France: Medical records seized at drug treatment centre
01 November 2000
On 28 June the investigating magistrate Magali Tabareau in Pontoise conducted a search of the Rivage methadone centre in Sarcelles, Val d'Oise (on the northern outskirts of Paris), where 165 drug addicts are treated annually. The raid, which contravened judicial precedent, resulted in the seizure of a list of patients' confidential medical records on 17 July. Several people receiving treatment at the centre were questioned by police. Staff were outraged that the centre's guarantee that addicts would receive "anonymous" treatment "free of charge" was broken. Medical treatment at the centre was badly disrupted for over two weeks.
A judge issued a search warrant for the centre after two members of staff refused to hand police a list of patients and their addresses on 14 June, during an investigation into cocaine dealing by a former patient - he had claimed that he had occasionally "helped out" people from the centre. Gilles Nester, a psychiatrist who practices in Gonesse hospital and the Rivage centre, explained that the list was protected by the professional duty of confidentiality "and by regulations governing the functioning of care centres for drug addicts". He complained that the duty of medical confidentiality was disregarded, showing the "total inadequacy of the law of 31.12.70. with regards to problems of public health".
This law deals with investigative powers and the medical sector, according to staff at the Rivage centre: "it gives magistrates all the power". Anne Coppell, president of the Association française de réduction des risques (French association for the reduction of risks), confirmed the criticism: "In this story, the problem is that practically everything was legal." The Pontoise court also stressed that Tabareau's actions did not contravene the law. Nonetheless, the daily newspaper Liberation commented that "until now it was common practice that judges did not search treatment centres".
The magistrate was able to seize all of the centre's medical records rather than just seizing the record of the person under investigation. Gilles Nester said: "All the patients have been indiscriminately...implicated...simply because they receive medical treatment in the same centre as the person under investigation." He argued that such practices will stop addicts from turning to drug treatment centres for help and will result in "generalised illegality and opacity" by driving users underground. In a press statement he explained that the magistrate's actions forced staff to operate in a "totally unusual manner" for 15 days. Daily trips to collect methadone had to be arranged, and staff had no access to patients" medical records.
Over 50 associations formed a support group and wrote an open letter to Prime Minister Lionel Jospin in defence of the Rivage centre. They stressed the "spectacular results" attained by health programmes for addicts, including the reduction of deaths from AIDS, of numbers of people infected by HIV, of lethal overdoses (down by 80% between 1994 and 1998) and of police interrogations related to heroin use (down by 54% between 1994 and 1998). They called for an urgent review of the law of 31.12.70. to "guarantee access to care by respecting confidentiality". The letter also expressed concern at the magistrate's scrutiny of urine tests which "are not meant to serve as judicial evidence of [drug] use in any circumstance".
The clash between social workers and law enforcement authorities is reminiscent of the case in the UK of Ruth Wyner and John Brock (See Statewatch vol 10 no 1 & 3/4), convicted and sentenced to four and five years jail respectively after refusing to disclose details about clients at Wintercomfort day centre for the homeless. Their defence relied on the charity's confidentiality policy which did not allow them to pass the names of suspected drug dealers to the police. They were bailed after seven months in prison and have been cleared to appeal against their sentence