Doctors in the UK Can Be Fired For Not Doing Their Jobs! May 30, 2012

Doctors in the UK Can Be Fired For Not Doing Their Jobs!

Ah the good ole United Kingdom. Those crazy kids are at it again!

They are working on medical guidelines (PDF) that prevent doctors from discriminating against their patients!  Here is part of the new draft, and it looks nothing like what we’re used to seeing in America:

You may have a conscientious objection to providing contraception. However, you cannot be willing to provide married women with contraception but unwilling to prescribe it for unmarried women. This would be a breach of our guidance as you would be refusing to treat a particular group of patients (unmarried women) rather than refusing to provide a particular treatment (contraceptive medication). This would also be illegal under the Equality Act 2010 which prohibits discrimination on the grounds of marriage and civil partnership.

So you can’t discriminate against people, eh?  Well isn’t that novel.  Just like you can’t refuse treating a cancer patient because they were a smoker, or an athlete with a blown knee because “What were you doing all of that running around for in the first place?!”

The new guidelines do still allow for a doctor to opt out of “providing a particular procedure because of your personal beliefs and values” but even that has a big fat asterisk next to it with the following footnote:

*The exception to this is gender reassignment since this procedure is only sought by a particular group of patients (and cannot therefore be subject to a conscientious objection — see paragraph 5). This position is supported by the Equality Act 2010 which prohibits discrimination on the grounds of gender reassignment.

So what the UK is going for, in laymen’s terms, is that doctors can opt out of performing a procedure, as long as it’s across the board.  If you prescribe birth control to one, then birth control for all!

The guideline also warns that “Serious or persistent failure to follow this guidance will put your registration at risk.”

Now, everyone hold on to your hats, cause the Catholics are — wait for it — pissed off!

… Bishop Tom Williams of the Archdiocese of Liverpool warned that the guidelines were in fact discriminating against ‘certain groups of doctors.’ He said they risked creating an ‘atmosphere of fear’ in which doctors would be ‘prohibited from ever expressing their own religion’. Dr Peter Saunders, chief executive of the Christian Medical Fellowship and a former surgeon, warned that the guidelines were yet another example of ‘legislation being used to marginalise Christian health professionals in Britain.’ He said: ‘The problem is that 21st century British medicine now involves practices which many doctors regard as unethical.’

Look, I understand that people take their morals and faith very seriously.  But it’s not like people just started using contraception yesterday.  If you’re under 50, the pill has been around your entire life. You have to be pretty smart to be a doctor — they had to have seen this issue coming, right?

On the birth control and abortion issues, the guidelines still do allow for a doctor to opt out all together, as long as the patient is set up with another doctor and the doctor’s ability to opt out doesn’t “obstruct patients from accessing services or leave them with nowhere to turn.”

It would be lovely if we could all pick and choose the parts of our job that we would or won’t do.  I used to wait tables for years and I worked with several vegetarians.  If their customer ordered a steak, they had to bring it out. If they said to their manager, “I have a fundamental moral issue with the consumption of meat and I will under no circumstances order up and carry out a steak!” then guess what happened?  Out on the street with them.

Is it a perfect metaphor?  Maybe not. But I just won’t hear of people crying foul because they feel like they are being treated unfairly when, in fact, they are being held to the same standards of any other medical professional.  No one would entertain a Jehovah’s Witness doctor who refused to perform blood transfusions. Sometimes blood transfusions are part of the gig.

In short, I think that we as a culture have decided what the collective thinks is moral, for better or worse.  Murder?  Immoral.  The Pill?  Moral. Those are the laws we have decided to live with.  No matter what your book says, if you want to play the game, play by everyone’s rules.

These new guidelines are still in the draft phase and the General Medical Council is still taking notes, so any British doctors, contact your GMC and support the changes!

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  • CelticWhisper

    Waaaaaitaminnit.  You mean people who are hired with the expectation of doing a certain job can be dismissed for not doing it?  Get out, no way!

    But what about their personal religious convictions?  They…they’d have to LEAVE THOSE AT HOME!  Surely we can’t expect people to do their jobs as required without bringing personal biases into the workplace!  There’s a word for that kind of malarkey, I know there is.  It’s…um…dammit, what was that– Oh, right.  “Professionalism.”

    Methinks the UK is onto something here.  Methinks I like it.

  • Chris

    I can’t help but think what would happen if we (and by “we”, I mean British people) started referring to America’s batshit evangelists as just “America”. Those crazy American kids. Those crazy, condescending, American kids.

  • Onamission5

    “He said they risked creating an ‘atmosphere of fear’ in which doctors would be ‘prohibited from ever expressing their own religion’.”

    Nope. Doctors can walk around saying “Hey everybody, I’m a catholic!” all day long if they want.  They just don’t have the right to impose their interpretations of their religious beliefs upon select groups of others. Too bad, so sad.

