Les violences médicales principalement explorées sont les institutionnelles et les gynécologiques. Elles sont pourtant présentes en soins primaires.Cette revue de la littérature avait pour objectif de faire l’état des lieux des violences involontaires de soignants envers les patients en soins primaires et d’identifier les pistes de solutions.La recherche documentaire a été réalisée selon les recommandations PRISMA , de mai à juin 2025. Les bases de données consultées étaient : PubMed, Cairn.info, Lissa et Cochrane Library. Les équations de recherche ont été élaborées à partir de termes MeSH combinés par des opérateurs booléens (« AND », « OR », « NOT »). Les principaux termes utilisés étaient “Primary health care”, “family physician”, “Violence”, “discrimination”, “stigmatization”, “patient mistreatment”, combinés avec des termes d’exclusion tels que “hospital”, “emergency care”, “surgery”. Un enregristement sur PROSPERO a été fait.Ce travail a mis en évidence de multiples formes de maltraitance, surtout sous forme de discriminations, stigmatisations et d’iniquités des soins. Elle touche en premier lieu les populations marginalisées et vulnérables, (telles que les minorités raciales et ethniques, les personnes LGBTQ+, les femmes, les personnes âgées, les patients en situation de précarité socio-économique, en situation de handicap, ou souffrant de troubles psychiatriques, d’addictions ou d’obésité). Ces expériences peuvent impacter les patients sous plusieurs formes: atteinte de la dignité et de l’autonomie, détérioration de la relation thérapeutique, impacts psychologiques et physiques.La force de ce travail est sa rigueur méthodolique et son originalité. Ses limites portent sur le peu d'articles traitant spécifiquement des soins primaires. Ces éléments correspondent aux données de la littérature, dans le domaine de l’obstétrique ou des soins institutionnelles. La normalisation des maltraitances retrouvée dans les différents types de soins impose un questionnement éthique sur sa genèse et sa persistance. Elles peuvent être expliquées par le résultat de mécanismes de défense de la part des soignants en proies à leurs propres difficultés mais aussi plus largement par des violences systémiques reflétant un problème sociétal.Optimiser la relation soignant-soigné par le biais d’une formation de communication, interculturelle et continue semble être, malgré des preuves d'efficacité demeurant limitées, la solution la plus prometteuse.

Research on trauma related to gender-based and sexual violence (GBSV) shows long-lasting effects on physical, psychological, and social health, exacerbated by silence, shame, and institutional denial. In societies shaped by a rape culture in which rape myths and victim-blaming persist, healthcare systems may—sometimes unintentionally—reproduce relations of domination. General practitioners (GPs) occupy a strategic position to identify, listen to, and support victims, yet they often remain insufficiently trained in comprehensive approaches to gendered social relations.This paper provides an overview of current knowledge articulated with materialist approaches to gendered social relations and aims to highlight concrete implications for general practitioners in order to improve listening practices and strengthen the quality of care.The article is based on a narrative and critical review of the literature in public health and the sociology of violence against women, including recent work on rape culture, combined with a multi-sited fieldwork approach. The findings are analyzed from a materialist perspective attentive to social determinants of health, power relations, and institutional forms of violence and silencing within care settings.Rape culture—and more broadly popular culture through the banalization and normalization of violence—shapes professional representations and practices, including those of general practitioners.A materialist approach to gendered social relations makes it possible to understand GBSV as structural violence intertwined with economic inequalities and gender hierarchies. For general practitioners, this entails shifting perspectives by questioning the power relations that run through patients’ life trajectories and the clinical relationship itself.Training general practitioners (GPs) on these issues is essential to ensure safe and reparative care. Integrating tools for identifying GBSV, practicing active listening, and developing critical reflection on rape culture and gendered social relations into both initial and continuing medical education is a central condition for establishing a genuine ethics of care.

