De la responsabilité des médecins en cas de certificat médical antidaté

Dans l’exercice de sa profession, le médecin est quotidiennement conduit à dresser un certificat médical au bénéfice de ses patients. Si ce document est exigé dans de multiples situations, il ne s’agit pas pour autant d’un acte anodin et sa rédaction est encadrée strictement de sorte que le praticien n’a pas vocation à en établir par pure complaisance.

Votre serviteur a établi la liste des textes condamnant cette pratique et, il faut l’avouer, il s’agit d’un véritable arsenal organisé contre les faux en général, et les certificats médicaux antidatés en particulier.

En premier lieu, le code pénal réprime sévèrement cet agissement en son article 441-7 qui dispose :

 » Indépendamment des cas prévus au présent chapitre, est puni d’un an d’emprisonnement et de 15 000 euros d’amende le fait :


D’établir une attestation ou un certificat faisant état de faits matériellement inexacts ;

2° De falsifier une attestation ou un certificat originairement sincère ;

3° De faire usage d’une attestation ou d’un certificat inexact ou falsifié.

Les peines sont portées à trois ans d’emprisonnement et à 45 000 euros d’amende lorsque l’infraction est commise en vue de porter préjudice au Trésor public ou au patrimoine d’autrui. »

Le code pénal se montre encore plus sévère lorsque l’auteur de l’infraction exerce la profession médicale. L’article 441-8 dispose en effet :

 » Est puni de deux ans d’emprisonnement et de 30 000 euros d’amende le fait, par une personne agissant dans l’exercice de sa profession, de solliciter ou d’agréer, directement ou indirectement, des offres, promesses, dons, présents ou avantages quelconques pour établir une attestation ou un certificat faisant état de faits matériellement inexacts.
Est puni des mêmes peines le fait de céder aux sollicitations prévues à l’alinéa précédent ou d’user de voies de fait ou de menaces ou de proposer, directement ou indirectement, des offres, des promesses, des dons, des présents ou des avantages quelconques pour obtenir d’une personne agissant dans l’exercice de sa profession qu’elle établisse une attestation ou un certificat faisant état de faits inexacts.

La peine est portée à cinq ans d’emprisonnement et à 75 000 euros d’amende lorsque la personne visée aux deux premiers alinéas exerce une profession médicale ou de santé et que l’attestation faisant état de faits inexacts dissimule ou certifie l’existence d’une maladie, d’une infirmité ou d’un état de grossesse, ou fournit des indications mensongères sur l’origine d’une maladie ou d’une infirmité ou sur la cause d’un décès. »

En second lieu, le code de la sécurité sociale punit également les professionnels de santé qui se sont livrés à ces agissements.

L’article L. 377-5 du CSS dispose en ces termes :

 » Le jugement prononce une des peines prévues au présent chapitre contre un praticien peut également prononcer son exclusion des services des assurances sociales.
Les médecins, chirurgiens, sages-femmes et pharmaciens peuvent être exclus des services de l’assurance, en cas de fausse déclaration intentionnelle. S’ils sont coupables de collusion avec les assurés, ils sont passibles, en outre, d’une amende de 3 750 euros, et d’un emprisonnement de six mois ou de l’une de ces deux peines seulement sans préjudice de plus fortes peines, s’il y échet. »

L’article L. 471-4 du même code ajoute :

 » Est puni d’une amende de 12 000 euros et d’un emprisonnement de trois mois quiconque, par menaces, don, promesse d’argent, ristourne sur les honoraires médicaux ou fournitures pharmaceutiques, aura attiré ou tenté d’attirer les victimes d’accidents du travail ou de maladies professionnelles dans une clinique ou cabinet médical ou officine de pharmacie et aura ainsi porté atteinte à la liberté de la victime de choisir son médecin et son pharmacien.
Est puni des mêmes peines, sans préjudice de celles prévues aux articles 441-7 et 441-8 du code pénal, tout médecin ayant, dans les certificats délivrés pour l’application du présent livre, sciemment dénaturé les conséquences de l’accident ou de la maladie.
Est puni des mêmes peines, sans préjudice de celles prévues aux articles 434-13 à 434-15 du code pénal, quiconque, par promesses ou menaces, aura influencé ou tenté d’influencer uen personne témoin d’un accident du travail à l’effet d’altérer la vérité. »

En troisième et dernier lieu, le code de déontologie médicale, intégré au code de la santé publique, impose notamment aux médecins les obligations suivantes :

L’article 76 du CDM (ou art. R. 4127-76 CSP) dispose :

 » L’exercice de la médecine comporte normalement l’établissement par le médecin, conformément aux constatations médicales qu’il est en mesure de faire, des certificats, attestations et documents dont la production est prescrite par les textes législatifs et réglementaires.
Tout certificat, ordonnance, attestation ou document délivré par un médecin doit être rédigé lisiblement en langue française et daté, permettre l’identification du praticien dont il émane et être signé par lui. Le médecin peut en remettre une traduction au patient dans la langue de celui-ci. »

L’article 50 du CDM (ou art. R. 4127-50 CSP) dispose :

 » Le médecin doit, sans céder à aucune demande abusive, faciliter l’obtention par le patient des avantages sociaux auxquels son état lui donne droit.

A cette fin, il est autorisé, sauf opposition du patient, à communiquer au médecin-conseil nommément désigné de l’organisme de sécurité sociale dont il dépend, ou à un autre médecin relevant d’un organisme public décidant de l’attribution d’avantages sociaux, les renseignements médicaux strictement indispensables. »

Plus encore, l’article 28 du CDM (ou art. R. 4127-28 CSP) dispose :

 » La délivrance d’un rapport tendancieux ou d’un certificat de complaisance est interdite. »

En somme, les textes sont suffisamment nombreux, explicites et sévères pour dissuader le médecin qui se risquerait à ce genre de pratique douteuse. Mais encore faut-il qu’il connaisse les sanctions auxquelles il s’expose.

Parce qu’il engage la responsabilité du médecin signataire, un certificat doit, outre la mention de ses nom et adresse, être signé de sa main, être lisible et daté. Le médecin ne peut ni antidater ni postdater un certificat. Il ne doit prescrire un arrêt de travail que s’il est médicalement justifié. Il doit, enfin, refuser de dater le début d’une incapacité de travail antérieurement à sa constatation, le certificat médical n’étant que le fidèle reflet de ce qu’il a personnellement constaté.

Il en va d’une pratique saine de la médecine.

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