New nurses should be judged on their compassion not just their skills, according to Sir Keith Pearson, chairman of the NHS Confederation. He’s been addressing the Royal College of Nursing’s (RCN) annual conference in Harrogate, and is one of the authors of a critical report into standards of care for older people and is expected to call for big changes in the way staff are recruited.

In response to the statement Steve Fouch, Secretary of Christian Nurses and Midwives, said:

‘Sir Keith Pearson’s view, aired at the RCN National Congress today, that compassion counts as much as technical skill in nursing, should come as no surprise.
‘However, in our target dominated NHS, the human dimension of care is often the last element to be remembered. We have seen the consequences of that in a series of shocking reports from the CareQuality Commission (CQC) and the Equality & Human Rights Commission over the last twelve months.
‘As well as being compassionate to patients, we also need to be caring for our staff who are struggling to give good care with inadequate staffing, in an NHS where radical structural changes are dictated more by efficiency than compassion.
‘Christian nurses in particular need to be supported by their churches; to be caring for one another, their colleagues and managers; and showing the love of Christ to all, not just to their patients.’

Dr Peter Saunders, CEO of Christian Medical Fellowship, said:
‘We welcome this fresh emphasis on rediscovering compassion in nursing but nursing also needs to rediscover the spiritual roots that gave it compassion in the first place. Modern nursing was born in the nineteenth-century, in no small measure due to the work of Christians like Elizabeth Fry and Florence Nightingale.
‘Their revolution in the practice of nursing also included making it a more socially acceptable pursuit for women. Their response to the Christian call to care for the sick and educate neglected children provided the templates for modern daily hospital nursing. Florence Nightingale also encouraged better hygiene, improved standards and night-nursing, as well as founding the first nursing school.
‘Nurses gained professional status at the end of the century, largely thanks to thework of another Christian nurse, Ethel Bedford Fenwick, with the majority of nurses being inspired to serve by Christian ethics. Many missionary nurses such as Mother Teresa and Emma Cushman have worked tirelessly, bringing hygiene and Western medicine to the four corners of the globe.
‘You can’t create compassion in a vacuum. It has to be motivated by a worldview which supports it. Many modern nurses do not have such a worldview and so lack the passionate commitment to sacrificial care that pioneers like Fry and Nightingale possessed in such measure. Nursing needs to rediscover its Christian roots or the present crisis in care will continue.’

Posted by Andrew Horton

CMF Media Producer

The number of Washington state residents who died of physician-assisted suicide rose to 70 in 2011, up from 51 in 2010 and 36 in 2009, when the state’s Death With Dignity Act took effect.

The Washington State Dept. of Health reported in May that 103 patients requested and received lethal doses of medications from 80 different physicians in 2011.

In addition to the 70 who died after ingesting lethal drugs, 19 died of natural causes. An additional five died, but it is unclear whether they took the drugs. No reports were received for the remaining nine patients, indicating that they were still alive at year’s end.

The vast majority of the terminally ill patients who received life-ending drugs feared loss of autonomy, dignity and ability to participate in activities that make life enjoyable.

More than 90% were white, and 75% had at least some college education. Nearly 80% of the patients had cancer, said the report.

Seventy-one patients in neighbouring Oregon died of physician-assisted suicide in 2011. Since 1998, when Oregon’s first-of-its-kind law took effect, 753 patients in Oregon and Washington have died with physicians’ aid.

Just last month I highlighted the huge increase in deaths from assisted suicide in Oregon and Switzerland of 450% and 700% respectively over ten years as further evidence of the incremental extension that inevitably follows any change in the law. Washington is now showing the same pattern with almost a 100% increase in two years.

Assisted suicide thankfully remains illegal in Britain and we see only a small trickle of 15-20 Britons per year going to the Dignitas facility in Zurich to end their lives.

But with an Oregon- type law we would see 1,200 deaths annually.

