Sunday, 22 May 2011

The GMC has overreacted in reprimanding Dr Richard Scott

A Christian GP has been reprimanded by the General Medical Council for talking about his faith to a patient.

Dr Richard Scott (pictured) was accused of ‘harassment’ and told by the medical regulator that he risked bringing the profession into disrepute by discussing his religious beliefs.

He has refused to accept a formal warning on his record, and is instead taking legal action to fight the censure with the assistance of the Christian Legal Centre and leading human rights lawyer Paul Diamond.

Dr Scott, who says he has shared his faith with thousands of patients in the past, saw the patient who is at centre of the complaint in 2010. Following the consultation, the patient’s mother complained that the doctor had abused his position by ‘pushing religion’ on her son.

However, Dr Scott argues that he acted within official guidelines, having asked if he could talk about his Christian beliefs to the patient, who is of a different faith, and having ended the conversation as soon as he was asked to. The conversation only turned to faith issues after they had fully explored the medical options.

This is Dr Scott’s version of what happened. “The GMC said I had exploited a vulnerable patient. I say I was trying to help a needy patient,” Dr Scott told the British Medical Journal.

'It’s actually one of the longest consultations I’ve had, 20 minutes, trying to establish the details of his very detailed problem. And then in the last five minutes I said to him, "Look, there’s something here that I’ve found over the years has been very helpful to me and many of the patients sat in your chair. It’s about the Christian faith; you probably realise I’m a Christian doctor."'

He asked the patient whether he could discuss this, and he had replied, 'Go for it.'

'Towards the end he actually did become a little bit heated and I could see it wasn’t going anywhere, so we stopped. I finally said, "I will do the things obviously your mother has rung up about in the first place, the standard medical stuff, we’ll do that." In her complaint against me she said that I’d been highly unprofessional and not done anything medical at all in the conversation, which is totally wrong and can be proved on the computer.'

After receiving the complaint, the GMC apparently sent Dr Scott a letter warning him over his conduct and told him that the way he expressed his religious beliefs had ‘distressed’ the patient and did ‘not meet with the standards required of a doctor’.

Dr Scott, a doctor for 28 years, works at the Bethesda Medical Centre in Margate, Kent. Its six partners are all Christians and state on the official NHS Choices website that they are likely to discuss spiritual matters with patients during consultations.

Niall Dickson, chief executive of the GMC, is reported by the Telegraph as saying: ‘Our guidance, which all doctors must follow, is clear. Doctors should not normally discuss their personal beliefs with patients unless those beliefs are directly relevant to the patient’s care. They also must not impose their beliefs on patients, or cause distress by the inappropriate or insensitive expression of religious, political or other beliefs or views.’

However Dickson has been quite selective in his quotation of the guidance which actually gives doctors a lot of freedom in expressing their faith, provided they do it in an appropriate and sensitive way.

The GMC guidance in question, Personal beliefs and medical practice, was published on 17 March, 2008.

Christian Medical Fellowship contributed to the consultation leading to its publication and published a review of the guidance at the time.

At the time of the publication of the guidance Dr John Jenkins, Chair of the GMC Standards and Ethics Committee said: ‘The GMC recognises that personal beliefs, values, and cultural and religious practises are central to the lives of doctors and patients. The guidance balances a doctors' right to practise in accordance with their views and beliefs, and patients' right to receive timely and appropriate medical care.’

The guidance states specifically (para 7) that it ‘attempts to balance doctors' and patients' rights - including the right to freedom of thought, conscience and religion, and the entitlement to care and treatment to meet clinical needs - and advises on what to do when those rights conflict.’ It is not intended to ‘impose unnecessary restrictions on doctors’ (p8) but does point out that doctors have an obligation not to impose their beliefs on patients:

‘You must not express to your patients your personal beliefs, including political, religious or moral beliefs, in ways that exploit their vulnerability or that are likely to cause them distress.’ (p1)

So there is no blanket prohibition on expressing personal beliefs, as long as it is done in a way that is sensitive and appropriate.

The guidance also underlines the principle that doctors must ‘make the care of (their) patient (their) first concern’ and must treat them ‘with respect, whatever their life choices and beliefs’.

These are all good principles that I personally have no problem with. No doctor, Christian or otherwise, should impose his views on his patient or seek to exploit his or her position.

However, the guidance goes on to stress that all patients and doctors have personal beliefs implying that these principles apply not just to those who subscribe to a particular faith, but to everyone.

‘Personal beliefs and values, and cultural and religious practices are central to the lives of doctors and patients.’ (p4) ‘All doctors have personal beliefs which affect their day-to-day practice.’ (p6)

It also emphasises that taking account of patients’ beliefs is part of good medical care.

‘Patients' personal beliefs may be fundamental to their sense of well-being and could help them to cope with pain or other negative aspects of illness or treatment.’ (p5) ‘For some patients, acknowledging their beliefs or religious practices may be an important aspect of a holistic approach to their care. Discussing personal beliefs may, when approached sensitively, help you to work in partnership with patients to address their particular treatment needs.’ (p9)

I recently blogged about a new report from CMF, which has had wide international news coverage which reviews the positive health benefits of Christian faith.

Good doctors do not treat their patients solely as biological or biochemical machines. Rather they practise ‘whole person’ medicine that is not concerned solely with physical needs, but also addresses social, psychological, behavioural and spiritual factors that may be contributing to a person’s illness.

