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“Ethics and equity,” wrote D. H. Lawrence, “and the principle of justice do not change with the calendar.” Just as immutable is the principle that makes doctors put their patients’ interests before their own. No doctor, surely, would hesitate for even the briefest moment before subscribing to the principle. Yet new guidance published today by the General Medical Council suggests that doctors do need to be told where their priorities lie when personal beliefs clash with medical procedures. “You must make the care of your patient your first concern,” the GMC tells the 128,000 doctors practising in the UK. “We expect [doctors] to set aside their personal beliefs where this is necessary,” it continues.
Doctor knows best, usually. But the GMC says doctors must ensure they retain patients’ confidence by sharing their scientific and medical expertise, not their personal codes of morality. Doctors must not discriminate against patients by allowing their personal views to get in the way of a professional relationship or treatment recommendations. Doctors should advertise their unwillingness to become involved in procedures they dislike, but they must not preach to patients in ways that exploit patients’ vulnerability or cause distress. Doctors cannot obstruct a woman seeking advice about the termination of a pregnancy. They must assist a family wanting a male circumcision and ensure that a cremation, if desired, can take place. Doctors must ask a patient about the wearing of a veil, and remove a garment that obscures the face if asked. Doctors must respect the views of a Jehovah’s Witness who does not want a blood transfusion.
Doctors may recuse themselves where they feel their own moral, religious or cultural beliefs demand such action. But they cannot allow this privilege to hinder the patient’s pursuit of care. A Roman Catholic doctor can refuse to become directly involved in abortions, but must see that a woman is referred to a doctor who is willing to help. “Serious or persistent failure” to follow the guidance could result in a doctor being struck off.
Ensuring that the patients’ interests come first does not mean that doctors’ sensibilities are ignored by the GMC. Doctors have as many rights as anyone to hold personal views on sensitive subjects. Since personal judgment invariably plays a part in medical assessment, it can be difficult to disentangle the personal from the professional. Ethics, in common with personal opinion, occupies a grey area that cannot always be defined in terms of black and white. The new GMC guidelines will help doctors to see the dividing line between the allowable and the unacceptable.
The new code acknowledges that personal beliefs and values, as well as cultural and religious practices, are central to the lives of doctors as well as patients. At the same time, the code does not give patients carte blanche permission to demand anything and everything. Serious crimes – such as female circumcision, an abhorrence better described as female genital mutilation – remain beyond the pale.
It is to be sincerely hoped that the new rules cause no more than a vanishingly small minority of doctors to conclude that they are obliged to stop practising on grounds of conscientious objection. But the principles outlined by the GMC cannot be compromised. There is no room for a pulpit in the surgery.
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The entire Jehovah's Witnesses no blood doctrine is senseless and deadly.
The Bible says nothing about blood transfusions. They didn't exist when the Old Testament and Acts were written. The Bible passages in question (kosher law) have to do with diet. Neither the Jews nor other groups oppose blood transfusions because they don't try to put a spin on something that isn't there. If the Watchtower had not issued this prohibition, no Jehovah's Witness would oppose them on Biblical grounds.
Charles, London, UK
""Doctors ... must assist a family wanting a male circumcision""
... better described as male genital mutilation.
""Serious crimes â such as female circumcision, an abhorrence better described as female genital mutilation â remain beyond the pale.""
hahah. lol. whats good for the goose is obviously not for the gander.
Jono, Auckland, New Zealand
Cutting bits off children and then to justify it with voodoo of various bents, and that society acquiesces to that mutilation, simply beggars belief.
David Masu, Zürich,
This report is very inadequate. What about the duty of the doctor to respect the human rights of the patient? What about the duty of the doctor to behave in a lawful manner? Do these take second place to the new duty "to make care of your patient your first concern."
In the case of a non-therapeutic male circumcision of a child who is not old enough to consent, who is the patient? Is the patient the child, or is the patient the parent who requests a circumcision? What if a circumcision (which amputates large amounts of sexually sensitive skin) violates the patient's right to bodily integrity and personal autonomy? In these cases, does the doctor still have to do a circumcision?
George Hill, Port Allen, Louisiana, USA
I was born a 3rd generation Jehovah's Witness in 1957 and endured the Watchtower's no blood commandment with longstanding bleeding Crohn's disease.The Watchtower leadership expects followers to die for their dogma and many have.The medical staff get blamed and are 'damned if they do damned if they don't'.
---
Danny Haszard
Danny Haszard, Maine, usa
I find it extraordinary that a doctor can pick and choose the treatments to offer. It is all very well saying they are obliged to pass a patient on to another doctor if it conflicts with their conscience but that supposes there will be a doctor available who has no such confliction. Obviously, as no doctor is obliged to offer services, you could get to the point where they supply none. This is a ridiculous situation. Surely if you object to some aspect of your profession you should not be in it or, at least, performing it fully whilst making representations etc.
Once again religion seeks special priviliges (I assume being a cycle club member will not be considered valid) whilst letting the rest make the difficult decisions and he assumption by the religious that "non believers" find it easier to do the sort of things they won't is, frankly, outrageous.
Martin Hughes, Oxford, UK
What do you mean when you say doctors must respect the views of Jehovah's witnesses who refuse a blood transfusion?
If it is life-saving and if it concerns minor children, what exactly do you mean by "respect"? Your leadere is not helpful
stephen bull, fontes, france
I would be extremely offended by a doctor who wanted to base treatment on unproven beliefs instead of the best medical science. I think it is sometimes forgotten that those not attached to a religion or having no supernatural belief have exactly the same rights as the religious and are now frequently being deeply offended by religious practises and pronouncements and Sectarian schools. I suspect the general public are getting very fed up with this avalanche of religion and particularly with the holier than thou claim that religions have a higher moral stance than the non religious. By empowering and funding religions New Labour have turned religion from a benign practise into a form of oppression for many and at the next election I believe this will be a major issue where being a religious politician will be serious vote loser.
Keith, Rayleigh, England
Some forms of female circumcision do *less* damage than male circumcision, and one form is the exact equivalent. Even making an incision on a girl's genitals is illegal though, whereas we're now being told that UK doctors must "assist" a family that want to have the most sensitive part of their son's genitals cut off.
I regard both male and female circumcision of non-consenting children as abhorrent. The fastest way to end female circumcision is to end non-medical male circumcision at the same time.
Mark Lyndon, Manchester, UK