  • Matto the Hun

    It isn’t the doctors’ job to express their religion. It’s to do their job, and if their magic friend in the sky has prohibitions on certain aspects of their job they can fuck right off and do something else… maybe carpentry like their magic zombie super hero.

  • Tanya Walker

    And this is why Romney made the asinine comment about how he wants to keep the US from becoming like *gasp* Europe.

  • monyNH

    Here’s a solution: if you don’t “feel comfortable” prescribing birth control, offering abortion counseling, or performing gender reassignment surgery…become a podiatrist. 

  • HowlerUK

    But Chris, we do… the same way as we (English at least) think all Welsh are sheep shaggers, all Aussies are convicts, and all French are, well, French! 🙂

    I was always under the impression that Doctors in the UK had to leave their religion at the doorstep anyway or risk being struck off the register. My old GP was from Bangladesh, and I’m sure she wasn’t Christian, but she never had any qualms with her religious beliefs and doing her job.  She always put the patient first. I was shocked when I was doing my nursing rotation at a hospital in Nebraska when I found out one of the main OBGYN’s was able to refuse to do abortions, or even tube tying, even in the event of saving a patients life. He also walked around the hospital with this f**k off huge cross around his neck. He’d have never been allowed to do that in the UK. 

  • Baby_Raptor

    Personally, I think it’s bullshit that doctors have a religious excuse at all. They went into that profession knowing that their beliefs were going to be in conflict. They chose to go through X number of years of school and be a doctor anyway. 

    Personally, I think that very obviously made choice should remove any exemption. 

  • And the chances of something like that happening nationwide in the US are zero. Because you know, we’re a Christian country. >peoplethatlearnedeverythingtheyknowfromtheirpastor,whoalsosaidtheinternetistheworkofthedevil (granted they’d be partly right, this isn’t a pretty place, but still)

  • Northgs

    This post is discussing the UK government’s attempt to set national practice standards for medical professionals. The collective, in this instance, is perfectly appropriate. 

  • Chris

    And I’m sure Americans just *love* being referred to through their elected representatives.

  • Ken

    Actually,I kinda like this idea, since it might shame the rest of the country into disassociating from the nutcases.  As it is, we tend to just tolerate those batshit crazy Evangelicals under the lazy guise of free speech.  They need to be called out as batshit crazy, because they are, and some of the rest of us aren’t.  

  • ‘The problem is that 21st century British medicine now involves practices which many doctors regard as unethical.’
    no, the problem is that christians do not live in the 21st century…

  • Sue Blue

    But even a podiatrist might have to treat a patient whose ulcerated feet are a direct result of vascular disease caused by smoking, or those of an AIDS patient or a homeless person with gangrene.  No matter what kind of doctor (or nurse) you are, you must be prepared to treat patients of all backgrounds, cultures, gender, sexual orientation, and lifestyles.  This is the most basic application of the medical ethical principles of justice and benevolence.  I say, if you don’t want to run the risk of having to deal with people or situations that you don’t approve of for religious reasons, go be a night watchman at a screen-door factory or something.

  • snoofle

    This is really necessary, and not just for Christians.  I recently read about issues medical schools in London have been having with muslim students refusing to attend lectures covering medical issues resulting from alcohol abuse, because drinking alcohol is against their religion, and muslims refusing to examine patients of the opposite sex.  One student doctor failed his final exam because at one point he was supposed to examine a patient, and as she was a woman, he refused.  He tried to claim he was being discriminated against because of his religion, but the university wouldn’t budge (gladly!)

  • Gary Hill

    My GP is an evangelical Christian but he has never treated or behaved toward me as anything other than a man of reason and science. If he can do it, so can Catholic doctors.
    The notion that religious ideals should be allowed some privileged place in any science fills me with dread.

  • I usually like to hold my temper becuase I know it twists up my reason, but I can’t help but get pissed off at all of this Catholic bullshit.  If you want to believe in some medeival mythology, that’s your idiotic worry.  But when you try to drag the rest of us back into the dark ages that’s bullshit.  Don’t want to pay attention to science and progress, then stay out of the medical field.  Otherwise, follow your Hypocratic Oath and do your damn job !!

    Sorry, I told you my temper was going to get the better of me.  I’m back now.

  • LifeInTraffic

    This. Absolutely this. And, I think the same of pharmacists. They intentionally went into a field they knew was going to conflict with totally legal procedures and medications. That’s their call, but shouldn’t be the rest of the world’s problem.
    In terrifying news about this, guess who is starting to induct medical students into their as-yet-unaccredited medical school next year? Liberty University. They plan to have it accredited by the time those first year’s graduate, so we can have yet more people with a shitty education making decisions about someone else’s health and life based on a myth. 

  • Michael S

    I love the formality of it: If your feelings apply only to a particular sub-group, it cannot be a conscientious objection.

    Translation: Discrimination is unconscionable.

