Dr Peter Saunders: A victory for Christian doctors and nurses

(This article was first published by the Christian Medical Fellowship)

Doctors and nurses wishing to practise in sexual and reproductive health have been granted more liberty to exercise freedom of conscience under new guidelines published earlier this year.

The Faculty of Sexual and Reproductive Healthcare (FSRH), a faculty of the Royal College of Obstetricians and Gynaecologists (RCOG), has relaxed its stance on conscience in new guidelines issued in April so that those with an ethical objection to certain procedures can now obtain qualifications that they were previously excluded from.

Christian doctors and nurses in the UK are practising in an environment that is increasingly hostile to their beliefs and values. We have accordingly come to expect new constraints on our freedom of conscience almost as a matter of course. So this is a refreshing backtrack by the College.

In April 2014, I highlighted the fact that the FRSH was barring doctors and nurses with pro-life views from receiving its degrees and diplomas and may also be breaking the law (see also here). The story was later picked up by the Telegraph.

Under the previous guidelines, now removed from the FSRH website but still accessible in the Telegraph, doctors and nurses who had a moral objection to prescribing ‘contraceptives’ which can act by killing human embryos (levonelleellaOne, IUCDs etc) were barred from receiving diplomas in sexual and reproductive health even if they undertook the necessary training.

The wording was as follows (emphasis mine):

‘Doctors who hold moral or religious reservations about any contraceptive methods will be unable to fulfil the syllabus for the membership … or speciality training…This will render them ineligible for the award of the examination or completion of training certificates.

However, the new guidance grants much more freedom.

It begins by underlining the faculty’s commitment to diversity:

‘The FSRH welcomes and values having a diverse membership, representing a wide range of personal, religious and non-religious views and beliefs.’

It then underlines the fact that there is already statutory protection for healthcare professionals (HCPs) to opt out of abortions and procedures authorised under the Human Fertilisation and Embryology Act (HFEA).

But it also recognises that both the Human Rights Act 1998 and Equality Act 2010 offer some conscience protection in areas other than abortion and IVF:

The guidance says that it applies to all FSRH qualifications and training, but a closer reading suggests that those seeking to sit the membership examination of the Faculty of Sexual & Reproductive Healthcare (MFSRH) will need to undergo ‘practical assessment of the provision of contraception (all methods including emergency contraception)’ and those seeking a Letter of Competence in Intrauterine Techniques (LoC IUT) will need to demonstrate ‘practical competence in the relevant live procedures’.

However, with respect to the Diploma of the Faculty of Sexual & Reproductive Healthcare (DFSRH and NDFSRH), a holder must simply be ‘competent and willing to advise on all forms of contraception and manage SRH consultations, including providing evidence-based informationon the options for unplanned pregnancy’. But there is no duty actually to provide all treatments.

HCPs who plan to opt out of providing aspects of care because of their personal beliefs may still be awarded the Diploma, or recertified, if they can demonstrate commitment in their practice to the principles of care in section 5 of this document. For example, if a HCP chooses not to prescribe emergency contraception because of their personal beliefs, she/he has a personal responsibility to ensure that arrangements are made for a prescription to be issued by a colleague without delay, ensuring that the care and outcomes of the patient are never compromised or delayed.’

Although some would see referral to another doctor or nurse as a form of complicity, this is nonetheless a big improvement on the previous guidance.

Previously doctors or nurses who refused to fit coils or prescribe the morning after pill (MAP) were also barred from receiving the diploma signifying expertise in the management of infertility, cervical cancer or sexually transmitted infections. This effectively meant that many thousands of doctors and nurses were not able to obtain qualifications to pursue a career in gynaecology and sexual health.

This is no longer the case.

Quite why the faculty has relaxed its guidance is not clear, but it is now quite similar to that of the  General Pharmaceutical Council (GPhC) who also similarly relaxed their draft guidance on dispensing drugs after receiving submissions from Christian Medical Fellowship and the Christian Institute earlier this year.

The GPhC’s attention was drawn to the fact that their proposed new guidance might well be illegal under Equality legislation (I made the same point about the FSRH in 2014).

The GPhC backtracked after the Christian Institute made it clear, in pre-action legal correspondence exchanged with the Council’s lawyers, that they ‘were fully prepared to litigate’.

Perhaps the FSRH also, on reflection, thought it wise to protect themselves by erring on the side of caution and taking themselves out of the legal firing line.

