of January 18, 1994 upholds the principle of medical secrecy in the prison setting, the practical reality is often quite different. Could a guarantee of medical secrecy be the key to ethical practices in prison? By reviewing the historical intervention of medicine in legal judgments and penal law in the penitentiary model in France, we note that medical secrecy is not a keystone of ethical practice in this setting. Considering the power struggle between the penitentiary authorities and the medical community, and in light of the recent changes in the legal regulations concerning medical secrecy, it can be concluded that this model must be revisited. In our opinion, the prerequisite to an ethical approach to medicine in the prison setting which respects the rules of deontology is the re-affirmation that medical decision-making must remain independent of judiciary authorities and outside the domain of forensic medicine. Confounding these different domains can only lead to the construction of political policies designed to use medicine as a cover for judiciary pitfalls.