  • I don’t see a problem with it.
    “Ah the good ole United Kingdom. Those crazy kids are at it again!”
    It was sarcastic because this is obviously a good thing that doctors can’t discriminate and give birth control to married women, but not to unmarried women.
    So “those crazy kids” are the good people.
    Still, good or bad, I understand that when someone says “America” they don’t necessarily mean every single person in America.
    The U.S is going to war. The U.S. made abortion illegal. The U.S. legalized pot. All of those are things that would clearly be handled by the government and I would not be offended for a second by the word choice, whether or not I agreed with what the government did.

  • Wouldn’t refusal to provide hormonal contraceptives violate the law, since it’s only women who use them? (Probably stretching it a bit but….)

    I’m really sick of all the selective moral grandstanding.  I work with disabled people.  I have to help them prepare meals.  I could never (and would never) refuse to prepare and serve them meat because I’m a vegetarian.  I could and would never refuse to take them to church if they wanted to go by claiming it was against my non-belief as an atheist.  I know that when I’m at work it’s not about me, it’s about the people I’ve been hired to provide aid to.  Apparently with Christians it’s a different story. 

  •  Maybe there should be a special enclave of “Christian doctors” who base their treatment on their faith rather than accepted medical standards and what the patients need.  They’ll advertise themselves as such so you’ll know not to go to them if you want comprehensive, humane treatment (particularly if you’re a woman, LGBTQ or a non-Christian).  It’s much the same way there are “Christian Counselors” who base their treatment on the Buybull rather than actual psychological standards. 

  • AxeGrrl

    Sounds like a great solution 🙂

    If any Christian doctor has a problem with this, I’d LOVE to hear why.

  • AxeGrrl

    I work with disabled people. I have to help them prepare meals. I could never (and would never) refuse to prepare and serve them meat because I’m a vegetarian. I could and would never refuse to take them to church if they wanted to go by claiming it was against my non-belief as an atheist. I know that when I’m at work it’s not about me, it’s about the people I’ve been hired to provide aid to. Apparently with Christians it’s a different story. 

    Really beautifully said, Buffy. 

  • Sindigo

    I noticed that too but read further and I think it was being used ironically. As in: “those crazy British kids who think government sponsored discrimination is actually a *bad* thing”. I think we were being complimented here.

  • Sindigo

    These guidelines bring us further into line with European anti-discrimination law and quite right too. Applause for the GMC.

  • jdm8

    I question the idea of going into a profession where your beliefs mean you have to turn away the legitimately prospective clients (different from single-sex practice like gynecology).  You’re already setting yourself up for a difficult career.

  • LifeInTraffic

    Unfortunately, that leaves many people without medical options. Almost all the doctors within an hour-and-a-half of me, and every hospital in that range, are Southern Baptist or Catholic. I’m lucky I can go elsewhere, but in an emergency situation, I would have no choice. Ambulances are required to take you to the nearest hospital, so if I were pregnant and needed an emergency life-saving abortion, for example, they’d just let me die without my having a say.

    If I am poor and can’t drive, I couldn’t readily get birth control services. 

    The problem is that any religious exception puts people at risk, and almost always adversely effects the poor the most, as well.  Having them declare themselves Christian in an area where almost all are doesn’t really help give the community quality, evidence-based medical care.

  • Onamission5

    I have the same issue with the availability of emergency medical care in my area. I am not a veteran, and the only other hospital in my county is catholic. That would be the one I’d be taken to in an emergency. Now, this hospital does have a regional reputation for exemplary medical care, but I can’t find any info on them regarding the types of exemptions they employ. I don’t know if I’d be denied a hysterectomy, should I need one, or an emergency abortion, for example. My life could potentially be in the hands of people who’d rather I died than go against their religious beliefs, and that scares me.

  • Jill B

    Where are the exceptions regarding if the doctor determines that a particular medication is contraindicated or otherwise not in the best interest of the patient?  I don’t want to see doctors refusing necessary treatment because of some discriminatory or archaic religious reason, but saying that a patient has a right to “any medical service they want” seems ridiculous.

    What if there are complications that would arise from giving a certain patient a particular contraceptive?  If a patient really wants to go on the pill, but the patient has heart disease, or a history of early breast/uterine cancer (contraindications for hormonal contraception), is the doctor required to put the patient’s health at risk because “what they want” is the most important issue?  What about if a patient really wants a copper IUD but has multiple metal tooth fillings; would the doctor have to override his/her professional judgement and just give the patient want they want, even thought that means the patient would basically be creating a galvanic cell in their body and would start seeing copper oxide deposits in their gumline? 

    Let’s say a doctor’s evaluation of a patient wanting a sex change is that they’re not mentally stable (perhaps like this guy:–hated-Samantha-man-Now-hes-getting-married-So-fiancee-crazy.html ), or that the sex change operation at this time would put their health seriously at risk due to another medical condition.  Does he/she have to perform the surgery anyway?

    Personally I don’t want to see the practice of medicine to be just another “service” people buy (like cosmetic surgery).  In medicine, I still want to see “First do no harm” prioritized over “the customer is always right”.

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