GPs free to object to taking part in firearm licensing

Practice Business

Tim Martin

GPs will be allowed to conscientiously object to taking part in the firearm licensing process, the British Medical Association has said.

The BMA is currently working with the Home Office to improve licensing rules around firearms, following the introduction of an information sharing process that was introduced last April, designed to ensure licence holders are medically fit to carry arms, On Medica reports. . .[Full text]

 

Doctors’ leaders clash with pro-shooting group over health checks on gun licence applicants

The Herald

W.N.M.P. Bowern

Apply for a firearms or shotgun licence and your family doctor will be asked by the police if he or she thinks there might any medical reason or ‘concerns’ to refuse to allow you to possess a gun.

A change in the licensing regime last April meant new information sharing processes between GPs and the police were introduced in an attempt to ensure those licensed to possess firearm and shotgun certificates were medically fit to carry sporting guns.

The British Medical Association expressed concerns at the time. This week it has gone further, advising doctors they can refuse to engage in the process if they have a conscientious objection to firearms and telling them if they do agree to provide information they should charge a fee. . . .[Full text]

 

Doctors told not to call pregnant women “mothers”

Bioedge

Xavier Symons

British doctors have been told not to call pregnant women ‘mothers’ in a British Medical Association (BMA) document that has been slammed by conservative commentators.

In a booklet entitled A Guide To Effective Communication: Inclusive Language In The Workplace, doctors are instructed to use “inclusive language” that demonstrates “a commitment to equality and inclusion”. This includes revising conventional language used during pregnancy:

“Gender inequality is reflected in traditional ideas about the roles of women and men…We can include intersex men and transmen who may get pregnant by saying ‘pregnant people’ instead of ‘expectant mothers’.”

In an introduction to the guide on the BMA’s website, senior executive Dr Anthea Mowat wrote: ‘I would encourage you all to read and share this guide, and think about how you can apply it in your day-to-day work. This is a time where we need to come together to support and protect our colleagues and our patients.’

Conservative MP Philip Davies described the guidance as ‘completely ridiculous’: “If you can’t call a pregnant woman an expectant mother, then what is the world coming to?'”

Women’s rights campaigner Laura Perrins was equally critical of the document:

‘As every doctor knows only females can have children. To say otherwise is offensive and dangerous. This will offend women up and down the country, and is an example of the majority of women being insulted for a tiny minority of people.’

The BMA controversy comes just weeks after British media outlets reported the ‘first male pregnancy’, involving a transgender who halted her gender transition to being a male so that she could have a child.


This article is published by Xavier Symons and BioEdge under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to BioEdge. Commercial media must contact BioEdge for permission and fees.

 

Nurses Cannot be Good Catholics

BMJ Blogs

John Olusegun Adenitire

It seems that if you are a nurse you cannot be a good Catholic.  Or, better: if you want to work as a nurse then you might have to give up some of your religious beliefs.  A relatively recent decision of the UK Supreme Court, the highest court in the country, seems to suggest so.  In a legal decision that made it into the general press (see here), the Supreme Court decided that two Catholic midwives could not refuse to undertake administrative and supervisory tasks connected to the provision of abortions.

To be sure, no one asked the nurses to directly assist in the provision of abortions.  The Abortion Act 1967 says that “No person shall be under any duty … to participate in any treatment authorised by this Act to which he has a conscientious objection.”  The Nurses argued that this provision of the Act should be understood widely.  Not only should they be allowed to refuse to directly assist in abortion services: they should also be entitled to refuse to undertake managerial and supervisory tasks if those were linked to abortion services.  The nurses’ employer was not impressed; neither was the Supreme Court which ruled that the possibility to conscientiously object only related to a ‘hands-on’ capacity in the provision of abortion services. . . [Full text]

 

Junior doctors to ‘escalate’ strike action by refusing to offer emergency care in full walkout

 Evening Standard

Tom Marshall

Junior doctors are to “escalate” their industrial action by refusing to provide emergency care during a strike next month, the British Medical Association has said.