The concept of distress has been developed to describe the specific experiences of patients in palliative care. This concept makes it possible to de-psychiatrising these situations.The aim of this study was to explore general practitioners’ feelings about the distress of palliative care patients and to better understand the patient-doctor relationship in these situations.The epistemological approach of the study was based on a constructivist paradigm. Interpretative phenomenological analysis was used in this qualitative study involving semi-structured interviews. General practitioners were included through snowball samplingTen general practitioners were included, five men and five women. Seven themes were identified, intertwined to form two distinct cycles. The first cycle showed total commitment to the patient on the part of doctors who, faced with death and distress, felt a trying limitation. This limitation led to a feeling of failure, forcing the doctor to seek control. The second cycle showed the establishment of a unique relationship with the patient, evoking emotion in the doctor but also a positive feeling of usefulness and value.The total commitment of general practitioners corresponds to the ideal they impose on themselves. Faced with death and distress, this ideal is shaken. The doctor is tested and struggles with this experience. The establishment of a unique relationship with the patient counterbalances this negative experience. At this point, the doctor meets the patient in a unique human relationship. This relationship generates appropriate and reactive emotions in the doctor. The doctor is no longer experiencing hardship, but emotion. Ultimately, it is this relational commitment that gives meaning to the care of these patients, with a deep positive sense of usefulness, value and enjoy.General practitioners are committed to their patients in distress in palliative care situations. This commitment generates a deep sense of usefulness and meaning when they manage to establish a unique human relationship with the patient.

In a context where notions of body, intimacy and consent are gaining prominence, medical touch, although central to physical examination, is increasingly questioned. While the patient’s experience has been widely studied, the perspective of general practitioners remains insufficiently explored.This study aimed to explore how they experience medical touch during consultations.Qualitative study inspired by Grounded Theory, conducted among twelve general practitioners in the Île-de-France region, recruited through purposive sampling. Individual semi-structured interviews were recorded, transcribed and analysed through iterative open, axial and theoretical coding, with triangulation between multiple researchers.Medical touch appears as an adjusted, secure and co-constructed act, evolving from a technical gesture toward a humanizing interaction. It is perceived as a gesture of clinical rigor, a relational language of presence, and a practice framed by communication, consent and sociocultural norms, shaped over time by experience and continuity of care.Our findings suggest that medical touch, once perceived mainly as a clinical routine validating the physician’s role, has evolved into a reflective, relational and ethical act. This shift mirrors societal changes regarding intimacy, consent and professional boundaries. Compared with the literature, our results move beyond Goffman’s notion of touch as a social ritual reassuring the patient, and align more closely with contemporary perspectives. Laugier and Andrieu describe touch as an ethical mediation between two vulnerable subjects, which resonates with doctors’ emphasis on transparency, consent and shared decision-making. Moreover, philosophers such as Merleau-Ponty and Serres highlight touch as a bodily language of presence and recognition a dimension strongly echoed by our participants, who see touch as a silent but meaningful mode of communication. Overall, medical touch appears as a multidimensional practice that combines technical skill, relational sensitivity and ethical responsibility. It embodies the transition from a paternalistic model toward a partnership-based doctor–patient relationship, where trust, consent and co-construction are central.Medical touch emerges as a multidimensional skill  technical, relational and ethical  moving beyond examination to become a bodily language of care, reflecting a shift toward a trust-based partnership model in the doctor–patient relationship.

The concept of taboo, which emerged in the 18th century, is nowadays defined as ‘that which is kept silent out of fear, modesty, or a system of religious prohibitions applied to what is considered sacred or impure.’ Yet, ‘it calls for silence even though its function is to speak.’ This work focuses on taboos specifically related to gynecological health, as the practice of gynecology is becoming increasingly common among general practitioners.To determine whether or not French adult women perceive the existence of taboos surrounding their gynecological health, to identify what these taboo subjects are, and to assess their consequences on women’s use of healthcare servicesThis is a descriptive, cross-sectional quantitative epidemiological study, conducted using an anonymous online self-questionnaire distributed via social media.More than one in two women consider that taboos exist regarding their gynecological health. Age, number of children, and marital status appear to influence the presence of taboos. Each of the topics mentioned is considered at least somewhat taboo, with those that seem to stand out the most being urinary incontinence, issues related to sexuality, and sexual violence. The impacts on healthcare-seeking behavior are mainly anxiety and apprehension at the idea of consulting a healthcare professional, but also hesitation and delay before seeking care.This quantitative work made it possible to address the topics we had initially considered as potentially taboo. Following an open-ended question on ‘other taboos,’ around twenty additional subjects emerged. It would be interesting to complement this study with qualitative research in order to ask women directly about what is taboo for them — but how can one inquire about what cannot be spoken?Gynecological health taboos appear to be a reality for some women in France. It is essential for physicians to overcome their own taboos and to ask patients about these issues in order to improve women’s healthcare. It could be worthwhile to distribute the questionnaire more widely to obtain a sample that is more representative of the entire French territory, and possibly to explore the situation among minors as well.

