Last week, the Secretary of State for Development, Chrysoula Zacharopoulou, was targeted by complaints of rape and violence.
The gynecologist dismissed these accusations on Friday, deeming them “unacceptable and revolting”.
The College of Gynecologists has published a forum and a press release to express its deep concern at the confusion between rape and malicious medical examination.
A reaction which makes patient associations fear that the opportunity to reflect on medical practice, in the place of patients, is missed.
The Prime Minister, despite being busy, has also described as “an important debate” that of “consent when we do exams”.
Proof that the government has heard the concerns of professionals and the urgency of patients.
The subject has been causing a lot of tension for a week.
Two complaints of rape and one complaint of violence target Secretary of State Chrysoula Zacharopoulou.
This gynecologist specializing in endometriosis worked at the Tenon hospital in Paris, in the service of Emile Daraï, implicated by 25 patients.
Some gynecologists have expressed alarm at the use of the term “rape” to refer to a traumatic gynecological examination.
And beyond the question of vocabulary or the law, it is the question of the relationship between gynecologist and patient that comes back under the spotlight.
“We are starting to be very worried about this assimilation between gynecologist and rapist”
If the issue of gynecological and obstetrical violence has exploded over the past ten years, and several male gynecologists have been accused of rape, it is rare for a woman to be the subject of such a complaint.
“We are starting to be very worried about this assimilation between gynecologist and rapist, between medical examination and rape, insists Joëlle Belaisch-Allart, president of the National College of French Gynecologists and Obstetricians (CNGOF).
This goes too far and represents a threat for gynecologists, who no longer want to choose this specialty, or will no longer carry out these examinations.
And patients will be scared.
To do cervical cancer prevention, you have to take a smear, which requires a speculum.
There is a fear of being faced with pathologies taken too late for lack of follow-up.
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A reaction not up to the challenge, according to patient associations.
“It reverses the guilt a little, notes Sonia Bisch, president of the association Stop obstetric and gynecological violence.
Distrust is not driven by testimonies, but because there is violence.
We are not saying that all doctors are like that!
The college could have focused on good practices rather than finding how to protect itself from complaints and remain in the protection of peers.
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"If a person screams and says 'stop' during a vaginal examination, continuing is not to treat them!
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Is taking a few seconds to make sure the patient is okay and ready before a non-urgent vaginal examination too time-consuming?
“The vast majority of doctors do it, defends the president of the CNGOF.
No doubt there is a minority of gynecologists who do not do this, but should we qualify them as rapists?
It's malice, not a crime.
There is no voluntary notion of evil.
The doctors in question must change, we have heard what the women tell us.
»
What some associations doubt.
“The debate on a so-called fake or real rape, extremely painful for the victims, is not at all the subject, continues Sonia Bisch.
We are also defended on social networks by victims of rape and Muriel Salmona, specialist in traumatic memory.
In the law, the definition of rape is penetration with surprise, violence or threat, the perverse sexual intention is not written *.
In the testimonies we receive, it is really the violent act that causes trauma, regardless of the will to harm or not.
If a person screams and says "stop" during a vaginal examination, continue, it is not to cure it!
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When Isabelle Derrendinger, midwife, talks about her practice, she proves that respecting patients' rights is not insurmountable.
“Most of the complaints from patients are linked to a lack of information, specifies the vice-president of the Order of Midwives.
Adopting a shared medical decision is simply explaining the reasons for an examination, proposing it, waiting for consent, warning that she can withdraw it at any time.
Throughout the review, I explain what I am trying to achieve.
We have abominable time constraints, but they do not allow us to free ourselves from information and consent!
What the Kouchner law of 2002 imposes elsewhere.
Go much further than a simple question of law
“The debate on this word “rape” exists and it would be a shame not to lead it, underlines Anne Evrard, vice-president of Ciane.
But the qualification risks being limiting since it equates to a sexual predator.
If for her, having the damage recognized remains important, the objective is not only to punish a handful of abusive gynecologists, but to reform the caregiver-patient relationship.
"It's easier to say to yourself there are a few thick brutes than to say: medicine has built a system where violence is explained, not because the practitioner is deviant, but because he is representative of the system in which it evolves.
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Should we go through a law that would define precisely what is gynecological violence?
“That would not solve the problem, warns Anne Evrard.
We must address the training, the way in which the interns are themselves respected during their internships, the know-how of the carer… ”
So, should a paper be signed to ensure the patient's consent before an examination?
Unnecessary, since patients can remove it orally at any time.
“The problem is that some doctors do not see the vagina as sexual, assures Sonia Bisch.
Maybe because they see them all day.
So that the point of view of patients is better taken into account, she advocates better training for caregivers on the notion of consent, respect for the law and the voice of women who come to consult.
An open debate on the subject with caregivers, patients and lawyers?
For all stakeholders, it is high time to move the dialogue forward.
"We are asking for a sharing of power so that patients are seen as partners in their health," continues Sonia Bisch.
If we make this gynecological violence visible, it is so that our medicine is at the service of patients and not the other way around, with episiotomies and triggers to save time, naked examinations or unnecessary smears… ”However, when the CNGOF wrote its charter of good conduct, which it puts forward today, it did not take into account the wishes of the group of patients... who suddenly resigned.
Proof that things are changing: the CNGOF calls in its forum for a great debate bringing together not only doctors, gynecologists, midwives, urologists, gastro, but also lawyers, magistrates, patient associations, to "find a solution".
A good idea for Ciane and Stop VOG.
“Whatever follows from the instruction concerning the Secretary of State, this is an opportunity to remind patients of their rights and health professionals, particularly in the field of gynecology, that the rights of patients, c It is the duty of caregivers,” insists Isabelle Derrendinger.
Moreover, in the school of midwives that she directs, in Nantes, patients have been taking part in courses on patients' rights for several years.
"But it should be done in all schools," she pleads.
* The exact definition being: “Any act of sexual penetration, of whatever nature, (…) committed on the person of another (…) by violence, coercion, threat or surprise is rape”.
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Government: Secretary of State Chrysoula Zacharopoulou considers accusations of rape against her "unacceptable"
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