Published: 25 September 2007
To be considered alongside the GMC's draft document: https:
1. Do you think the guidance is clear? Yes
As an organisation representing professionals (5,000 doctor and 1,000 medical student members) and as a faith organisation (all our members desire their personal and professional lives to be governed by the Christian faith as revealed in the Bible) we are naturally very interested in the content of this consultation.
We think it is generally good and strongly support the concept that doctor and patient must have trust and respect each for the other. However, we do draw attention to an apparent undercurrent throughout - reflecting that which currently runs through society - that there is somehow an objective, neutral, secular position that does not affect doctors' behaviour, but that any personal beliefs of a faith nature are by definition subjective and therefore somehow suspect. We point out that all doctors have a worldview, whether they realise it or not, and suggest therefore that the beginning of Paragraph 5 should be amended from 'Doctors' personal beliefs may inform their day-to-day practice' to 'All doctors have personal beliefs which inevitably inform...'
We are not just being semantic or defending our own position here. We think it is essential that this point be made clear so that no avowed secularist, for example, can conclude that somehow this guidance does not apply to them.
2. Is the guidance helpful in further explaining the relevant paragraphs of Good Medical Practice (paragraphs 7, 8 and 33)? Yes
We support the view in Paragraph 17 that doctors should not 'impose' their beliefs, and likewise that there should not be 'inappropriate...expression' of them. But the use of the word 'inappropriate' means that there must be possible an expression of beliefs which is 'appropriate'. We are glad the GMC recognises this. As one senior member put it in a discussion to plan this submission, 'we share from a position of mutual trust which has to be earned and won'.
We do however have concerns about the question of how such general expressions might come to be interpreted in some contexts.
3. Are there any other issues relating to personal beliefs in medical practice on which guidance from the GMC would be helpful? Yes
A frequent issue for many of our members is the prescription of so-called 'emergency contraception' - the Morning After Pill, which is potentially abortifacient. If this is to be prescribed, the time frame is critical. This raises the question of the language in Paragraph 16 of 'delay'. What period constitutes 'delay' and who is to interpret its significance?
We suggest that 'You must not allow any personal views...to...delay' should be amended to 'delay unreasonably'.
Again, our concern is for the question of future interpretation. With the current cultural erosion of the professional ethos we fear a time in the not-too-distant future when doctors will be expected to be technicians delivering for their employers a service to consumers, and that significant ethical concerns will no longer receive the attention they deserve.
4. Do you have any other comments on the guidance? Yes.
We are more concerned about the future interpretation of 'conscientious objection' issues than we are about the discussion of personal views. In the general principles of Paragraphs 18-21, and their specific application to abortion in Paragraphs 22-23, we point out that for many members reservation or refusal to sign abortion forms is not based in a subjective sense on the personal ethics, the 'conscience' of the doctor, but is based objectively on the spirit and the letter of the law in the 1967 Abortion Act. Thus refusing to sign the form could arise because it is the considered belief of the dutiful doctor, respecting the law, that the circumstances of this particular case do not qualify under the law.
This objective medicolegal decision is nothing to do with the somewhat more nebulous concept of conscientious objection, and we urge the GMC not to make this confusion in this or any future guidance. The whole subject of conscientious objection is a complicated and difficult one and needs a great deal more work, not least by ourselves.
We are grateful for the GMC's consideration of these brief comments and are very willing to help further if requested.
Dr Peter Saunders (CMF Chief Executive) 020 7234 9660
Philippa Taylor (CMF Head of Public Policy) 020 7234 9664
Catherine Butcher (CMF Head of Communications) 020 7234 9675
Alistair Thompson on 020 3008 6063 or 07970 162 225
Christian Medical Fellowship (CMF) was founded in 1949 and is an interdenominational organisation with over 4,000 British doctor members in all branches of medicine. A registered charity, it is linked to about 65 similar bodies in other countries throughout the world.
CMF exists to unite Christian doctors to pursue the highest ethical standards in Christian and professional life and to increase faith in Christ and acceptance of his ethical teaching.