It is no wonder that over 100 attempts to legalise assisted suicide in other US states have failed over the last 15 years and that Oregon and Washington remain the only states to have legalised the practice on the basis of a referendum.
Earlier this month Georgia became the latest US state to ban it.

Posted by Dr Peter Saunders

CMF Chief Executive Officer

There is an inspiring story in the Daily Mail this morning about a 21 year old mother who beat cancer after refusing to sacrifice her unborn child.

Daniella Jackson was diagnosed with a tumour in her left lung shortly before discovering she was pregnant and refused doctors’ advice to abort her child so they could operate on her.

After a difficult pregnancy she gave birth to healthy girl and then had an operation to remove the tumour along with half her lung. According to the Metro report, the tumour was a carcinoid, a slow-growing tumour with a good outcome relative to other lung tumours.

Carcinoid lung tumors generally have a better outlook than other forms of lung cancer. Persons with carcinoid lung tumors have an overall 5-year survival rate of 78%-95% and a 10-year survival rate of 77%-90%.

A year on, she is the proud mother of Rennae – her second child – and has been told that she is free of disease.

A devout Roman Catholic, Miss Jackson has said that aborting her child was never an option because of her strong faith: ‘I was always determined to have my baby. I felt such a close bond with her, I couldn’t let her go.’

Abortion to save the life of the mother makes up a miniscule fraction of the 200,000 abortions carried out each year.

In the UK it was reported in 1992 that in the first 25 years of the operation of the Abortion Act 1967 only 0.013% of all abortions were performed ‘to save the life of the mother’ and it is even questionable whether many of these required such radical action. The 2009 Abortion Statistics for England and Wales do not record any on these grounds.

Usually when the mother’s life is at risk from an ongoing pregnancy, the baby is at a viable age and so can be saved simply by bringing forward the time of delivery. However on very rare occasions doctors may say it is necessary to terminate an early mid-trimester pregnancy (13-22 weeks) in an emergency in order to save the life of the mother.

But it is so rare that many obstetricians will not see a case personally in a lifetime of practice.

Even Alan Guttmacher, former President of the pro-abortion US Planned Parenthood Federation said as long ago as 1967:

‘Today it is possible for almost any patient to be brought through pregnancy alive, unless she suffers from a fatal illness such as cancer or leukemia, and if so, abortion would be unlikely to prolong, much less save life’.

In fact, women with cancer will often forgo chemotherapy, and in this case surgery, for the sake of the baby.

Daniella did not know whether she would survive from her illness, but such was her love for her baby that she was willing to take the risk and if necessary lay down her life for her. Now she has the joy of caring for and treasuring her daughter and seeing her grow up. One day maybe, at the other end of life, it will be Rennae caring for Daniella.

I wish Daniella and Rennae all the best in their life together and pray that the strong faith in God and self-giving love that has led both to Rennae’s birth and Daniella’s survival will continue to grow.

Reading their story has encouraged me and I hope that by sharing it this testimony will be equally an encouragement to others to rejoice at how precious human life is and to thank God for his faithfulness and self-giving love in sending Jesus to lay down his life for us because he couldn’t let us go.

Jesus said, ‘Greater love has no one than this: to lay down one’s life for one’s friends’. And he demonstrated that love by going to the cross to pay the price for our sins, so that he could share not just this life, but all eternity with us. He loved us that much.

You see, at just the right time, when we were still powerless, Christ died for the ungodly. Very rarely will anyone die for a righteous person, though for a good person someone might possibly dare to die. But God demonstrates his own love for us in this: While we were still sinners, Christ died for us. (Romans 5:6-8)

Posted by Dr Peter Saunders

CMF Chief Executive Officer

A YouTube video that a young mother has created about her blind baby boy and his rare cleft palate condition has spread virally, racking up some 7 million views and delivering hundreds of personal messages of support to her Facebook and email inboxes.

In the short home made video the 25-year-old mother describes the struggles she and her husband face, with constant stares and whispers in public from strangers when they see her son.  But she also tells of the triumph of witnessing 14-month-old Christian’s giggles when people interact with him and how she knows that she did the right thing in not aborting him. She describes him as her miracle baby.

