Evaluation of the quality of medical certificates in the context of the opening of a measure of legal protection for adults over 60 years of age.

In France between 700,000 and 800,000 people will be covered by legal protection. The opening of any measure is conditioned by a detailed medical certificate. It is drawn up by a doctor registered on the list drawn up by the public prosecutor. No specific training is required. A single piece of legislation frames the content of the certificates. We therefore investigated whether the medical certificates currently produced were in compliance with the code of civil procedure. 111 medical certificates collected and anonymized by the tribunal d'instance of Saint-Étienne, from 4 January to 3 April 2016. The certificates concerned applications for the opening of legal protection for adults over 60 years of age. 57% of detailed medical certificates satisfied the requirements of article 1219 of the code of civil procedure, with no difference between requests for curatorship and guardianship. 76% of adults had cognitive impairment, 14% had a psychiatric disability, and 10% had a functional disability. 72% medical certificates proposed a guardianship measure, 21% a reinforced curatorship and 7% a simple curatorship. The circumstances justifying the opening of a measure of protection and the way of life of the adult were respectively found in 32% and 83% of the certificates. In 49% of the cases, the doctors dispensed the majority of hearing with the judge and the right to vote was retained in 10% of the adults subject to a guardianship application. The study showed a deficiency in the application of article 1219 of the code of civil procedure but also in the information that was requested. The drafting of the detailed medical certificate requires specific medical and legal knowledge. This raises the question of the training of doctors on the list of public prosecutors. Like the medical assessment carried out in the context of the assessment of bodily injury, the detailed medical certificate must become a real expertise carried out by doctors trained in this exercise.