In a context where notions of body, intimacy and consent are gaining prominence, medical touch, although central to physical examination, is increasingly questioned. While the patient’s experience has been widely studied, the perspective of general practitioners remains insufficiently explored.This study aimed to explore how they experience medical touch during consultations.Qualitative study inspired by Grounded Theory, conducted among twelve general practitioners in the Île-de-France region, recruited through purposive sampling. Individual semi-structured interviews were recorded, transcribed and analysed through iterative open, axial and theoretical coding, with triangulation between multiple researchers.Medical touch appears as an adjusted, secure and co-constructed act, evolving from a technical gesture toward a humanizing interaction. It is perceived as a gesture of clinical rigor, a relational language of presence, and a practice framed by communication, consent and sociocultural norms, shaped over time by experience and continuity of care.Our findings suggest that medical touch, once perceived mainly as a clinical routine validating the physician’s role, has evolved into a reflective, relational and ethical act. This shift mirrors societal changes regarding intimacy, consent and professional boundaries. Compared with the literature, our results move beyond Goffman’s notion of touch as a social ritual reassuring the patient, and align more closely with contemporary perspectives. Laugier and Andrieu describe touch as an ethical mediation between two vulnerable subjects, which resonates with doctors’ emphasis on transparency, consent and shared decision-making. Moreover, philosophers such as Merleau-Ponty and Serres highlight touch as a bodily language of presence and recognition a dimension strongly echoed by our participants, who see touch as a silent but meaningful mode of communication. Overall, medical touch appears as a multidimensional practice that combines technical skill, relational sensitivity and ethical responsibility. It embodies the transition from a paternalistic model toward a partnership-based doctor–patient relationship, where trust, consent and co-construction are central.Medical touch emerges as a multidimensional skill  technical, relational and ethical  moving beyond examination to become a bodily language of care, reflecting a shift toward a trust-based partnership model in the doctor–patient relationship.

In a context where notions of body, intimacy and consent are gaining prominence, medical touch, although central to physical examination, is increasingly questioned. While the patient’s experience has been widely studied, the perspective of general practitioners remains insufficiently explored.This study aimed to explore how they experience medical touch during consultations.Qualitative study inspired by Grounded Theory, conducted among twelve general practitioners in the Île-de-France region, recruited through purposive sampling. Individual semi-structured interviews were recorded, transcribed and analysed through iterative open, axial and theoretical coding, with triangulation between multiple researchers.Medical touch appears as an adjusted, secure and co-constructed act, evolving from a technical gesture toward a humanizing interaction. It is perceived as a gesture of clinical rigor, a relational language of presence, and a practice framed by communication, consent and sociocultural norms, shaped over time by experience and continuity of care.Our findings suggest that medical touch, once perceived mainly as a clinical routine validating the physician’s role, has evolved into a reflective, relational and ethical act. This shift mirrors societal changes regarding intimacy, consent and professional boundaries. Compared with the literature, our results move beyond Goffman’s notion of touch as a social ritual reassuring the patient, and align more closely with contemporary perspectives. Laugier and Andrieu describe touch as an ethical mediation between two vulnerable subjects, which resonates with doctors’ emphasis on transparency, consent and shared decision-making. Moreover, philosophers such as Merleau-Ponty and Serres highlight touch as a bodily language of presence and recognition a dimension strongly echoed by our participants, who see touch as a silent but meaningful mode of communication. Overall, medical touch appears as a multidimensional practice that combines technical skill, relational sensitivity and ethical responsibility. It embodies the transition from a paternalistic model toward a partnership-based doctor–patient relationship, where trust, consent and co-construction are central.Medical touch emerges as a multidimensional skill  technical, relational and ethical  moving beyond examination to become a bodily language of care, reflecting a shift toward a trust-based partnership model in the doctor–patient relationship.