She made the video about their struggle because she wanted her son to grow up knowing he is important and knowing he has value, despite the way that he looks.

‘I’m thrilled that Christian is becoming a face and a voice for this, that beauty is so much deeper than what you look like.’ she says.

You can watch the seven minute video here.

Posted by Philippa Taylor

CMF Head of Public Policy

Today the BMA has begun to ballot members on whether to take industrial action over government pension plans. The ballot runs from 15 to 29 May on two questions – firstly whether doctors are prepared to strike, and secondly whether they are prepared to take action short of a full strike. However, the BMA has made it clear that an all-out strike is not being proposed. This is only the second such BMA ballot in the last half century. The scope of the action is likely to be limited to cancelling clinics and GP surgeries, and providing emergency cover and walk in/emergency appointment services only on the day of action.

Opinion seems to be divided amongst BMA members about whether such action is either necessary or likely to be effective in changing the Government’s proposals. Under the proposals, doctors will see their final salary pension scheme replaced with a career average one, the retirement age would also rise to 68 and contributions for the highest earning doctors could reach 14.5 per cent by 2014.

Many point out that even with these proposed changes, many doctors will not see a drastic reduction in their pensions, although for many working part time the reduction in the size of pension and the increase in contributions may be proportionally more considerable, and the rise in retirement age will affect many seeking early retirement. Others feel that, even if there were a vote in favour of industrial action (as recent polls suggest is likely), few would actually take action in practice, especially if the turnout was low (although it is hard to know how widespread this feeling is).

However, the Government is adamant that there is no better deal on the table. The BMA, meanwhile, are adamant that the current proposals are unacceptable. A deadlock has been reached, and this vote will be key in determining whether there is any mandate to put further pressure on the Government to make a better offer.

Many CMF members will be weighing up over the next couple of weeks how or whether they should vote. So let’s look once again at some of the issues around how and if Christians in the medical profession should get involved in industrial action.

To start with we need to ask the following questions (borrowing somewhat from Augustine’s ‘Just War’ theology) before going any further:

1: Is the cause just?

2: Have all other reasonable measures been exhausted?

3: Will the industrial action be of finite scope and duration (ie. will there be a clear set of boundaries

and an end point)?

4: Will it adversely affect patients and vulnerable people?

5: Will the likely outcome of the action be more beneficial than the likely outcome of not taking action (not least, is there a reasonable chance of success)?

To stand up for a just cause is always an obligation for Christians (eg. Isaiah 1:17) – although that is usually fighting a cause for the sake of those with less voice, power or privilege than ourselves. Nonetheless, if we, or our colleagues are likely to be facing significant hardships in retirement because of these new pension arrangements, then we must consider how we can act to change the situation.

But as we have blogged previously, it is hard to know if this dispute fulfils any of the above criteria – for doctors at least. Whilst it initially looked as though that those on lower salaries, such as ancillary staff and care assistants, would be disproportionally affected by these changes, it seems that the new proposals no longer affect those on the lowest incomes.

The Government remains intransigent, however, as do the unions, so it seems that all other options have been exhausted. It therefore looks unlikely that any action will have any effect on the Government, especially the modest action being proposed by the BMA (which looks unlikely to cause major problems for most patients). Whether the likely outcome of the action will leave the situation any better than before remains open to question.

Once again, I would lay out the following biblical framework for thinking through the way we approach this dispute:

Firstly, industrial relations:

Col 3:22 ‘Slaves obey your earthly masters in everything’

1 Peter 2:18 ‘Slaves, submit yourselves to your masters with all respect, not only to those who are good and considerate, but also to those who are harsh.’

1 Timothy 6:1 ‘Let all who are under a yoke as slaves regard their own masters as worthy of all honour, so that the name of God and the teachings may not be reviled’.

