Population control lobby seeks to impose its agenda rather than addressing the real causes of poverty

The world’s population is due to pass seven billion on 31 October and campaigners for population control are again using it as an opportunity to promote their agenda.

Back in February 2009 Jonathon Porritt (pictured), former chairman of the UK Government’s Sustainable Development Commission, said that curbing population growth through contraception and abortion must be at the heart of efforts to combat global warming, and that couples who had more than two children were irresponsible.

He is back again this week in the Independent with an article titled ‘Over-population: the global crisis that dare not speak its name’ which reruns much the same message.

In the tradition of Malthus and Ehrlich, Porritt warns of ecological and environmental disaster ahead unless we do something rapidly to curb population growth.

Today’s Metro, in a report titled ‘World’s poor hit worst as population tops 7 billion’, tells us that ‘the world’s poorest regions will be worst hit’ and that ‘areas where there is extreme poverty, food insecurity and inequality will suffer high death rates and high birth rates as part of a “vicious cycle”’.

The solution to these problems? Well you might have imagined that it would be better education of women, community development, better healthcare, more food production and more even distribution of resources, but no! According to International development secretary Andrew Mitchell the answer is still more contraception and abortion.

‘The British government is working to improve access to contraception and family planning education for 10million women in the developing world. This will prevent five million unintended pregnancies, save the lives of 50,000 women and avoid the deaths of 250,000 newborns by 2015.’

And the source of the information on which Mitchell bases his policy? Well not surprisingly it is a new report by the UN Population Fund (UNFPA), a key supporter of China’s population control programme, which is in large part responsible for 160 million missing women (as a result of sex selection abortion) in Asia.

Mitchell’s policy is consistent with the report this week by UN Special Rapporteur for Health, Anand Grover, which linked unrestricted abortion with the right to the highest attainable standard of physical and mental health. He adamantly affirmed his intention to redefine the ‘right to health’ in UN conventions and treaties to include abortion.

This is despite the fact that saying ‘no’ to abortion is actually an international human right, as outlined in the recently published San Jose articles by a group of leading international lawyers, ethicists and academics.

Grover has not surprisingly come in for stiff criticism from Egypt, Honduras and Chile. The Chilean government emphasized that it is essential to recognize the right to life of all human beings. Its statement was of special interest given the country’s history with legalized abortion. Abortion was legal in Chile until 1989. After its criminalization, maternal mortality actually decreased.

Whether the world is overpopulated is debatable. All the world's buildings would fit in Scotland or Ireland alone and the world's population could currently stand shoulder to shoulder on the Isle of Wight. World per capita food production has more than kept pace with population and Europe's own past demonstrates that fertility can be managed effectively - even without contraceptives - as living standards improve.

Furthermore citizens of the developing world choose large families for good reasons, as insurance against an uncertain future in circumstances of high infant mortality, low and insecure income and labour intensive farming.

Family planning combined with economic development allows couples to plan the number and spacing of their children in the light of their own circumstances and beliefs.

On the other hand imposed population control, with all that involves, coupled with mounting developing world debt and economic austerity measures which slash health and education budgets, actually causes huge damage to poor indigenous populations.

Our stewardship of the earth is not a licence to exploit but to govern wisely. We cannot impose solutions on the world's poor without addressing our complicity in unjust economic structures, environmentally destructive technologies, and consumptive lifestyles.

I have previously argued that, regardless of what we might believe about the importance of global warning, those countries which are amongst the biggest contributors are not those in the developing world with rapidly growing populations but those with relatively static populations.

The top four contributors to global warming are China (23% of total), US (18%), India (6%) and Russia (6%)) which have population growth rates of only 0.51%, 0.86%, 1.34% and -0.07% respectively according to World Bank figures.

Carbon footprint is much more about consumption per capita than about population. It is not how many children we have, but how much resource each one consumes. That is the real issue.

Sodom came under God's judgment, at least in part, because she was 'arrogant, overfed and unconcerned; (she) did not help the poor and needy' (Ezekiel 16:49).

This description fits our Western World well. Let’s not simplistically condemn people for having children without addressing the real problem – consumption of more resources than one needs coupled with neglect of those in real need.

