Aspects historiques et juridiques du secret médical

Today, patient management involves many different healthcare professionals. The respect of the medical secrecy is more and more crucial. This forensic theme interests both specialists of the law and healthcare professionals. Here, we present on one hand the abstract perception of a jurist and on the other hand the practical vision of a pharmacist in two papers. In the first paper, juridical and historical aspects of the medical secrecy will be studied. The position of medical secrecy has evolved overtime. While the Hippocratic oath already mentioned it in the 4th century B.C., a legal text dealing with the question of medical confidentiality violations was published only in 1810. The debate between an “absolutist” vision versus a “relativist” vision has long-lived. In the contemporary legal system, the medical secrecy is no longer the privilege of the ethics but a matter of law, and concerns all of the healthcare professionals. In the second paper, an analysis of recent plans and hospital practices will be done. Medical knowledge's segmentation leads to share medical information. In this perspective, several strategies were set up. The institution of price per activity (T2A) in 2005 modified the hospital daily life. The Personal medical file project introduced in 2004 was then followed by the Pharmaceutical file in 2007. The healthcare process keeps evolving, in particular in the field of the clinical pharmacy; therefore a clarification on the subject is necessary. It was completed by a survey realized within a hospital pharmaceutical department. This study allowed reviewing the current needs regarding medical secrecy by the pharmaceutical personnel.