Divided Loyalty
February 26, 2008 by athinkingman
Cardinal Cormac Murphy O’Connor, head of the Catholic Church in England and Wales, has been criticised by the British Medical Association (BMA) after he dramatically increased pressure on the private Hospital of St John and St Elizabeth, in St John’s Wood, North London, to implement a new code of Roman Catholic ethics. Members of the old board had previously been asked to resign in a dispute over the provision of advice on abortion and contraception, and gender reassignment.
The admission of a local NHS GP practice on to the hospital’s premises had distressed staunch Catholics on the board, who argued that the provision of services such as abortion and contraception would undermine the religious ethos of the hospital.
Cardinal Murphy O’Connor’s solution was to produce a code as a way of solving the dispute and maintaining the institution as a Catholic hospital. But it was opposed by the hospital’s Medical Advisory Committee and its introduction last December triggered the resignations of at least four directors, including Lord Fitzalan Howard and a GP, Dr Martin Scurr, followed a week later by the chairman, Lord Bridgeman.
The BMA are now concerned that doctors at the hospital are being required to follow two conflicting codes of ethics. The BMA code specifies that doctors may not let their own beliefs interfere with the care of patients.
While a patient would not expect to go to a Catholic hospital for an abortion, if she were pregnant and her foetus turned out to have severe abnormalities and she wanted to consider an abortion she would have the right to information and help. The General Medical Council agree that doctors with a conscientious objection to abortion are not required to refer patients for the operation but they are obliged to provide them with information to enable them to obtain treatment.
Surprisingly, a small part of me has some understanding of what Cardinal Murphy is trying to do. If you have beliefs, and the money to employ medical expertise to deliver a service in a particular way, and if people are prepared to pay for that service, then who am I to argue against it. However, the problem comes when you realize that the doctors have been trained under, and are operating under a set of ethics which put the interests of the patient rather than those of the doctor’s religion first.
If you want to operate a Catholic hospital staffed by Catholic doctors who are bound by duty only to the Catholic church, then you have to remove them from the British Medical Council, and make sure that they are trained and accredited by a hypothetical Catholic Medical Council. Such a hypothetical Council would then have to get permission from the British Medical Council to practise in this country. I doubt that they would get it because of the potential conflict of interest between their faith and the interests of the patient.
I suspect that the hospital will continue to operate - partly because of the doubtless excellent service it provides in many areas, and partly because taking on the Roman Catholic church is unlikely to be a high government priority. However, if it were a proposal for a new private hospital, and if it were unable to give categorical assurances that it would put the interests of its patients first, even above Roman Catholic dogma, I would want to stop it from being built. If Roman Catholics are able to circumvent the British Medical Council’s ethical code, it won’t be too long before other religious groups are trying to do the same. I suspect that any religious hospital which has a mythical being rather than a human one as its top priority is ultimately likely to be bad news for patients.
I don’t have any sympathy at all for the cleric. If you want to open a hospital, then you run it according to the rules set by the medical council. If you don’t want to follow those rules, then you don’t open a hospital. Do something else such as running a greengrocer’s.
What does concern me is that patients receive all the medical treatment that they need. I have no confidence that in a Catholic-run hospital patients would be fully informed of all their options if these ran counter to Catholic dogma. Doctors might just “forget” that certain remedies were available in other hospitals.
I think this points up the concern that many of us feel about the government allowing religious bodies to set up schools, hospitals and other services. Imagine the plight of the patient in a religious hospital who needs urgent treatment but cannot get it in that hospital because of a doctrinal ban. At the very least, that patient would have to be moved to another hospital and the move could prove injurious to the patient.
No, it is not acceptable for religious groups to open hospitals (or pharmacies or schools) and then refuse to provide the services that these institutions are required to provide. I think the government should provide a compulsory code for hospitals (and other institutions) and refuse a licence to any body not prepared to implement the whole of that code.
We cannot allow religious bigots to play fast and loose with people’s health and lives.
A very complicated tangle of arguments here, considering you have no health background per - say, though appreciating your own profession, which counsels many people’s complex issues,including health, I think you have a sound grasp of the difficulties surrounding this debate.
Here to summarise are my feelings.
1) A NHS GP practice within a private Catholic hospital and grounds! The hospital, if it objects with the services this practice offers, including contraception and pregnancy related services, should not have had it built in its grounds in the first place.
Now, I am confused. Were these same doctors in the Catholic hospital also having to practice at the GP centre, hence the conflict of interest? I do not understand this. Why couldn’t the two be kept separate. I suspect perhaps there were staffing and budget/contract issues but I really don’t know.
Anyway, leaving that aside, all Doctors, as far as I am aware, all fall into the BMA Code of Ethics.
Take myself for example. I can refuse to help in performing an abortion, if my conscientious beliefs say I can not, nor want to do this,either for religious or for humanity reasons. But I still would have to care for that person before and after that procedure.
It is as you say:we have a duty of care to patients, clients and put their best interests and welfare first. We can not refuse to care, only to not be actively involved in such a procedure.
You said:
“If you want to operate a Catholic hospital staffed by Catholic doctors who are bound by duty only to the Catholic church, then you have to remove them from the British Medical Council, and make sure that they are trained and accredited by a hypothetical Catholic Medical Council. Such a hypothetical Council would then have to get permission from the British Medical Council to practise in this country. I doubt that they would get it because of the potential conflict of interest between their faith and the interests of the patient.”
Absolutley right. Also:
“However, if it were a proposal for a new private hospital, and if it were unable to give categorical assurances that it would put the interests of its patients first, even above Roman Catholic dogma, I would want to stop it from being built. If Roman Catholics are able to circumvent the British Medical Council’s ethical code, it won’t be too long before other religious groups are trying to do the same. I suspect that any religious hospital which has a mythical being rather than a human one as its top priority is ultimately likely to be bad news for patients.”
I couldn’t agree with you more.
I suspect the Cardinal has tried to appease both sides. I can see what he is trying to do but it is a difficult one to call.
Above all, inspite of any difference in people’s personal beliefs, it is vital that women and men receive the care they need without prejudice, judgement and in their best interests as patients.
This is a code I wish to see remain and should be never be altered because of any faith, or religion, or one particular hospital being a Catholic institution.
[...] to subvert the British Medical Associations Code of Ethics in a Roman Catholic hospital (see Divided Loyalty). I am saddened by many other things too - his attempts to increase sectarianism by the promotion [...]