General Medical Council guideline criticized by Protection of Conscience Project

Unfair to impose “long-discredited policies of forced conversion and exclusion”

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Protection of Conscience Project

The Protection of Conscience Project has expressed concern that the state physician regulator in the United Kingdom intends to  prosecute those who refuse to convert to the religious, moral or ethical systems it approves.  If actual conversion is not required, it appears that by forcing physicians to do what they believe to be wrong as a condition of practising medicine, the regulator “may simply be resurrecting the Test Act in modern professional dress.”

The criticisms appear in a Protection of Conscience Project submission to the General Medical Council (GMC) of the United Kingdom in response to the draft GMC guideline Personal Beliefs and Medical Practice.  The Project comments that “it would be unfair to impose on physicians long-discredited policies of forced conversion and exclusion that would be plainly unacceptable to other professions and to the people of the United Kingdom as a whole.”

The Project submission points out that it would be hypocritical for the GMC to discipline objecting physicians who refuse to refer  for morally contested treatments, since they act on the same principles applied by the GMC in its policies on organ trafficking and assisted suicide.  Strong exception is taken to the suggestion that physicians act like bigots if they refuse to facilitate adultery, premarital sex, and morally contested services like the mutilation or amputation of healthy body parts or the killing of human embryos or fetuses.

In other respects, the Project expressed qualified agreement with the provisions of Personal Beliefs and Medical Practice and identified parts of the guideline requiring clarification.  Specifically, physicians

  • should do their best to notify patients and employers in advance of treatments to which they object for reasons of conscience, though they cannot be expected to anticipate every possible conflict;
  • should not refuse to provide treatment or care to a patient on the grounds that she has had a previous morally contested treatment;
  • must be prepared to treat “the health consequences of lifestyle choices” with which they disagree or to which they object (though not to provide morally contested treatments);
  • should disclose beliefs only when the disclosure is solicited by a patient, or when it is reasonable to believe that it would be welcomed by the patient;
  • should limit discussion of beliefs to what is relevant to the patient’s care and treatment, taking into account the importance of dialogue that is responsive to the needs of the patient.

The Project cautioned the GMC that physicians should not be discplined or criticized for a conversation naturally arising from the disclosure of conscientious objection, since disclosure is required by its guidelines.  It also warned that an adverse emotional response by a patient is not necessarily evidence of professional misconduct.


The Protection of Conscience Project is a non-profit, non-denominational initiative that advocates for freedom of conscience in health care. The Project does not take a position on the morality or desirability of controversial procedures or services.

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