The real challenge is how we can live more simply in order that others might simply live.

(See also 'The next challenge: not too many people, but too few?' - Reuters; 'Media Promotes Left-Wing Panic Over 7 Billion People' - Life Site News; 'Seven Billion Strong, and Counting' - Witherspoon Institute; After 7 billion - Demographic denialists are ignoring the perils of an ageing population - Mercatornet)

Excellent interview on stem cell patent ruling

Bioedge this week carries an excellent interview with Professor David Jones of the Anscombe Centre (pictured) on the Brustle stem cell ruling which I blogged about last week. I have reproduced it here.

Last week the European Court of Justice, in the case of Oliver Brüstle v Greenpeace, ruled that research involving the destruction of embryos cannot be patented. This provoked an uproar among stem cell scientists. BioEdge interviewed Dr David Albert Jones, director of the Anscombe Bioethics Centre in Oxford, about the judgement.

BioEdge: Oliver Brüstle has described the decision as “an unbelievable setback for biomedical stem cell research." How would you respond?

David Albert Jones: This is an overreaction and also very misleading. The decision of the European Court of Justice does not affect most “biomedical stem cell research" because most such research does not use embryonic stem cells. There are an increasing number of sources of adult stem cells (amniotic fluid, cord blood, bone marrow, eyes, noses, even fat from liposuction!) and cutting-edge research in this area is turning ordinary adult cells into stem cells. These forms of stem cell research will not be set back and may benefit from the diverting of resources away from embryonic stem cells.

BioEdge: Do you think that this will drive profitable research out of Europe?

David Albert Jones:I think most of this research will stay in Europe. Lawyers who represent the interests of embryonic stem cell companies tell me they are already thinking of how to mitigate the effect of this legal decision. I doubt this judgment will make companies uproot, but I hope it will be a “nudge” which will encourage them to look more at other more ethical kinds of stem cells.

BioEdge: How has the decision been greeted in the UK? Is there a different reaction in other countries in Europe?

David Albert Jones: In the United Kingdom the press has widely reported the comments of Oliver Brüstle and similar comments by British scientists. The status of the human embryo is not taken seriously in the United Kingdom and the views of the embryonic stem cell lobby are accepted uncritically. The United Kingdom is also ambivalent about its relationship with Europe and so it is easy to report this case in a way that plays on anti-European feeling. My impression is that the attitude in other European countries, and particularly in Germany, is quite different.

BioEdge: In your opinion, why do human embryos deserve special respect in Germany but not in the UK?

David Albert Jones: This is a complex question and relates not only to religion (Germany is more than 30% Catholic whereas in England the population is less than 10% Catholic) but more importantly to cultural and historical context. In Germany, given their history, there is a reluctance to sacrifice ethical principles for pragmatic considerations.

BioEdge: Why should science and industry care about ethical limits if the result of their research will benefit the economy?

David Albert Jones: Economic wealth is a human good but it is not one that should be pursued at any cost. People may draw a line at different points but everyone draws the line somewhere.

BioEdge: In the English-speaking world, at least, this is a surprising decision, as the plaintiff is not a Christian group, but Greenpeace. What explains the coincidence of interests here?

David Albert Jones: Greens are not generally opposed to legal abortion (though of course some are). As a movement they are concerned primarily not with the embryo as a person but with the manipulation of human nature, as shown by cloning, eugenics, genetic engineering and the patenting of life. Also Greens tend to come to biotechnology with a more critical attitude and are more likely to see through the hype of claims made by companies with a financial interest.

BioEdge: The court declared that ethics must take precedence over commercial interests. Many would say that this is imposing the ethics of a Christian minority upon scientists. How would you respond?

David Albert Jones: This case was not brought by a Christian group and it is extreme permissive views like those in the United Kingdom that seem to be in a minority in this area. Research is allowed in the United Kingdom that is illegal in many countries in Europe and the United Kingdom even allows research that is banned by the European Convention in Human Rights and Biomedicine. Nevertheless, patent protection requires cooperation between countries and part of the price of this cooperation has been the upholding of some minimum ethical standards. A majority in the European Parliament have decided that patents should not be given from the commercialisation of human embryos.

