Professor Sir Graeme Catto
General Medical Council
I am writing with respect to changes recently made in the ‘Good Medical Practice’ document, the latest edition of which I received on the 20th January.
As a practising physician since 1988, I have valued the GMC’s guidance documents and viewed with considerable respect the care and sagacity with which it has navigated difficult and changing waters.
I preface my comment with a short personal background. I am a Christian, and after coming to faith in Jesus the Messiah, the pursuit of His glorious example inspired me to practise medicine. I have since often been invited to preach in churches of many different kinds in this country and overseas, and have also participated in open air evangelistic preaching for my own church and for that of others, and count that a sacred privilege. This of course is no novelty, it is the very bedrock of a huge number if not the majority of our hospitals, given that so many of them are actually named after the Lord, His apostles and disciples, whose primary labour was identical.
It has been also a great pleasure and stimulation to serve some 5 and a half years as a physician in the Middle East, including during the second Gulf War, and back in the NHS since 2004 again to work, think through and discuss difficult cases with colleagues of a breathtaking variety of backgrounds. I have held a consultant’s post as a locum since that time. My wife is not British born, nor are many members of my family, and my church welcomes and contains people from all kinds of backgrounds – some of whom lived in very degraded circumstances before knowing Jesus Christ.
It is a solemn duty and honour to help and minister to the sick of every conceivable background, and as a physician, I have endeavoured with God’s help to care for soldiers of causes I oppose, convicted criminals, adulterers, drug addicts and many others, as compassionately and firmly as I would my own family if they fell into such a state. I have sought to put aside an abhorrence of the harm and injury to themselves or others, of their political or ethical views, or their personal degradation. I have not received any indication from patients that they have judged this determined impartiality unsuccessful – quite the contrary.
I have no difficult endorsing the changes that have been made in paragraph 7.
However there is a sharp distinction between duty of service to patients and the effects that similar changes to the code in paragraph 46 are likely to have on future medical practice. It is remarkable that these new clauses on diversity are the only ones with an immediate, explicit encouragement by the profession to police itself. Promoting diversity appears to have become more important to GMC than financial corruption or sexual misconduct, as yet unaccompanied by such exhortations to report and reprove colleagues’ transgressions of the code. Even the sections dealing with frank incompetence are handled more circumspectly. Is the most intolerable offence of all now intolerance, even intolerance of sin? It is well the body has not learned this wisdom.
The distinction between articles 7 and 46 can easily be highlighted by the difference between treating a Jehovah’s Witness, a common but important source of heartache, and the almost inconceivable nonsense of working with an openly declared Jehovah’s Witness as a practising physician colleague on an acute take. Again just as there is an increasing tendency of some stricter Muslim patients to refuse medication because it contains gelatin, what about a physician who felt similarly conscience bound to delegate the task of prescribing such ‘unclean’ medications to other colleagues? The GMC will be aware this issue is not theoretical. Dr Abdul Majed Katme’s (? Kadom, reg. no. 2778275), of the Islamic Medical Association, has issued a public call for patients to shun ‘unholy’ vaccinations – is the GMC considering this extremely serious initiative which may lead to infant death and morbidity, or will the weight of article 46 now take precedence? Unnecessary dilemmas of this nature are likely to proliferate.
Given the well documented tendency of certain minority groups to play up their victimhood in order to gain public sympathy and recognition, it is regrettable that the precise definition of ‘harassment’ or ‘bullying’ has not been specified more clearly. Especially since to harass may be defined as simply as to ‘irritate continually’ – a criterion based on subjective perception, which many may be to tempted to apply to existing colleagues! Christians would explicitly repudiate harassment and bullying in the workplace, nevertheless it is relatively easy to envisage an occasion where an accusation founded on these articles might arise from a legitimate use of discrimination. What is ‘unfair’ discrimination? – it sounds reasonable, but what does it amount to in practice?
To take some extreme examples, would the GMC now regard a candidate who declares himself a Satanist, worships the Prince of deceit, drinks chicken blood, and engages in orgiastic rituals, widely rumoured to involve minors and prostitutes, suitable for a doctor’s post? If not, how is it that the judgement is solely founded on his (or her) private religious practise? If so, then the failure to discriminate has lead to a state of tolerance more akin to the effects of HIV than to integrity or wisdom. He (she) might justifiably argue a refusal of a post amounted to discrimination on the grounds of faith. Most of the British public of all communities would regard it as lunacy not to regard such an applicant with grave caution, on the sole basis of religious profession.
Again, would the GMC regard a jihadist who openly admires Bin Laden, praises the atrocities of 9/11 – as a good proportion of my patients did whilst I served overseas – a suitable candidate as a nurse for a post requiring complex unsupervised tasks in my unit? If not, then again this ‘intolerance’ is rooted in the candidate’s radical religious principles alone. Many of my medical and nursing colleagues in the Middle East were Muslim, some of them were excellent and highly respected for their skills, whom I still miss keenly, yet most were swift to distinguish between religious fanatics and moderates in a way the GMC apparently now is not. The shutting down of discernment in the way that ‘Good Medical Practice’ is now recommending appears both illogical and imprudent. Effective medical practice requires the proper discrimination of signs of disease, so also in the realm of moral and religious thinking its complete disregard is unsafe.
Gay rights advocates have been militant and determined in shaping public opinion and hammering through their agenda even for adoption rights and equivalence of civil partnerships with marriage. Holy Scripture describes even the affections which undergird homosexual orientation as ‘vile’ (Romans 1.26), and analyses the process of godlessness which results in homosexual practice, crown in a family of vices (v.18-32). What British law defined as an imprisonable crime less than 40 years ago, a practice marked as harmful to society, considerably more dangerous to health than smoking and degrading to the integrity and character of the young, is now enshrined by the GMC, along with altogether worthy aspects of diversity, like disability and race. It is equally immune from criticism, and now sanctified from critical scrutiny. avHaveHave HaveHavvkjkjkjksljlkjlklkj Have we so far surpassed the moral wisdom of our forebears as to kick over the traces like this? In humble and imperfect submission to the Divine Law that has formed the foundation of British Law, I judge and preach the opposite, along with many others.
Now I believe most of my colleagues know my position on the unique sanctity of marriage, on fornication, adultery, idolatry and homosexuality, and I have had good working relationships with most of them and entertain hostile terms with none, including those embedded in these sins. As the gentle martyr John Bradford loved to say, ‘there but for the grace of God go I’. However by continuing to preach publicly for repentance from such evil and the liberating power of Christ, albeit out of the hospital, there is a high likelihood that sooner or later I will face allegation founded on the new article 46.
Is frank and compassionate reproof now apparently regarded as proper occasion for discipline by the GMC? (Lev.19.17-18 - the true context of the golden Law of love). How subversive of the moral character of our profession such a position will prove to be. What an awful tragedy it will prove to be for a great institution like the GMC thus to discount Divine Law, as mere ‘personal opinion’, in exchange for political expediency in embracing the blind and crumbling policy of multi-cultural equivalence. Will it even safeguard the communal cohesion it aspires to?
If ultimately I am forced to choose between my profession and conscience, as others have been before me in previously less enlightened regimes, it will be an honour to follow the One after whose disciples so many of our best and brightest institutions were named in days of much clearer moral vision,
Yours sincerely in Christ,