Philippians 2:14-16 also encourages us to not be grumblers and moaners in the workplace, but to be a positive influence.

It is clear that Paul and Peter, in writing these messages were urging slaves not just to do their jobs, but to be exemplary, going over and above the call of duty, and to have a positive attitude and spirit in so doing. While this is referring to the institution of slavery, the principles apply equally to modern employment.

Secondly, motivation:

Col 3:23-24 ‘Whatever you do, work heartily as for the Lord and not for men. Knowing that from the Lord you will receive an inheritance as your reward. You are serving the Lord Christ’.

Matt 25:40 ‘The King will reply “I tell you the truth, whatever you did for the least of these brothers of mine, you did for me”

We serve God when we serve our employers (and more importantly, our patients) well. But we are also enjoined throughout the Bible to have a concern for justice and to stand up for those who are disadvantaged or poorly treated: Isaiah 1:17 ‘Learn to do good, seek justice, correct oppression, bring justice to the fatherless, plead the widow’s cause’.

We are also called to make peace where there is conflict – Matt 5:9 ‘Blessed are the peacemakers’ – and to act with good conscience, putting others needs ahead of our own – Philippians 2:3-4 ‘Do nothing from rivalry or conceit, but in humility count others more significant than ourselves. Let each of you look not only to his own interests but also to the interest of others.’

Thirdly, our attitude to authority

In Romans 13, Paul urges the early church to see the governing authorities as instituted by God for the sake of all people, and therefore to act in obedience to them. Clearly Paul is not saying that we must go along with everything that government says and does, especially when it is clearly wrong or unjust – there are examples throughout scripture and the history of the church of God’s people challenging the authorities when they went against God’s way, and standing up for justice and righteousness in an unjust society. However we must be clear that we should not be challenging the Government unless it is failing to act in the interests of what is right and just.

So, in Christian workplace ethics, obedience and service are vital, putting the interests of others first, standing up for what is right, but seeking to honour our employers, and in so doing honour God. We serve God ultimately through serving the needs of our patients in obedience to our employers.

I would suggest that after thinking through these questions and the theological principles, there is one last question to ask when making a decision on how to vote, namely will I be honouring God in taking or not taking industrial action in this instance?

Finally, I would urge all CMF members in the BMA to vote in this ballot after weighing up these issues. To not vote is to tacitly accept the decision finally reached by the majority, but only those who actually vote can shape that final decision.

History, in the end, is only made by those who actually turn up!

Posted by Steve Fouch

CMF Head of Allied Professions Ministries

Hot on the heels of warnings last week about one in ten babies suffering birth defects after ICSI (intracytoplasmic sperm injection) come more warnings about the use of drugs in fertility treatments that is putting both women and children at real risk to their health.

In some ways neither news item should come as a great surprise as the risks of both have been known about for years. However the fertility industry is a big commercially driven, money-making business and the danger is these risks are too often downplayed or ignored.  These new reports should serve as a reminder that money appears to be putting the health of women and children at risk.

Last week a large new study from Australia found a significantly increased risk of handicap for children born using the common and popular infertility treatment, ICSI.  It found that one in ten children conceived using the fertility treatment ICSI have birth defects.

This study was widely reported in the media.  ICSI involves injecting one sperm directly through the shell of an egg and depositing it inside.  It is used when sperm quantity or quality is not sufficient to achieve fertilisation through normal intercourse. The major advantage of ICSI is that as long as some sperm can be obtained, even in very low numbers, fertilisation is possible.

The Australian research followed 1,000 babies born by IVF or ICSI for five years, and followed 500 five-year-old children who were conceived naturally. The unadjusted risk of a birth defect was 5.8% following natural conception, compared with 7.2% following IVF, and 9.9% after ICSI.

ICSI is inceasingly popular in the UK with around half of fertility treatment cycles in the UK using it.  The number of babies born in the UK through using ICSI has steadily increased since it was introduced in 1992.

