1. There is no legal obligation for a physician to notify a criminal act, whether a patient is the author or the victim of it. Article 20 of the Crown Order of 31 May 1885 approving new instructions for physicians, pharmacists and druggists provides that a physician has to notify any case that may give rise to a prosecution, e.g. poisoning, to the competent authorities. However, this Crown Order does not contain penal provisions. Moreover, the Court of Cassation has judged that the duty imposed by Article 20 does not contain a limitation of the duty to medical secrecy in Article 458 Criminal Code. In a more recent judgment the Court of Cassation judged that Article 458 Criminal Code prohibits a physician to notify facts that may give rise to a prosecution against a patient. Another article that may at first sight be relevant in this respect is Article 30 Code of Criminal Procedure, that imposes upon every citizen a duty to notify any crime of which he has been a witness. However, in most cases, a physician is not a witness of the crime committed by a patient or of which a patient is a victim. Moreover, no penal sanctions exist in case of nonobservation of this article.
2. Article 458 Criminal Code may not be considered independently of the general principles of Belgian penal law. Next to the exceptions to the duty of medical secrecy provided for in this article itself (testimony in a court and statutory obligations to disclose), other exceptions may in specific cases arise from grounds of justification. Grounds of justification are special circumstances that make an act or omission lawful, that justify the conduct, although they violate the literal terms of criminal law.
3. When the patient is a victim of a crime, e.g. in case of child abuse, the same reasoning if often made in the literature. The conflict between the duty to medical secrecy and the duty to rescue a person in great danger may result in a right (not an obligation) to notify a case of child abuse to the competent authorities. But in a judgment of 9 February 1988 the Court of Cassation has followed another reasoning. Article 458 Criminal Code intends to protect the interests of the patient.Consequently, this article may not impede the prosecution of the author of a crime of which the patient has become a victim. The prohibition to divulge information may therefore not be extended to facts of which the patient has become a victim. This reasoning has been confirmed recently by the legislature in Article 458bis of the Criminal Code.

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