Case 270234

C.E., n°270234, 26 September 2005
Download Judgment: English French
Country: France
Region: Europe
Year: 2005
Court: Conseil d'Etat [Council of State]
Health Topics: Health information
Human Rights: Right of access to information, Right to privacy
Tags: Confidentiality, Disclosure, Health facilities, Health information, Health records, Medical records, Non-disclosure

The petitioners brought this challenge to a decision of the French Minister of Health and Social Welfare and to a decree legislating the patient’s right to access his/her health information held by health professionals or facility and her/his right to use the help of a mandated third person to access such information. The petitioners requested the cancellation of this decree because it approved the contested paragraphs of the best practices recommendations regarding such access.

The Court considered certain aspects of the law, including the third paragraph of IV of the best practices recommendations approved by the contested decree. This paragraph stipulated that the information about the health of a patient may be disclosed to an authorized and duly mandated person under various conditions.

The Court also considered the 23d paragraph of IV-1 of the best practices recommendations approved by the contested decree which confirmed that the beneficiaries of a deceased person may have access to the health information of the latter if it was necessary to know the cause of the death or to defend the memory of the deceased person. In such situation, if the deceased didn’t oppose such access before her/his death, the beneficiaries could have access to all medical records.

The Court held that the legislature did not intend, with Articles L. 1110-4 and L. 1111-7 of the Code of Public Health, to exclude a patient’s ability to access her/his medical information by using a mandated representative, provided such third person could prove her/his identity and had a duly justified mandate. The Court therefore declared that the French National Medical Council could not request the cancellation of the third paragraph of IV of the recommendations approved by the contested decree.

The Court determined that the legislators intended to authorize disclosure of medical information about a patient to her/his beneficiaries and that this communication could refer to all the information in the medical file. The Court held that such broad disclosure ignored the principles stipulating that the beneficiaries should only have access to the information necessary for knowing the cause of the death or honoring the deceased person’s memory. The Court therefore declared that such provisions and the decision by which the Minister refused to withdraw such provisions should be cancelled.

“Medical confidentiality does not preclude the entitled beneficiaries to have access of information about a deceased person if it is necessary in order to know the cause of death, to defend the memory of the deceased or to assert their rights, except if the person expressed her/his opposition before her/his death; that under Article L. 1111-7 of the Code of Public Health: Everyone has access to all information about her/his health held by health professionals and facilities (…).” “Le secret médical ne fait pas obstacle à ce que les informations concernant une personne décédée soient délivrées à ses ayants droit, dans la mesure où elles leur sont nécessaires pour leur permettre de connaître les causes de la mort, de défendre la mémoire du défunt ou de faire valoir leurs droits, sauf volonté contraire exprimée par la personne avant son décès ; qu’aux termes de l’article L. 1111-7 du code de la santé publique : Toute personne a accès à l’ensemble des informations concernant sa santé détenues par des professionnels et établissements de santé (...)”.   “Considering that it is not the result of the above definitions of the Code of Public Health that the legislator intended to exclude a person’s possibility to access her/his medical information held by health professionals and facilities by using, under the conditions of ordinary law, a mandated person if the latter can prove her/his identity and has an express mandate, that is to say duly justified; that therefore, the FRENCH NATIONAL MEDICAL COUNCIL is not entitled to request the cancellation of the third paragraph of IV of the recommendations approved by the contested decree;” “Considérant qu’il ne résulte pas des définitions précitées du code de la santé publique que le législateur ait entendu exclure la possibilité pour la personne concernée d’accéder aux informations médicales relatives à sa santé détenue par des professionnels et établissements de santé en recourant, dans les conditions de droit commun, à un mandataire dès lors que ce dernier peut justifier de son identité et dispose d’un mandat exprès, c’est à dire dûment justifié ; que dès lors, le CONSEIL NATIONAL DE L’ORDRE DES MEDECINS n’est pas fondé à demander l’annulation des dispositions du troisième alinéa du IV des recommandations homologuées par l’arrêté attaqué ;”   “Considering that …. the legislator intended to authorize the communication to the entitled beneficiaries of a deceased person only the information necessary to achieve the objectives of those beneficiaries, namely to know the cause of death, to defend the memory of the deceased or to assert their rights; that these contested provisions, which establish that the communication to the beneficiaries may refer to all the information in the medical file, ignore these principles; that such provisions, therefore, should be cancelled, like the decision by which the Minister of Health and Social Welfare has refused to withdraw them;” “Considérant […] que le législateur a entendu autoriser la communication aux ayants droit d’une personne décédée des seules informations nécessaires à la réalisation de l’objectif poursuivi par ces ayants droit, à savoir la connaissance des causes de la mort, la defense de la mémoire du défunt ou la protection de leurs droits ; que les dispositions attaquées qui prévoient que la communication aux ayants droit peut porter sur l’ensemble des informations figurant dans le dossier médical, méconnaissent ces principes ; que ces dispositions doivent, par suite, être annulées, ainsi que la décision par laquelle le ministre de la santé et de la protection sociale a refusé de les retirer ;”
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