The HFEA produces long-term data on fertility treatments so I did a quick calculation of their figures for numbers of live babies born using ‘micro-manipulation treament’ (99% of which are through using ICSI, none through IVF).

Between 1992-2005 there were approximately 37,800 babies born using ICSI.  It does not take a good mathematician to work out that, in the UK alone, one in ten would give a rough total of 3,700 babies born with handicap as a result of ICSI up to 2005.

The journal article warns: ‘Although the large majority of births resulting from assisted conception were free of birth defects, treatment with assisted reproductive technology was associated with an increased risk of birth defects, including cerebral palsy, as compared with spontaneous conception. In the case of ICSI, but not IVF, the increased risk of birth defects persisted after adjustment for maternal age and several other risk factors.’

So why might using ICSI carry these extra risks of handicap?

The risks mostly stem from the fact that nature no longer selects sperm – it is the embryologist in the laboratory who does this. ICSI bypasses natural selection of sperm (eliminates competition) because only one sperm is used.

The following concerns have arisen from using ICSI:

• The risks of using sperm that potentially carry genetic abnormalities; it is thought that males eligible for ICSI carry a higher rate of genetic defects.
• The risks of using sperm with structural defects: although there is no absolute evidence that a physically abnormal sperm has abnormal genes, these sperm would not normally be able to fertilise an egg.
• The potential for damage (eg. from the needle or the chemicals used in the procedure), especially damage to the chromosomes.
• the risk of introducing foreign material into the oocyte: some culture media may contain heavy metals known to be toxic to sperm.

ICSI has been described as an experiment on a large scale, using children as subjects. This new research shows that too many children are bearing the brunt of the costs of this experiment.

The other news to hit the headlines is a direct accusation that IVF clinics are putting money before safety by using aggressive fertlity drugs that put women’s and children’s health at unjustified risk. The use of high doses of drugs to stimulate the ovaries for egg production can cause ovarian hyper-stimulation syndrome (OHSS), with symptoms such as chest pains, shortness of breath and, in rare cases, kidney failure and death. It can also cause chromosomal abnormalities in the resulting embryos.

Again, this has been a long-term concern with fertility treatment but the news today is that there were almost 30,000 cases of OHSS between 1991 and 2007 in the UK, according to figures obtained from the Human Fertilisation and Embryology Authority (HFEA) in response to a request under the Freedom of Information Act.  OHSS is now one of the biggest causes of maternal mortality in England and Wales.

I’m sure the women at Cambridge University currently being directly targetted by one clinic for their eggs would think twice if they knew more about the long-term dangers to their health and fertility from these drugs.  But do they know?

These reports should be a challenge to clinics offering fertility treatments and to the regulator, the HFEA. What are their obligations to prospective parents and to children born from such procedures, when doctors know there are risks involved? Are women being told of these risks? Is money put before safety? Is data being kept hidden? Is the use of prenatal diagnosis leading to more abortions after ICSI? When IVF and ICSI children grow up, will we see lawsuits and claims for healthcare costs against doctors and clinics?

Of course fertility treatments have brought the joy of parenthood to many thousands of couples facing the hearbreak of infertility. However, the costs that come with this are ignored or dismissed by fertility clinics, and yet are paid for, with their pockets and their health, by couples desperate to conceive.  The risks from eggsploitation cannot be ignored forever.
[For some further Christian reflections on infertility treatments more generally, this blog by Peter Saunders may be of interest.]

Posted by Philippa Taylor

CMF Head of Public Policy

The fifth Millennium Development Goal (MDG) put forward by the United Nations (MDG-5) proposes to reduce the world’s maternal mortality ratio by 75%, by 2015.

But what is the best way of doing this?

International programmes sponsored by the UK and US governments, and delivered under the auspices of international organisations like the UNFPA (UN Population Fund) and IPPF (International Planned Parenthood Federation), focus on the provision of contraception and ‘safe’ abortion as key priorities.

However a new 50 year follow-up study from Chile has literally blown that hypothesis out of the water and demonstrated that the key determinant of maternal mortality is actually the educational level of women.