The second of two bouts of industrial action planned next month will see a full walkout from junior doctors, the BMA announced.

In previous days of industrial action, junior doctors have still provided emergency cover.

The BMA said the move “follows the continued refusal by the Government to step back from its decision to impose a new contract on junior doctors from August this year and resolve the dispute by re-entering talks”. . . [Full text]

 

The unsettled status of conscientious objection in the UK

BioEdge

Michael Cook

What are the rights of doctors who have a conscientious objection to certain procedures in the United Kingdom? The slightly confusing status quo is the subject of an article in the Journal of Medical Ethics by a Cambridge University academic, John Adenitire.

Dr Adenitire sketches a gradation of hostility towards conscientious objection.

1. At the very top there are Julian Savulescu and others who have argued that conscientious objection is “a door to a Pandora’s box of idiosyncratic, bigoted, discriminatory medicine” and has little place in modern medical practice. This is not a widely shared view.

2. Then there is the British Medical Association (BMA), the profession’s “trade union”, which defends conscientious objection only in three specific scenarios. It “should ordinarily be limited to those procedures where statute recognises their right (abortion and fertility treatment) and to withdrawing life-prolonging treatment from patients who lack capacity, where other doctors are in a position to take over the care.”

3. And then there is the General Medical Council (GMC), the profession’s regulator in the UK, which allows conscientious objection, albeit with a number of caveats. According to its 2013 policy statement, Personal beliefs and medical practice: “You may choose to opt out of providing a particular procedure because of your personal beliefs and values, as long as this does not result in direct or indirect discrimination against, or harassment of, individual patients or groups of patients. This means you must not refuse to treat a particular patient or group of patients because of your personal beliefs or views about them.‡ And you must not refuse to treat the health consequences of lifestyle choices to which you object because of your beliefs.”

4. Most accommodating of all is a ruling of the European Court of Human Rights (ECtHR) in the British case of Eweida in 2013. It applied Article 9 of the European Convention on Human Rights to several cases of discrimination in the UK. Article 9 guarantees “the right to freedom of thought, conscience and religion”, “subject only to such limitations as are prescribed by law and are necessary in a democratic society in the interests of public safety, for the protection of public order, health or morals, or for the protection of the rights and freedoms of others”.

It is Dr Adenitire’s contention that the Eweida ruling “effectively provides that medical professionals have the right to conscientiously object to providing certain healthcare services well beyond the scope endorsed by the BMA”.

This implies that “Given the unsettled nature of the law on the topic, [National Health Service] employers will have to proceed very cautiously as it will not always be clear whether denying a request will be considered lawful by a court. This entails that NHS bodies may be at risk of expensive legal challenges by medical professionals whose requests have been denied.”

Dr Adenitire therefore believes that the BMA’s policy should be changed to align more closely to the Eweida ruling.

However, the law is still unsettled and Dr Adenitire is not necessarily hostile to proposals for legalised assisted dying which are currently being debated in the UK. In an unpublished paper he goes on to argue that in certain circumstances doctors already have a “conscience-based right to provide assistance in dying”.


cclicense-some-rightsThis article is published by Michael Cook and BioEdge under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation to BioEdge. Commercial media must contact BioEdge for permission and fees. Some articles on this site are published under different terms.

The BMA’s guidance on conscientious objection may be contrary to human rights law

J Med Ethics doi:10.1136/medethics-2015-103222

John Olusegun Adenitire

Abstract

It is argued that the current policy of the British Medical Association (BMA) on conscientious objection is not aligned with recent human rights developments. These grant a right to conscientious objection to doctors in many more circumstances than the very few recognised by the BMA. However, this wide-ranging right may be overridden if the refusal to accommodate the conscientious objection is proportionate. It is shown that it is very likely that it is lawful to refuse to accommodate conscientious objections that would result in discrimination of protected groups. It is still uncertain, however, in what particular circumstances the objection may be lawfully refused, if it poses risks to the health and safety of patients. The BMA’s policy has not caught up with these human rights developments and ought to be changed. [Full text]

 

 

BMA reiterates opposition to assisted dying

The BMA has reiterated its firm opposition to legalising assisted dying in the face of renewed calls for a change in the law.

