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Alexis Carrel

Occupational Medicine and the Vichy Regime (1940-1945): From control to prevention

The period of Occupation and the Vichy regime mark a tumultuous era for France, especially in the field of occupational health. It was a paradoxical time when the development of occupational medicine was both part of a progressive vision for workers’ health and a context of authoritarian control and collaboration.

Estimated reading time: 4 minutes

The Vichy regime, allergic to class struggle, perceived occupational medicine as a means to regulate the relationship between workers and employers. This period saw the institutionalization of occupational medicine, which became an essential cog in the system of controlling labor and industrial production. The medicalization of the fight against unemployment was part of this dynamic, where the health status of workers became a strategic issue for the state.

Pioneering Figures in Dark Times

Notable personalities, such as Guy Hausser, an influential occupational physician during the Popular Front, found their fate tragically linked to this dark period. Arrested in 1942, Hausser did not survive deportation, perishing in Auschwitz the same year. The National Association of Occupational Medicine (ANMT), founded in 1940 and chaired by Henri Desoille, suffered a similar fate when he was arrested and deported in 1943.

Alexis Carrel, Nobel Prize winner in medicine, initiated the French Foundation for the Study of Human Problems (FFEPH) in 1941. Under the patronage of Pétain, this foundation enjoyed remarkable autonomy, particularly financially. It positioned itself in a reconciliatory approach between employers and employees, while treating the latter as elements of a production system, aiming to maximize efficiency and minimize human wear.

The occupational medical inspection, placed under the dual supervision of labor and public health, saw the appointment of the first three general medical inspectors, who were tasked with overseeing an extensive territorial organization and collaborating with various branches of government, as well as with the FFEPH.

The Permanent Committee of Occupational Medicine (CPMT) was then created, without worker or employer representation, with the mission to define the orientations of occupational medicine and to regulate the actions of medical inspectors. This committee, composed of figures such as the general medical inspectors, professors, and occupational physicians, enjoyed great autonomy, becoming the main driver of the profession under the auspices of the ANMT and the FFEPH.

Mandatory Medical Services and Physician Reaction

Faced with food restrictions, war-related diseases, and German pressure on French labor, the CPMT established mandatory medical services for companies with more than 50 employees. However, this measure met with resistance from numerous occupational physicians who, by declaring men unfit for the Mandatory Work Service (STO), exposed themselves to severe sanctions.

The Vichy era saw the emergence of a profusion of intercompany services and the creation of bodies such as the Interservice Center for Health and Occupational Medicine in Business (CISME). However, the complexity and internal conflicts made the system opaque and subject to frequent reorganizations.

At the Liberation, mistrust remained among workers towards occupational medicine, marked by its use during the Vichy regime. Desoille, returning from deportation, replaced Guy Hausser and undertook a purging of the profession. Under the pressure of the Medical Association, the caregiving mission was removed, and occupational medicine shifted towards an exclusively preventive role.

In conclusion:

The history of occupational medicine under Vichy is that of a profession caught between the humanistic aspirations of its members and the demands of an authoritarian regime. While the names of Guy Hausser, Henri Desoille, and Alexis Carrel remain etched in collective memory, they also recall the ethical dilemmas that occupational physicians had to face in times of extreme adversity.

Philippe Casanova

Specialist in occupational medicine and forensic medicine.