Furthermore, one of the most significant findings is that, contrary to widely-held assumptions, making abortion illegal in Chile did not result in an increase in maternal mortality. In fact, after abortion was made illegal in 1989, the MMR continued to decrease from 41.3 to 12.7 per 100,000 live births (69.2% reduction).

The result is that Chile is now doing better with maternal mortality than the United States.

Chile offers an opportunity to investigate the influence of these determinants on maternal mortality trends. Not only are large time series of vital and socioeconomic data available for this country that are of similar quality to those of developed countries, but legislation prohibiting therapeutic abortion was passed in 1989.

As a result, data from Chile provide a rare and unique natural experiment to evaluate the influence of population factors, the legal status of abortion and other historical policies on maternal mortality trends since data are available before and after interventions were implemented.

Another recent report has shown how Ireland and Northern Ireland benefit significantly from their near complete ban on abortion in a number of ways.

The report, ‘Ireland’s Gain’, links Ireland’s low abortion rate to low incidences of breast cancer and comparative good mental health among women when compared with those in England, Scotland and Wales.

The implications for international policy are clear, but will the lavishly funded birth control and abortion industry take note?

I’ve reproduced below the press release from AAPLOG about the Chilean study which gives more of the detail.

Chile Outperforms US and Dramatically Reduces Maternal Deaths by Increasing Women’s Educational Level

A scientific analysis of 50 years of maternal mortality data from Chile has found that the most important factor in reducing maternal mortality is the educational level of women.

‘Educating women enhances women’s ability to access existing health care resources, including skilled attendants for childbirth, and directly leads to a reduction in her risk of dying during pregnancy and childbirth,’ according to Dr Elard Koch, epidemiologist and leading author of the study.

The research entitled ‘Women’s Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: a Natural Experiment in Chile from 1957 to 2007’ was conducted on behalf of the Chilean Maternal Mortality Research Initiative (CMMRI) and published in the Friday, May 4 issue of PLoS ONE.

Using 50 years of official data from Chile’s National Institute of Statistics (1957-2007), the authors looked at factors likely to affect maternal mortality, such as years of education, per capita income, total fertility rate, birth order, clean water supply, sanitary sewer, and childbirth delivery by skilled attendants. They also analyse the effect of historical educational and maternal health policies, including legislation that has prohibited abortion in Chile since 1989, on maternal mortality.

‘This study uncovers an ongoing “fertility paradox” in maternal health: education is the major modulator that has helped Chile to reach one of the safest motherhood in the world, but also contributes to decrease fertility, excessively delaying motherhood and puts mothers on risk because of their older age.’ Thus, an emerging problem nowadays ‘is not a question of how many children a mother has, but a question of when a mother has her children, specially the first of them’ concluded Koch.

Press Release from American Association of Pro Life Obstetricians and Gynecologists (AAPLOG)

A more complete statement on the study by the study’s author is available here

Conclusion by Elard Koch, the main author

Taken together, the Chilean natural experiment over the last fifty years suggests that the progress on maternal health in developing countries is a function of the following factors: an increase in the educational level of women, complementary nutrition for pregnant women and their children in the primary care network and schools, universal access to improved maternal health facilities (early prenatal care, delivery by skilled birth attendants, postnatal care, availability of emergency obstetric units and specialized obstetric care); changes in women’s reproductive behaviour enabling them to control their own fertility; and improvements in the sanitary system ie. clean water supply and sanitary sewer access. Furthermore, it is confirmed that women’s educational level appears to have an important modulating effect on other variables, especially promoting the utilization of maternal health facilities and modifying the reproductive behaviour. Consequently, it is proposed that these strategies outlined in different MDGs and implemented in different countries may act synergistically and rapidly to decrease maternal deaths in the developing world.

Posted by Dr Peter Saunders

CMF Chief Executive Officer

The veteran British pro-life campaigner Phyllis Bowman has died aged 85.