Here we have the case of a doctor who has talked to many patients about faith matters and who has had only a very small handful of complaints. He seems genuinely to make his patients welfare his main concern, and when he feels it appropriate to raise spiritual issues does so with sensitivity and respect.

From the facts of the case, as reported, it appears that the General Medical Council has acted with inappropriate and disproportionate force and appears to have applied its (very reasonable guidance) in a selective and unbalanced way.

The Telegraph, in today’s editorial, ‘Doctors can be Christians too’, quite rightly says that ‘this case of a doctor reprimanded for discussing his religion is a worrying one’ and accuses the GMC of an ‘excessive reaction’. It concludes that ‘we appear to be heading towards an alarming situation in which the profession of faith becomes an active disqualification’.

The GMC has clearly overreacted and I am on record in the Telegraph today saying just this.

Let’s hope that it reassesses its position and applies its own guidance in an even-handed way by balancing more carefully what it calls ‘the right to freedom of thought, conscience and religion’ with ‘the entitlement to care and treatment to meet clinical needs’.

If it fails to do so it may find itself losing more than its credibility.

15 comments:

  1. There appears to be a dispute as to the facts, a dispute as to what actually did or didn't happen. Has the GMC actually given the accused a chance to give his side of the story, or to cross-examine the witnesses against him, before "convicting" him? Who are the witnesses against the accused, given that the complaint was brought, not by the alleged victim (who remains a patient of the accused!), but by the victim's mother, who wasn't even present when the alleged offences took place?

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  2. For an example of the GMC's hypocrisy with regard to warnings please read the judgement and my grounds of appeal on the page found here:

    http://www.gmcabuse.com

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  3. What was the faith of the alleged victim?
    And did said victim object to the doctor proselytising? If so, the doctor should have stopped as soon as the patient objected. Did he?

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  4. Dr Jennie Colman24 May 2011 at 12:15

    The GMC is a deeply flawed organisation and not fit for any purpose in the modern era. I say this as someone who was an elected member of the GMC.

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  5. I have written about Dr Scott on my blog too. I'm an agnostic, but I'd really like to know what you think.

    http://www.thanetwaves.co.uk/2011/05/local-gp-in-trouble-for-god-chat.html

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  6. Doctors are paid by the taxpayer to provide medical care, not to peddle their personal beliefs! If I ever find myself in a similar position to this patient, I'd be complaining to the GMC.

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  7. This doctor was providing medical care! As a Christian your duty to God should be your priority whatever your work. Spreading the news of Jesus is a fundamental part of the Christian faith and should be part of everything you do, so banning this at work would effectively be banning practising Christians from that job.
    The main way we can share Jesus' love with others is by caring for them, their physical needs (food, shelter, medical treatment, help with the shopping etc) as well as their spiritual. This may help explain why so many Christians are doctors, nurses, teachers, carers, or with other jobs helping others.
    As a Christian I beleive that anyone who is not a Christian will face Gods judgement and be sent to hell, so to not share the many warnings in the Bible with others would be to show I don't care, which would be an unchristian attitude, though usually more to do with fear than indifference.
    If we cannot let people know we are Christian then we are unable to practise our faith and this would be discrimination. Just as we should treat other people with respect we should also be treated with respect. The GMC cannot expect Christian doctors to hold what they say on the matter in higher regard than what God has said. As long as the Doctor in question was providing appropriate medical care then he should not be in any trouble.

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  8. Why has CMF not done any media/television interviews about this very important matter?
    Should CMF not make this a priority, considering Dr. Scott is a christian doctor, and may even be a CMF member himself?

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  9. CMF has done at least a dozen media interviews defending Dr Scott and our press release on the matter has been quoted and made headlines all over the world.

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  10. Well done, in that case.
    Do you have any links to CMF's media interviews?
    And to your press releases?

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  11. Press Statement

    Dr Peter Saunders, Chief Executive of the Christian Medical Fellowship which represents over 4,000 British doctors said, 'The General Medical Council appears to have acted with inappropriate and disproportionate force in this case and applied its own guidance (Personal beliefs in medical practice, 2008) in a selective and unbalanced way. Good doctors do not treat their patients solely as biological or biochemical machines. Rather they practise "whole person" medicine that is not concerned solely with physical needs, but also addresses social, psychological, behavioural and spiritual factors that may be contributing to a person’s illness. The GMC guidance itself acknowledges that "all doctors have personal beliefs which affect their day-to-day practice" and acknowledges that "discussing personal beliefs may, when approached sensitively, help (doctors) to work in partnership with patients to address their particular treatment needs". I would urge the GMC to reassess its position and balance more carefully what it calls "the right to freedom of thought, conscience and religion’" with "the entitlement to care and treatment to meet clinical needs". If it fails to do so it may find itself losing more than its credibility.'

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  12. Telegraph article quoting CMF - http://bit.ly/mPzQB7

    Roxana Whelan interview -
    http://chirb.it/eNkM2B

    Some more on facebook page -
    http://www.facebook.com/ukcmf

    More links via Google news to CMF quotes on case -
    http://bit.ly/iluatn

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  13. No television interviews then?

    Those would give this issue the far greater exposure it deserves and needs.

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  14. We were not given an opportunity to do any television issues on this case - but had we been asked we would have done so. Most of the media, understandably, wnated Dr Scott himself.

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