BioEdge: How has the Anscombe Bioethics Centre engaged in the UK's embryo debate?

David Albert Jones: In February 2011, the Anscombe Bioethics Centre had an event to engage with stem cell scientists in closed discussion under “Chatham House” rules. In June we had a letter published in Nature co-signed by 25 professors and directors of ethics centres throughout Europe, expressing the priority of ethics over commercial interests in embryo research. In September we brought professors from Germany, Italy, France, Ireland, United States, and the United Kingdom to a conference in Oxford on the status of the embryo. The Anscombe Bioethics Centre seeks to be a voice within the United Kingdom reminding people of the dignity of human life from its very beginnings.

Three horrific stories of abuse of women and children abroad raise a disturbing question

Three horrific stories involving the abuse of women and children abroad have featured in our newspapers in the last couple of weeks.

First was the report that witch doctors are abducting children in Uganda for the purpose of child sacrifice. The ritual, which some believe brings wealth and good health, was almost unheard of in the country until about three years ago, but it has re-emerged, seemingly alongside a boom in the Uganda’s economy.

According to the BBC, the mutilated bodies of children have been discovered at roadsides, the victims of an apparently growing belief in the power of human sacrifice. Many believe that members of the country's new elite are paying witch doctors vast sums of money for the sacrifices in a bid to increase their wealth.

Second was the distressing report of a two-year-old girl run over twice, about 100 metres from her home in a hardware market district of Foshan, a prosperous city in southern China. As she lay on the ground, writhing in pain, before being hit by the second vehicle, 18 people, on their bicycles, in cars or on foot, passed by but chose to ignore her. Finally, a 58-year-old female rubbish collector came to the girl’s rescue, but it was too late. By the time she was brought to the hospital, the girl Yueyue, (whose name translates as Little Joy), was brain dead.

A Chinese journalist writing for the Guardian asks, ‘How can I be proud of my China if we are a nation of 1.4bn cold hearts?’ and says the incident is symptomatic of a deepening moral crisis.

Finally is the story of a woman, also recounted in the Guardian, of a Chinese woman who died on operating table after officials forced her to go with them to hospital for an abortion she did not want.

These stories are of course shocking, and it is not surprising that they made headlines in Britain. It is truly horrendous when children are killed to give someone else a financial benefit, when the cries of injured children are ignored by adults and when women die as a result of operations to which they have not given consent – all of which raises a very interesting question.

Every year in Britain 200,000 children are sacrificed, have their cries ignored as they are dismembered and killed and die as a result of ‘operations’ to which they have not given consent.

Of course they are children who are both very young and very small and we call their deliberate deaths ‘terminations of pregnancy’ or ‘abortion’. Abortion is, if you like, the ultimate form of child abuse.

Around the world there are 42 million such procedures each year and as result of sex selective abortions there are now estimated to be 160 million missing women in China and India alone.

In fact there is no one more innocent, more vulnerable and killed in greater numbers than children in the womb.

Child sacrifice in Uganda, and two year old hit-and-runs and women dying during forced abortions in China rightly shock us.

But why are we not equally shocked by 200,000 abortions a year in our own country?

Well that is a very interesting question indeed.

Arise Sir Richie! It was a tough fight but the right team won

By most reckonings New Zealand’s victory in the rugby world cup final last night should have been a mere formality.

The All Blacks were playing France, who they beat by 20 points in the pool stage of the competition, in front of a stadium of over 50,000 supporters at Eden Park, Auckland where they have not lost for 17 years.

They had been the most impressive team throughout the tournament by a distance, scoring 73 more points and 11 more tries than any other side. And they had just dispatched Australia, the world number two side and tri-nations champions 20 to 6 with a consummate display of all round skills in the semi-finals.

By contrast France had limped through to the finals, losing two pool games on the way, sneaking past Wales in the other semi-final by just one point after a controversial red card had left their opponents playing 60 minutes with 14 men.

But all New Zealanders, including the All Blacks themselves, approached this game with trepidation. France, unlike any other side, have the ability to lift their game for the big occasion, and in the 1999 and 2007 world cups had sent the All Blacks packing with inspired second half performances.