However, whatever the reason, the climb-down is most welcome and will enable many more doctors and nurses to obtain diplomas in sexual and reproductive health. That can only be good for patient care.

Peter Saunders

  • Mohammed Loombucket

    A giant step backwards.

    • Johannes Factotum

      Nonsense? You mean like a Muslim checkout operator not wanting to handle a bottle of wine or vacuum sealed bacon – because they believe in what you call ‘nonsense’?

      • Mohammed Loombucket

        Yep. Same as that. Ridiculous.

    • Little Black Censored

      Yawn.

    • Jeremy Poynton

      FOFF troll bore.

      • Mohammed Loombucket

        I love a persuasive argument such as yours. What an intellectual you are!

    • Phil R

      Shall we run with this a bit further?

      What you are saying that s doctors should always do what the Goverment tells them wiout a conscience?

      I bet there are situations that you would support a doctor refusing to cooperate with an elected Government.

      • Mohammed Loombucket

        We are talking about contraception and a refusal to issue it based on the ignorant musings of an ancient desert tribe in the middle east. Common sense should prevail.

        • Phil R

          Of course the “intelligent” view would be to bow to your worldview and try to make sense of the shifting sands of atheist “morality”

          You have not answered my question btw.

          • Mohammed Loombucket

            Gods come from us, morality comes from us. It’s an evolving consensus in society. Please explain what is immoral about contraception.
            Of course we shouldn’t do something just because governments tell us to, but that doesn’t excuse nonsense like this.

          • Phil R

            What we see is that morality is that our morality is largely based on our Christian heritage and what we also notice is that when atheists are in power and abandon Christian morality the result is tyranny.

          • Mohammed Loombucket

            Christianity is a man made construct and the Bible is no guide to moral behaviour. You do talk some rubbish.

          • Phil R

            I doubt that even many atheists would agree with this off the wall statement.

          • Mohammed Loombucket

            Think about what it is that you are suggesting. You are saying that without belief in what is quite frankly absurd nonsense you would run amok. That Richard Dawkins is a real hooligan, isn’t he?

          • Phil R

            Without faith there is no basis for morality.

            For an atheist, there is no difference between killing a man and burning a lump of coal.

            After all it all comes down to rearranging a few atoms.

            BTW I suspect that even Dawkins is beginning to realise that he is regarded as being a bit of an idiot

          • Mohammed Loombucket

            I have plenty of faith. Just not in the non-existent and ludicrous.

            Explain these stats if you can.

            http://www.patheos.com/blogs/friendlyatheist/2015/08/21/atheists-now-make-up-0-1-of-the-federal-prison-population/

          • Phil R

            So off we go on another tangent…..

          • Mohammed Loombucket

            Run away.

  • Colkitto03

    I think this is a good and sensible outcome. A little flexibility is a good thing.

    • Groan

      Agree. I can’t help thinking that the result had more to do with representations from other religions higher up the hierarchy of “protected” beliefs.

      • Colkitto03

        I cant help thinking you are absolutely right.

  • The Duke of Umberland, England

    Doc

    What a shame that they haven’t provided a rationale for their decision.

    Prior to the rise of Nazism, German medical ethics were atacked.

  • David

    As a conservative Christian who believes in the sanctity of life I am very pleased to hear this most welcome news. Only murderers should be executed, and not the innocent unborn.
    Now we need to see similar justice extended to other persecuted Christians working and operating in other fields.

    • Trumpton

      What about a woman or even a child that has been raped? Is her life worthy of consideration at all?

  • Fern

    I have no problem with this as long as patients are aware of the beliefs of individual doctors, nurses and other medical professionals and can choose not to be treated by or referred to them. GP surgeries, for example, should clearly state that because of the beliefs of the practice or of individual doctors within it, contraceptive services are not offered and no referrals for abortion in any circumstances will be made. Patients are then clear on what they can and cannot expect and can choose whether they want to register with surgeries with these sorts of restrictions. Similarly, pregnant women should have the option of refusing to be attended by a midwife who is opposed to abortion since they may well have perfectly valid concerns about the priority such a medical professional might put on the mother’s life versus the baby in the event of serious complications.

    • Phil R

      I would 100% agree. I would love to have the chance to pick medical professionals who are Christian and be able to refuse to be treated by non Christians.

      Good idea well said.