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]

 

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.

Pre-signing abortion forms is illegal, General Medical Council admits

Nearly 70 doctors who were found to be pre-signing abortion forms without knowing anything about the individuals involved were breaking the law, the head of the General Medical Council admitted

The Telegraph

Miranda Prynne

More than 60 doctors who pre-signed abortion forms without knowing anything about the women concerned did break the law, the head of the General Medical Council admitted last night as pressure grew on police to investigate.

Niall Dickson, chief executive and registrar of the GMC, said the 67 physicians were acting “against the law” but insisted no patients had come to harm as a result.

He claimed the practice of pre-signing the forms had become widespread but was “unacceptable” and vowed to “bring this unlawful and unacceptable practice to an end”. . . [Full text]

Scandal of the doctors who were let off after approving abortions for women they’d never even met

67 doctors were identified in an investigation by NHS watchdog
Care Quality Commission said they illegally signed blank abortion forms
But none of them will be brought before a fitness to practise hearing

Daily Mail

Simon Caldwell

Dozens of doctors found to be signing off abortions for women they had never met will not face any disciplinary action, it was revealed yesterday.

The 67 doctors were identified in an investigation by NHS watchdog the Care Quality Commission as having illegally signed blank abortion forms, which should be filled in only once they have a thorough understanding of a woman’s circumstances.

One of the doctors had signed so many blank forms that they were still being used by the abortion clinic four years after he left.

All 67 were referred to the General Medical Council but a Freedom of Information request has now established that none of them will be brought before a fitness to practise hearing, where they could be disciplined, suspended, or struck off.

The GMC has also refused to pass the names to the police, even though the offence can merit a jail sentence. [Full Text]

Letter to General Medical Council (UK) re: conscientious objection to abortion

 Peter Saunders

When two Glasgow midwives won the right to opt out of supervising abortions last April I suggested that the General Medical Council (GMC) needed to revise its professional guidance on the matter which now seemed to be at odds with the law.

At the time Niall Dickson (pictured), the GMC’s chief executive, actually told the Guardian that the GMC would need to consider the implications of the judges’ decision on its guidance. He is quoted as saying:

We will study the outcome of this ruling, which has just come out, to see if there are any implications for our guidance. We already have clear guidance which says that doctors should be open with employers and colleagues so they can practise in accordance with their beliefs without compromising patient care.

As I have heard nothing further from the GMC about the matter, and almost two months have passed, I have today written to Mr Dickson to ask what is happening. [Full text]

 

General Medical Council guideline criticized by Protection of Conscience Project

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

NEWS RELEASE

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.

Project Submission to the General Medical Council of the United Kingdom

Re: Personal beliefs and medical practice: A draft for consultation

  • Background | The General Medical Council is the state agency that regulates the medical profession in Britain.  A draft guideline on personal beliefs and medical practice generated concern that, if adopted, it would produce an “atmosphere of fear” among physicians who are religious believers. Project Submission

Concern expressed in United Kingdom over proposed physician guidelines

Bishop Tom Williams, chairman of the Healthcare Reference Group of Britain’s Catholic bishops’ conference, is encouraging Catholic physicians and others to respond to the General Medical Council’s draft guideline on personal beliefs and medical practice.  Bishop Williams warned that the document is likely to produce an “atmosphere of fear” among physicians who are religious believers.  The General Medical Council is the state agency that regulates the medical profession. [Catholic Herald]

British General Medical Council proposes to force physicians to set aside “personal beliefs”

Britain’s General Medical Council has released a draft document for consultation that proposes to force physicians to facilitate practices to which they object for reasons of conscience by helping patients find someone who will provide the procedures.  The proposal would also prohibit physicians from explaining their beliefs to patients “in ways that. . . are likely to cause them distress”  – a subjective requirement open to abuse by disgruntled patients. Comments are sought from 18 April, 2012 to 13 June, 2012. [Document] [GMC] [Bioedge]

Sex selective abortions in United Kingdom

An investigation by the Daily Mail has revealed that some physicians in the United Kingdom will arrange for sex-selective abortions.  A physician suspended by the General Medical Council following the disclosure agreed to falsify the reason for the procedure.  Another physician and an obstetrician/gynaecologist also face discipline.  [Daily Mail]