Legislative Framework And Ethical Basis Of Medical Certificates For Children Entering Community A Narrative Review

Background. General Practitioners (GPs) are often requested to provide medical certificates when children enter a school or a nursery school. The aim of this review was to identify which medical certificates are actually required for children entering a school or nursery school, and to describe the content of such certificates as well as their drafting rules.Methods. We conducted a narrative review of literature and searched medical and legislative databases for articles or texts related to childhood and certificates. All included articles were published from 1946 to 2012.Results. Only one certificate has been found as legally required when a child is entering a school certifying the immunization against diphtheria and tetanus when entering primary school (Article L311-2 from public health code, modified by law n degrees 2007-293 in 2007, March 5). The obligation to submit a medical aptitude certificate for admission in a nursery or primary school was officially abrogated in 2009. In other situations for which medical certificates are not required, article 76 from the French code of medical ethics specified that GPs should decide whether he should provide the certificate.Conclusion. No medical certificate is required when a child enter a school or a nursery school except for the immunization status certificate. Although GPs may refuse to issue those non-mandatory medical certificates, the occurence appears as a privileged time for screening and prevention.