Friday 16 November 2007

Abortion - Doctor's rights and patients' rights

I have just discovered an alarming news report in last Sunday’s Observer about a Christian doctor I know who is under investigation by the General Medical Council (GMC) for how she responds to patients seeking an abortion and being criticised by my own MP here in Oxford. Tamie Downes apparently gave an interview to the Daily Mail earlier this year in which she spoke of patients who decided to continue with their pregnancy rather than proceed with termination after her consultation with them. She is also one of the organisers of a petition to the British Medical Association (BMA) about the current abortion law and its briefing paper on the subject of early abortions.

While one must be cautious about basing too much simply on one news reports it would appear that Dr Downes is being targetted because other doctors - including Evan Harris MP - are unhappy that after conversation with her some patients decide not to have an abortion and that Dr Downes has spoken to the media about this fact. There is - in the report - no evidence that she has broken the GMC guidelines which do not prevent those doctors conscientiously opposed to abortion speaking to patients seeking termination but simply and sensibly state they must respect patients and their views and

You must not unfairly discriminate against them by allowing your personal views to affect adversely your relationship with them or the treatment you provide or arrange. If carrying out a particular procedure or giving advice about it conflicts with your religious or moral beliefs, and this conflict might affect the treatment or advice you provide, you must explain this to a patient and tell them that they have the right to see another doctor

As the Chair of the BMA’s medical ethic committee is quoted as saying at the end of the report

’In discussions with patients [about abortion] GPs may want to investigate a woman’s individual circumstances for requesting abortion to ensure their patients are confident about the decisions they make - this is good clinical practice. However, doctors who force their own personal views about abortion on their patients are acting against BMA and GMC guidelines and are not behaving in their patients’ best interest.’

This whole debate raises a host of important ethical questions. It would appear that (uniquely?) in relation to this medical "treatment" some people think that the doctor is simply there to do whatever the patient demands with no right to ask questions: agreeing to termination is the only professional medical response to someone who is pregnant and unhappy enough about being so to go to the doctor to enquire about abortion. Any doctor who thinks otherwise should, it appears, be banned from treating a patient in this condition and force them to see someone who will simply sign the necessary form. If they do not - and especially if they dare to tell people that actually quite a significant number of women, after talking, decide to continue with their pregnancy - then they must be reported to the GMC and investigated by the government. The irony is that Dr Downes is quoted in the article as saying, "It has to be the mother’s choice. I have no right to make that choice for them". It is the allegedly ’pro-choice’ movement that is here opposing attempts to ensure that women (many of whom are, unquestionably, wrestling with big moral questions and perhaps in some emotional turmoil) are truly giving informed consent. The basis for this appears to be the claim that doctors giving facts or allowing space to make this momentous decision are giving partisan and religiously biased advice whereas simply giving medical approval without necessarily engaging seriously with the patient as a hurting human person is somehow a ’neutral’ response and so the only legitimate one.

3 comments:

Anonymous said...

I too was shocked that at the reaction, in my opinion the Doctor presented the facts aprropriately and allowed time for her patients to consider them and make an autonomous decision.
It is a duty of a doctor to do so with any procedure. It should be the doctors who fail to do this in the case of abortions who should be investigated, as patients need to be made aware of the significant physical and psychological risks of abortion.
Medical Student

Unknown said...

Thanks for the information on abortion ethics. This seems like a huge mess, one that would take a lot of time and research to make heads or tails of.

We recently wrote an article on ethics at Brain Blogger. What if a patient did not tell a doctor all the information they could about their condition/s? Would that be ethically wrong, or should the patients have the right to keep that information to themselves?

We would like to read your comments on our article. Thank you.

Sincerely,
Kelly

Unknown said...

I think that patients and doctors have their equal rights, but both also have their obligations. As a patient, he/she should follow protocols given by the hospital, obey the doctor's orders and don't blame the doctors for self inflicted side effects during medication. On the other hand, the biggest obligation goes to the Doctors, as they are accountable for a patient’s diagnosis -- they know this all too well because they've studies it for many years. Anyhow, this is the reason why we have medical malpractice lawyers, such as Arizona medical malpractice lawyer to investigate which side is truly liable.