Wednesday 1 July started well with the annual BMA Breakfast. For the first time since one of CMF's predecessors, the Medical Prayer Union, began these annual outreaches in 1892, the Breakfast was not a formal part of the BMA programme. Nevertheless, it was a well supported fringe meeting, and about 40 gathered to hear Trevor Stammers, GP and recent CMF Chairman, speak about 'A dangerous cocktail? – Religion, Belief and the NHS'.
Safeguarding spiritual care
Each of the three main debate items in the Medical Ethics section of the Agenda was of specific interest to CMF. Bernadette Birtwhistle had already received much media coverage even before she proposed:
*368 Motion by THE AGENDA COMMITTEE: That this Meeting:
(i) recognises that the NHS is committed to providing spiritual care for patients;
(ii) notes the position on inappropriate discussion of faith matters in GMC Guidance on Personal Beliefs and Medical Practice;
(iii) while welcoming the constructive and necessary advice in the document "Religion or belief", is concerned that some paragraphs suggest that any discussion of spiritual matters with patients or colleagues could lead to disciplinary action;
(iv) believes that offering to pray for a patient should not be grounds for suspension;
(v) calls on Health Departments to allow appropriate consensual discussion of spiritual matters within the NHS, when done with respect for the views and sensitivities of individuals.
(Sheffield Division has been asked to propose this motion)
In a 22-minute debate, well chaired as usual by Dr Peter Bennie, her eloquent, reasoned and reasonable proposal was supported by Stephen Blair, a consultant surgeon from Mersey region, and by Christine Robertson from Scotland, who said that she was 'not a Bible basher' but 'a Church of Scotland member with a poor attendance record' who was concerned that the Caroline Petrie scenario could have happened to any doctor.
A young woman from the JDC opposed, arguing that doctors were doctors and should only refer, and Keith Brent of the CCSC argued that the intention of Religion or Belief was simply to define the law. John Chisholm of Council forcefully opposed 'imposing'; Tony Calland, Chair of the MEC, felt that (iii)-(v) were 'too open to interpretation'; and Hamish Meldrum, Council Chair, had nothing to add, saying that the vote was down to each member's conscience.
In a card vote (show of hands), not requiring an electronic count, (i) and (ii) were carried; (iii)-(v) were not. But as the ARM Chair reminded the meeting, just because a motion was not passed, it did not mean that the opposite held. Spiritual issues still belong at the frontline of NHS care.
TV advertising of abortion services
Mark Pickering was given a rougher ride (the Chair intervening to stop some heckling) when he proposed:
369 Motion by YORKSHIRE REGIONAL COUNCIL: That this Meeting believes that the proposed use of TV advertising for abortion services will continue to send the wrong message to young women; namely that sex is a values-free activity and that consequences have a quick medical fix. We call upon the BMA to:
(i) oppose TV advertising for abortion;
(ii) continue to support values-based education on sex and relationships.
He argued that the proposed advertising was unnecessary (there were plenty of sources of information), discriminatory (only abortion providers funded by government would be able to afford TV advertising), and sent the wrong message (most women watching would not be pregnant but the profile of an alleged safety net would be raised). Reminding the ARM of the power of TV, he advocated values-based education instead.
A young woman from the MSC spoke in favour; another young woman from Scotland spoke against, making pro-choice arguments such as preventing access to abortion drove it underground. Jan Wise from the CCSC also spoke against, giving increasingly bizarre examples about 'whose values?'
The MEC chair clarified the terms of the BCAP consultation; Council Chair had nothing to add; and the ARM Chair proposed voting on the stem first and then if necessary on (i) and (ii). After Mark Pickering had responded briefly, the Meeting voted, rejecting the stem on a card vote. But the issue was well aired.
Despite the over-run of time the Meeting was anxious to debate:
*370 Motion by THE AGENDA COMMITTEE: That this Meeting would support a change in legislation to:
(i) ensure that those accompanying the patient at an assisted death, but not actively
participating, will not be subject to criminal prosecution;
(ii) allow the choice of an assisted death by patients who are terminally ill and who have mental capacity.
(Tameside Division has been asked to propose this motion)
The proposer essentially made two points – re (i) that because there were no prosecutions of relatives accompanying Britons to Dignitas, the law was unclear and should be changed; and re (ii) that changing the law altogether in Britain was an important matter of human choice where there could be adequate safeguards.
Baroness Ilora Finlay spoke powerfully against, comparing this motion with Lord Falconer's amendment before the House of Lords considering the Coroners and Justice Bill, due to be debated the next week. She said that the numbers demanding assisted suicide were tiny; that two House of Lords Select Committees had concluded there could be no effective safeguards; that the law worked well; and that passing this motion would go against two medical Royal Colleges, disability groups, and the Association of Palliative Medicine.
Jackie Avis from Council spoke in favour, pleading patient autonomy. Helen Grote from the JDC spoke against on patient safety grounds. Before moving to a vote, Tony Calland, MEC Chair, argued that the motion was even looser than Lord Falconer's amendment; that the ARM vote would profoundly impact the imminent Lords' debate; reviewed the BMA's recent history – in 2005 the ARM had switched the BMA to a 'neutral' position, which after a 'furore' had been reversed in 2006; wondered where the new logic and arguments were that should cause the BMA to reverse this current position; and concluded that if it passed the motion, the BMA would be out of step with the RCP and the RCGP.
Hamish Meldrum pointed out that the latest survey of doctors' opinions in March 2009 showed 2/3 against, and said he had found Ilora Finlay's speech 'compassionate and compelling'. After the proposer had replied 'What would you want for yourself?' the Meeting voted.
(i) required an electronic vote, which was 'Yes': 44.4%; 'No' 52.6% and therefore lost
(ii) was clearly lost on a card vote
Under the 'Equality and Diversity' part of the agenda, a little later in the morning, Philip Howard proposed:
419 Motion by THE AGENDA COMMITTEE: That this Meeting calls for all deaneries to implement appropriate policies for equality and diversity within their training schemes including:
(i) the responsibilities of employers to have protocols to deal with issues of conscientious objection without any individual being disadvantaged;
(ii) the responsibilities of trainees to inform the employer of any conscientious objection issues in advance of taking up a post.
(London Regional Council has been asked to propose this motion)
After debate, (i) was narrowly carried on an electronic vote by 51.9% for;
(ii) was carried by clear majority on a card vote
Membership of Medical Ethics Committee
The following motion had been put forward because of continuing concerns about balance in the membership of the MEC, but because of time, it was not reached. It will be followed up by correspondence.
Motion 510 by LONDON REGIONAL COUNCIL: That this Meeting calls on BMA Council to reform themembership of the BMA Medical Ethics Committee such that:
(i) the committee will always have a majority of doctors engaged in clinical practice;
(ii) the committee will always have consultant members who work in obstetrics and palliative
(iii) the processes for selecting and appointing co-opted members will be made transparent and available for scrutiny;
(iv) the professional backgrounds and material interests of co-opted members will be made available to BMA members.
Steven Fouch (CMF Head of Communications) 020 7234 9668
Alistair Thompson on 07970 162 225
Christian Medical Fellowship (CMF) was founded in 1949 and is an interdenominational organisation with over 5,000 doctors, 900medical and nursing students and 300 nurses and midwives as members in all branches of medicine, nursing and midwifery. A registered charity, it is linked to over 100 similar bodies in other countries throughout the world.
CMF exists to unite Christian healthcare professionals to pursue the highest ethical standards in Christian and professional life and to increase faith in Christ and acceptance of his ethical teaching.