An editorial in the BMJ today calls for the Assisted Dying Bill championed by Lord Falconer to become law.

BMJ editor-in-chief Fiona Godlee, UK editor Tony Delamothe and patient editor Rosamund Snow argue that people should be able to exercise choice over their lives, which should include how and when they die.

They write: ‘Ultimately, however, this is a matter for Parliament, not doctors, to decide. Let us hope that our timid lawmakers will rise to the challenge.’

The BMJ is a wholly-owned subsidiary of the BMA but has editorial independence.

BMA council chair Mark Porter acknowledged there were strongly held views within the medical profession on both sides of the assisted-dying debate.

But he insisted: ‘The BMA remains firmly opposed to legalising assisted dying. This issue has been regularly debated at the BMA’s policy-forming annual conference and recent calls for a change in the law have persistently been rejected.’ . . . [Full text]

British Medical Association affirms stand against euthanasia

Despite claims that 80% of the British population supports euthanasia and assisted suicide, and that 40% of physicians do so, the British Medical Association has voted against supporting a euthanasia bill being proposed in the Scots parliament.  Strong views were expressed by those on opposite sides of the issue. [The Scotsman]

Access to appointments: the effect of discrimination on careers

T. Everett Julyan, MBChB BSc *

 ABSTRACT

INTRODUCTION The practice of discriminating between applicants for posts within obstetrics and gynaecology on the basis of their beliefs about the status of the embryo is becoming increasingly common. This affects not only the individual discriminated against, but also medicine and society as a whole. When this discrimination is faced because of a desire to please the God of the Bible it is more accurately described as persecution (Matthew 5:10-12).

EFFECTS ON THE INDIVIDUAL The effects of this persecution on the individual may be vocational, social, financial, emotional or spiritual. These include influencing ultimate choice of career, rejection by colleagues, unemployment in extreme cases, disappointment, disillusionment and temptation towards compromise. The only positives may be the maintenance of personal integrity and promise of heavenly reward.

EFFECTS ON MEDICINE & SOCIETY Excluding all those who refuse to end a human life simply because its existence happens to be inconvenient to another does medicine a disservice. It is antithetical to historical medicine which calls for self-sacrifice on the part of the doctor in order to preserve the patient according to an established ethical code. It seems that contemporary medicine only wants doctors who follow the status quo by changing their ethical framework to suit the wishes of their patients. The logical outcome of this kind of thinking is that autonomy may be considered to be of greater value than human life in a variety of clinical situations. But medical practice will become unethical if doctors are expected to give treatment which they consider to be inappropriate, such as killing an unborn child. The practice of medicine is in danger of becoming a commodity marketed with the expedient business ethic of supply on demand, where the value of human life can fluctuate as a relative integer. Denying employment to those who seek to preserve life instead of destroying it is a logical step of pragmatism in a culture where abortion is on demand. But medicine should not be a business designed to supply every demand indiscriminately when the demand may not be in the patient’s best interests. If medicine evolves by defining good practice simply as what the patient wants then society will ultimately become a victim of its own unethical requests (cf. Romans 1:28-32).

CONCLUSION Discrimination against those who refuse to include ending human life as part of their job description is becoming increasingly common. However, this serves neither doctors nor patients and is a symptom of a relativistic view of medical ethics. Its detrimental effects are far-reaching, affecting individuals, the medical profession and society in general. Those who see the dangers in this trend have a duty to protect society, the future of medicine, their colleagues and themselves from wrongly redefining beneficence and non-maleficence. [Full text]