True to form, France lifted their game again for this final and, many would say, were perhaps unlucky not to have won. Instead they went down 8-7, denied by desperate All Black defence.

Like most Kiwis I found the whole experience unbelievably stressful. I felt elation at the end of course, but this was overshadowed by a feeling of profound relief.

After 24 years since the last world cup victory, the agony was finally over.

‘Not pretty’, as captain Richie McCaw said, but effective, and after all a win is a win.

This win makes it two-all for South Africa, Australia and New Zealand in world cups and is especially important for New Zealand because of the trauma the country has been through in the last year.

Just over a year ago an earthquake of 7.1, miraculously non-fatal, struck Christchurch on the same day that a plane crashed on the Fox glacier killing nine people. Two months later 29 died in the Pike River mining disaster and in February this year 181 died in a second Christchurch earthquake which destroyed most of the centre of the city.

On world scale these might not seem to be big numbers, but for a small country of 4 million people they were devastating. And the damage from the current ongoing oil spill from the stranded container ship Rena, off the North Island’s east coast, had added insult to injury.

In addition all New Zealanders felt the pressure to throw off our reputation for under performing at world cups.

New Zealanders are rubgy’s leading points scorers of all time and the only international team with a winning record against every test nation they have ever played. The All Blacks have held the top ranking in the world for longer than all other countries combined and in over 100 years only five of the top twenty ranked test rugby nations have ever beaten them.

New Zealand competes annually with Australia and South Africa in the Tri Nations competition, and has won the trophy a record ten times in its 16 year history. They have also completed a northern hemisphere Grand Slam four times (in 1978, 2005, 2008 and 2010), defeating all four Home Nations (England, Wales, Ireland and Scotland) during one tour. Ireland and Scotland have never beaten them.

They have won a record 75% of all rugby matches they have ever played since 1903 and they were named the International Rugby Board (IRB) Team of the Year in 2005, 2006, 2008 and a record fourth time in 2010. In the decade from 2000–2009, New Zealand won 100 Tests (82% winning percentage). They won 15 consecutive Tests at one point and recorded a world record 30 straight wins at home.

In view of New Zealand’s dominance, their lack of success in world cups has been one of the great mysteries of modern sporting history.

France was truly magnificent last night. By contrast, the All Blacks stuttered and probably put in their worst performance of the tournament, missing three out of four kicks at goal and having only 45% of the possession.

But the result was the right one for the country and for international rugby. Apart from captain McCaw, who has finally won in his third and last world cup, probably the happiest man on the pitch last night was New Zealand Prime Minister John Key, who faces a national election on 26 November. Losing their third fly half in the tournament during the match made things even harder. But it was perhaps ironic that their fourth choice Stephen Donald, kicked the winning goal.

If the All Blacks had lost last night he could have effectively written off his chances. But now, with the change in national morale this victory will bring, perhaps he still has at least a fighting chance.

‘In praise of stem cell simplicity’ – brilliant New Scientist Editorial

The New Scientist editorial this week, ‘In praise of stem-cell simplicity’, gives a fantastic overview of exciting new avenues in ethical stem cell research which are opening up.

It should be required reading for all UK science journalists who sadly use press releases from the biotechnology industry or briefings from the Science Media Centre as their main (and often sole!) source material.

In so doing they misinform and short change the British public.

I have pasted a lengthy excerpt below but the full article with links is available free on line.

Although the New Scientist is still supporting all forms of stem cell research, including embryonic stem cell research (in spite of the EU court ruling this week), it does at least, unlike the British press and the BBC, acknowledge the tremendous advances being made with ethical stem cell approaches.

Read this because you won’t hear about it in any British newspaper!

In praise of stem-cell simplicity

DID you know that you have accessible stem cells up your nose? Or that human fetuses shed stem cells into the fluid around them? Both of these seemingly random facts could spawn novel, personalised stem-cell treatments that, if not simple per se, are simpler than what has gone before.

What marks these treatments out is that they are eminently practical and ethically unquestionable. This is in stark contrast to much previous work, which has focused on human embryonic stem cells, or hESCs.

