A general practitioner from Bois-de-Céné, in Vendée, finds herself in the spotlight after a patient sued her for refusing care. The man blames him for not having renewed his treatment for hypertension, despite his chest pains and headaches. The case, brought before the disciplinary chamber of the order of doctors, highlights the limits of a doctor’s right to refuse a patient and the possible recourse for those who believe they have been neglected. Dr. Gérald Kierzek, emergency physician and Medical Director of True Medical, enlightens us on the challenges of this refusal.
A refusal following difficulties with the patient
A general practitioner from Bois-de-Céné, in Vendée, appeared on October 15 before the disciplinary chamber of the Pays-de-la-Loire order of doctors. She was sued by a former patient who accused her of having refused, for no apparent reason, to renew treatment for hypertension prescribed a few days earlier in the emergency room. The facts date back to February 2024. The patient, aged 44, then suffered from chest pain and severe headaches. His GP had estimated that there was “no medical emergency”, which had provoked his anger.
But the dispute between the two does not date from this episode. Already in 2022, the practitioner had reported aggressive behavior from the man towards her replacement. He also distinguished himself by an altercation with another patient and a medical secretary, after his refusal to wear a mask during the health crisis. The disciplinary chamber decided to put its decision under advisement. She will decide in the coming weeks on a possible sanction.
What the law says about refusal of care…
To understand the issues of this affair, Doctor Gérald Kierzek recalls that “a doctor can refuse to treat a patient except in an emergency or if he fails in his duties of humanity, for professional or personal reasons“. These reasons can be a disagreement, an overload of patients or even aggressive behavior.
On the other hand, this right has its limits:This refusal must never be discriminatory, whether because of origin, state of health, family situation, religion or disability, nor motivated by financial reasons.“, he explains.
An obligation of continuity of care
The Code of Medical Ethics strictly regulates this type of situation. Article R.4127-47 of the Public Health Code stipulates that a doctor has the right to refuse to treat a patient, provided he informs him and “transmit to the doctor designated by him the information useful for the continuation of care“.
For Gérald Kierzek, this requirement is essential: “Continuity of care is a fundamental principle. The doctor must refer the patient to another professional in order to avoid any disruption in care.“.
Possible sanctions in the event of unjustified refusal
When a refusal is not justified, the consequences can be serious. “The doctor is exposed to disciplinary, civil or criminal sanctions“, emphasizes Doctor Kierzek. On the patient’s side, several remedies are possible. “He can contact the director of the local health insurance organization or the president of the council of the medical association. He can also file a complaint if he considers that the refusal is unjustified or discriminatory.“, he explains.
Before getting there, however, the specialist advises dialogue: “The patient must first ask the practitioner for clear explanations of the reasons for the refusal.“For him, everything is based on transparency and communication.”Refusal of care must never be an act of authority, but a justified, explained and supported medical decision.“, concludes Dr Gérald Kierzek.