Sir, – There is no doubt that GPs were thrown off balance when, out of the blue, the recent abortion legislation identified us as key decision-makers in the process. There was little or no preparation in terms of education or resources. None of the continuing medical education groups I attend have discussed it yet.
Discussion has moved to the area of freedom of conscience and derogation for those doctors like Dr Fiona O'Hanlon (October 5th) who want a right to refuse information, referral or access to women requesting termination. At a human level Dr O'Hanlon will surely find it very difficult to turn a distressed patient away if her right to object is upheld. It is central to clinical medicine that a distressed human being can expect competent, non-judgmental help from a doctor legally empowered to provide it.
If doctors decide that they want freedom to decide not to respond to distressed women with unwanted pregnancies others may want similar freedoms in their own areas of practice. Examples abound. A cardiothoracic surgeon who has strong views about smoking may refuse to operate on smokers because of their poorer outcomes. A GP who doesn’t agree with vaccination for measles may legitimately refuse to authorise it because of anecdotally attributed harms. Doctors who don’t like drug users may refuse to have anything to do with them.
The nature of being in a profession like medicine is that the doctor’s individual rights are curtailed.
We provide respectful treatment to patients whose politics, religious and health practices we may not agree with on a regular basis.
The education of doctors in medical ethics has been poor, and at times non-existent, in Irish medical schools partly because of the battle between religious and secular approaches. It has led to otherwise kind and competent doctors thinking that they can pick and choose to whom they will offer legally approved services usually in the area of women’s health.
The Medical Council is clear that if a doctor refuses treatment they must explain the reason and offer the patient an opportunity to have their case reviewed by another doctor.
Refusing to provide medical treatment has no place in legislation and patients should know that doctors will respect the laws of the land.
Our profession has the structures and authority to ensure every patient receives good non-judgmental care from a trusted doctor. – Yours, etc,
TOM O’DOWD, MD
Emeritus Professor
of General Practice,
Trinity College Dublin,
Dublin 2.