From the outset, the use of hESCs has been fraught with controversy. Only last week, after years of trying, and the notorious fraud involving Korean researcher Woo Suk Hwang, hESCs were finally created through a variant of the cloning technique that gave us Dolly the sheep. This fused skin and egg cells, leaving the nucleus of the latter intact. Unfortunately, human eggs are still required, embryos still perish in the process and in this case the embryos and resulting hESCs had three sets of chromosomes instead of two, ruling out medical uses.

A promising alternative to hESCs emerged in 2006 when researchers produced so-called induced pluripotent stem cells (iPS) from ordinary tissue such as skin. But to convert adult cells into embryonic-like cells means genetic reprogramming, for example with a virus, and the reprogrammed cells do not yet match embryonic stem cells.

Now there are different avenues of research that are simpler in many ways. In ‘Diabetic rats cured with their own stem cells’, we report how researchers cured diabetic rats by turning brain stem cells extracted through the nose into insulin-producing cells in the pancreas. They did this without any genetic trickery.

And in ‘Baby repair kit found inside the womb’, we report how congenital defects such as holes in the diaphragm could be patched up using a baby's own stem cells extracted from the surrounding amniotic fluid.

Stem cell patent ruling is a triumph of ethics over commercial expedience and will open fruitful new areas of research

British scientists are kicking up an enormous stink about yesterday’s court ruling that scientists can’t patent stem cells if they are obtained by destroying human embryos.

Europe’s highest human rights court, the EU Court of Justice, said the use of human embryos ‘for therapeutic or diagnostic purposes which are applied to the human embryo and are useful to it is patentable. But their use for purposes of scientific research is not patentable.’

The EU judges were asked by the German Federal Court of Justice to provide a ruling in a case regarding a German scientist, Oliver Bruestle, whose patent on a method to create nerve cells from human embryonic stem cells was ruled invalid. The court said ‘a process which involves removal of a stem cell from a human embryo at the blastocyst stage, entailing the destruction of that embryo, cannot be patented.’ The ruling mentions 'respect for human dignity'.

The full implications of the judgment are explained in more detail by LifeSite news and C-Fam.

The British media is somewhat predictably filled with reports of scientists condemning the judgment.

A leading article in the Independent calls it ‘A patently poor ruling on stem cells' and a lengthier piece in the same paper says that ‘medicine has been thrown into crisis’.

The Daily Mail leads with the headline ‘Stem cell research in chaos as scientist loses patent battle over extracting cells from human embryos’ and the Times with ‘Europe’s ban on stem-cell patents threat to UK medicine industry’

The BBC declares ‘European court ruling “threatens stem cell work”’.

Most broadcast coverage has been mind-numbingly superficial.

The above articles consist largely of a series of quotes from scientists making the kinds of statements that scientists never used to make:

We are told that Europe is now facing ‘a Dark Age of stem cell research’; that this is 'an unbelievable setback'; that 'Many years of intensive research are being destroyed'; that the decision will ‘will hold back research into new treatments for blindness, paralysis and Parkinson’s disease’; that it is a ‘devastating decision which will stop stem cell therapies use in medicine’ and that ‘emerging regenerative medicine industry that the Government has placed at the heart of its plans for economic recovery could be wrecked’.

The usual warnings about ‘experts’ moving off shore to more favourable jurisdictions are reminiscent of the threats emanating from bankers at the time of the economic crisis of 2008 when it was suggested that the government might like to consider regulating the finance industry.

There is virtually nothing in any of these articles about the new advances in ethically uncontroversial non-embryonic stem cell therapy being made all over the world.

The British media coverage tells us much more about the state of science journalism in Britain than it does about the actual scientific facts. But we have now reached a point where most science journalists in this country writing on this issue simply mindlessly recycle press releases from the biotechnology industry or prepackaged ‘briefings’ and soundbites from the Science Media Centre.

Those who wish to know more about the actual facts will need to take their reading off shore.

The truth is that UK scientists have overhyped embryonic stem cells to a gullible public and parliament for over ten years with very little to show for it in terms of any promise of therapeutic advance. I have urged caution about their conclusions before.

