In a political context pointing to the restriction of immigration flows, asylum seekers find excessively difficult to overcome obstacles related to substantiating the reasons they escaped from their country of origin, and facing the strong suspicion reflected by the French Administration. Patients under medical and psychological treatment appeal to us consequently to generally grave psychic traumas. Their follow up necessitate a professional and human engagement that will permit a trusting therapeutic relationship. It is strictly within this context that the specialist could issue a medical certificate, often required by a third party to complete the instruction for an asylum request. Indeed, people having suffered grave psychic traumas are in difficulty to establish a coherent story, itself a condition precedent to an asylum request. The aim of the medical certificate is to describe, establish links, but also to convince. Hence, its efficiency depends a lot on its author. Medical certificates are all the more requested for the provision of medical care, posterior to all other access to assistance having been exhausted. All the more so, these requests embarrass doctors, especially because they give access to limited rights. These requests for medical care must be restructured, currently reflecting a very limited interpretation of the Geneva Convention. In all respects, medical certificates are considered of modest importance and reflect a symptom of an increasingly unfair policy towards asylum seekers. © 2006 Elsevier Masson SAS. All rights reserved.

Immigration policy Asylum seekers Medical and psychological care Residence request for medical care Medical certificate

medical practice health care policy medical profession certification Article medical care human rights follow up human physician health care access