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Dr Gérald Kierzek (Medical Director of Doctissimo)
Medical validation:
March 11, 2023
To prevent sexually transmitted infections, the Haute Autorité de Santé wishes to encourage partner notification procedures. Should medical secrecy be broken? The opinion of Dr Gérald Kierzek, medical director of Doctissimo.
The High Authority for Health (HAS) has just proposed to change the current legislative framework in terms of professional secrecy in order to “to offer the patient in whom an STI is diagnosed the possibility of choosing the way of informing his partner(s) and thus favoring the initiation of a notification process“. A measure that divides health professionals.
Inform the patient’s partner
Concretely, “The idea would be that the health professional or a third party can inform the partner of a patient with the latter’s consent.“, writes the HAS in its opinion.
A possibility that is currently not allowed by professional secrecy.
This notification would consist, for a doctor who would announce a diagnosis of STI, “to encourage the patient to inform his sexual partner(s) in order to lead them to get tested and, in certain cases, to benefit from appropriate treatment, initiated early..
The possibility of expedited processing
Another key point of this notice: the possibility of accelerated processing of partners (TAP), which “should also be authorized in France“says the public authority.
This would consist of giving the patient infected with an STI a prescription for the benefit of his partner, without prior consultation with the latter.
The advantage of this change? Allow “partners to be treated as soon as possible, especially if there are no symptoms and if it is known that they will not seek medical attention or approach the health system“, estimates the HAS.
More broadly, this strategy would aim to interrupt the chains of transmission.
“Medical secrecy is the basis of trust”
For Dr. Kierzek, this measure calls into question article 4 of medical ethics, that is to say professional secrecy.
“There are 36 notifiable diseases (which must be reported to health authorities, editor’s note), 32 of which require urgent public health intervention. In this context, collective risks prevail over individual risks. On the other hand, for the rest, the information must remain within the walls of the cabinet. Medical secrecy is the basis of trust between the patient and the doctor. Admittedly, it is the practitioner’s duty to convince the patient infected with an STI to warn those around him. But the authorities should not reveal it to the partner. Disclosures of private life constitute an offence’.