I have blogged about this issue ad nauseam and won't repeat the arguments here but refer readers to my past blogs on spinal cord injury, cord blood, three parent embryos and adult stem cells where they are outlined in some detail.

If you follow the links in these blogs you will be able to access information about the science in this whole arena which you may never learn from the BBC or the press releases of British scientists whose salaries are paid by the biotechnology industry.

The case before the court was originally begun by Greenpeace in Germany.

An adviser to Greenpeace, Dr Christoph Then, said in bringing the case that the organisation was not opposed to all stem cell research: 'We do not think the opinion of the Advocate General is so clear. Our original purpose was to clarify the patent law, especially around the industrial use of embryos.'

It is the commercial exploitation of human life that bothers them. It bothers me too. And I think it would bother thousands more people too if they were able to learn the truth.

Dr Then said after the ruling: 'We wanted a fundamental decision on how the protection of human embryos is to be laid out under EU patenting law. The court has said that ethics take priority over commercial interests.'

The Anscombe Bioethics centre has welcomed the ruling as a ‘triumph of ethical standards over commercial interest’.

The ruling does not stop embryo research but it could well take the wind out of the European biotechnology industry's sails by making it no longer economically viable to fund embryonic stem cell research.

That would mean less money wasted on blind alley research by people with financial and ideological vested interests and more being invested where it is really needed for the good of all - in adult stem cell and induced pluripotent stem cell (iPS) technology.

In an opinion column in the French medical daily Le Quotidien du Médecin, Prof Claude Huriet commented earlier this year: ‘While innovations in the field of the life sciences arouse ethical reactions often regarded as obstacles to innovation, it sometimes happens that these ethical objections stimulate the imagination of researchers and finally lead to progress! Who could quarrel with that?’

This court ruling may actually prove to be the best thing that ever happened to stem cell research in Europe by closing ‘a road to nowhere’ and opening a new highway to research that is both ethical and fruitful.

The GMC is recognizing the importance of spiritual care but is still struggling to define what it actually is

The General Medical Council is about to review ‘Good Medical Practice’, its general guidance to doctors, and new draft guidance is due to be issued later this month.

Early indications are that the revised guidance will give more latitude to doctors attempting to provide whole-person healthcare (including spiritual care) but will take a harder line than at present on doctors who attempt to share their own faith with patients in the context of a consultation.

But given that there is a substantial body of evidence which suggests that religious faith benefits health, does withholding ‘spiritual care’ constitute a breach of GMC guidelines?

One doctor decided to pose exactly this question to the GMC and has given me permission to post his letter along with the reply he received.

Letter to GMC from Dr David Chaput de Saintonge

Dear Sir,

Thank you for your detailed reply to my letter of 27.5.2011.

In fact, my query was not ‘… whether doctors are permitted to offer or provide spiritual care of their patients’ though I'm pleased to note the GMC’s acceptance of this, always providing it is done sensitively.

The question I asked was when it would be allowable to contravene GMC guidelines by withholding spiritual care which is shown to be beneficial?

Of course I recognise that, as you state, the committee cannot, require doctors to offer faith-based management options. I don’t think that is the point. Your guidance on consent: patients and doctors making decisions together (Part 1; para 5) clearly states:

‘The doctor and the patient make an assessment of the patient's condition, taking into account the patient's medical history, views, experience and knowledge. The doctor uses specialist knowledge and experience in clinical judgement, and the patient's views and understanding of their condition, to identify which investigations or treatments are likely to result in overall benefit from the patient. The patient weighs up the potential benefits, risks and burdens of the various options as well as any nonclinical issues that are relevant to them. The patient decides whether to accept any of the options and, if so, which one.’

However the patient will be unable to weigh up the risks of an intervention which has not been discussed with them. They will therefore be denied the freedom of choice which your guidelines indicate they should be given and spiritual care might be wrongfully withheld.

I recognise, of course, that the doctor might consider that spiritual interventions ‘would not be of overall benefit to them’ and would advise against any such intervention.

However, according to your guidelines, this does not absolve the doctor of the responsibility taking the patient's views into account when entering into this discussion.

Clearly the doctor cannot fulfil this requirement with respect to spiritual care without ascertaining the patient's views. It would therefore seem an essential part of the assessment not just to enquire about physical, social and psychological aspects of the patient's condition, but the importance to the patient of spiritual aspect also.

Failure to do so restricts the patient's choice and is would appear to be a denial of their autonomy.

It may be I have misunderstood the GMC’s position on this. If so I'd be very grateful for your clarification.

Yours sincerely

Reply from Jane O’Brien, Assistant Director, Standards and Fitness to Practise Directorate

Dear Dr Chaput de Saintonge,

Thank you for your letter of 30 August 2011.

I think your analysis of our guidance is absolutely right, and where there is medical treatment that is clinically appropriate for the patient and likely to provide overall benefit, doctors should raise this with the patient as part of the consent process.

The more difficult issue is where the boundaries lie between medical treatment and management, which are within the expertise of doctors and properly provided by the NHS or other health funding bodies; and the provision of spiritual support and care, which is generally provided by religious or faith leaders or others with expertise in this area. The GMC does not place a duty on doctors to provide 'spiritual care' - but rather to recognise patients' need for such care and to facilitate patients’ access to it, where the patient would welcome this and is not in a position to do so him or herself.

There are some therapies that might be regarded as 'faith based', including meditation and yoga, but in general it is difficult to identify treatment options which would be available only as part of faith-based management of conditions. Where such treatment options exist, they should be discussed with patients.

I would not claim to be an expert on the research on the impact of faith or spirituality on health, but much of the most accessible evidence relates to the health benefits of practising religion or having a 'spiritual' life more generally. We encourage doctors to help patients to take an interest in their health (see paragraph 6 of Good Medical Practice), for example by talking about the benefits of lifestyle choices, such as taking exercise or losing weight. Of course, doctors can also tell patients about the evidence of the impact on health of being an active member of a faith community or otherwise engaging in a spiritual life.

Finally, the GMC fully supports a holistic view of patient care. You will see in our guidance on consent and treatment and care towards the end of life, in particular, that we encourage doctors to think about the patient’s overall needs, and to take into account their values and beliefs. You may be interested to note that as part of the review of Good Medical Practice we will be consulting shortly on changes to our guidance on good clinical care. This will include the following (additional text in bold type):

If you assess, diagnose or treat patients you must provide a good standard of clinical care: Good care will involve:

a. Adequately assessing the patient’s conditions, taking account of their history (including the symptoms, and psychological, spiritual, religious, social and cultural factors), the patient’s views, and, where necessary, examining the patient.

If you would like to be sent an alert when the consultation is launched later this month, please let me know.

Yours sincerely

Observations

The GMC letter makes a number of statements that Christian doctors will welcome, namely:

1.Where faith-based treatment options exist, they should be discussed with patients (but what does the GMC actually understand by the term 'faith-based'?)
2.The GMC fully supports a holistic view of patient care (but what does it understand by the term 'holistic'?)
3.Good care, which doctors must provide, involves taking a spiritual, cultural and religious history.

But there is still lack of clarity over whether providing information about spiritual care and access to it is a duty or an option.

On the one hand the GMC says that doctors must recognise patients’ need for spiritual care and facilitate their access to it, when they would welcome this and are not in a position to access it themselves.

On the other hand the GMC seems to give doctors an option about whether or not to tell patients about the evidence of the impact on health of being an active member of a faith community or otherwise engaging in a spiritual life.

But if patients are not aware of the benefits of faith to health then how can they be in a position to welcome spiritual care?

The GMC is moving in the right direction but needs to be clearer on its requirements so that doctors understand their duties and patients understand their rights.

Perhaps the key problem here is that while the GMC is recognizing the importance of spiritual care for health, it has not yet managed to define what spiritual care actually is. They will need help from doctors practising spiritual care on the front line to do this effectively.

I would urge Christian doctors to respond to this consultation in order to ensure that a whole person approach - including spiritual care - is universally implemented; that doctors are given freedom to practise it and that patients are given full opportunity to make use of it. A majority of patients actually want their doctors to practise whole person medicine which involves the spiritual dimension. Shouldn't that be the bottom line?