Bowman, who was described today as a ‘leading light of the global pro-life movement’, died peacefully this morning in Hammersmith Hospital, west London, with her family at her side.

For over 40 years she played a leading role in efforts to overturn the Abortion Act, which has claimed millions of lives since it was passed in 1967. She also fought tirelessly against efforts to legalise euthanasia in Britain.

She was a key figure in the founding of the Society for the Protection of Unborn Children (SPUC) in January 1967. In 1998 she left SPUC and went on to found Right to Life, one of Britain’s leading pro-life political lobbying organisations.

There is a list of fitting tributes to Phyllis in a Catholic Herald article posted today.

I consider it a great privilege to have known her. Phyllis’s tireless efforts against much opposition for those most vulnerable members of our society have made a huge impact and have inspired many to follow in her footsteps.

Thanks be to God for Phyllis Bowman.

Other Tributes

David Alton

Catholic Universe

Catholic Herald

Independent Catholic News

Posted by Dr Peter Saunders

CMF Chief Executive Officer

The General Medical Council, the official regulatory body for doctors, has published a leaflet in conjunction with gay rights activist group Stonewall, giving detailed advice about how to lodge a complaint against doctors who are felt to be discriminating against gay, lesbian and bisexual patients.

The leaflet, titled ‘Protecting patients: your rights as lesbian, gay and bisexual people’, has been ‘part funded’ by the Department of Health and has been published following a survey carried out by Stonewall into ‘Gay & Bisexual Men’s Health’.

Niall Dickson, the Chief Executive of the General Medical Council, has said that the leaflet ‘explains to lesbian, gay and bisexual patients what they should expect from the doctors treating them and what to do if they experience levels of care such as those detailed in the Stonewall survey’.

The new leaflet is based on an earlier draft in 2007 which has now been revised in the light of the Equality Act 2010.

It says that ‘the General Medical Council (GMC) sets out the principles of good practice in our core guidance to doctors, Good Medical Practice’ and tells doctors:

‘You must not unfairly discriminate against [patients] by allowing your personal views… about sexual orientation… to affect adversely your professional relationship with them or the treatment you provide or arrange.’

‘…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.’

It says that this latter requirement ‘applies to doctors’ personal beliefs about sexual orientation’.

The leaflet says that it is:

‘unlawful under the Equality Act 2010 for doctors to discriminate unfairly against lesbian, gay and bisexual (LGB) people and that Stonewall have told the GMC that LGB people have sometimes found that doctors have:

• failed either to examine or to respond to a patient properly, for example they have not been willing to offer a smear test to lesbians
• told others that a patient is gay, when this had nothing to do with their treatment
• refused to accept someone as a patient because of their sexuality
• made offensive or discriminatory comments about LGB sexuality’

It goes on to say that people who have experienced any of these things ‘may want to talk to someone to try to prevent it happening again’ and tells them first to ‘contact the place where (they) received care’ but also advises that ‘the GMC can take action if we need to stop doctors from practising or to restrict their practice in some way’.

It adds that ‘if you think your doctor is not fit to practise, or may be a risk to patients, then please contact us’ and gives a helpline, email and postal address.

It adds that ‘we will review it carefully and respond to you as quickly as we can’.

The leaflet concludes by reminding the reader again that ‘if you think your doctor is not fit to practise, or may be a risk to patients, then contact the GMC’.

Now let me say at the outset that I believe doctors have a duty to serve their patients according to their healthcare need without partiality or discrimination on any basis and that LGB people with illness or other health problems should be treated with the same degree of respect as anyone else.

That should go without saying.

So why should I be concerned about a leaflet like this?

My concern is that it in the current environment it will be used to make vexatious complaints against doctors who take a traditional Christian view on sexual ethics.

We have already seen an escalation of civil liberties cases under the Equality Act brought against counsellors and adoption advisors who have not wanted to participate in sexual counselling or adoption involving same-sex couples.

The referral pathways for such services often involve GPs as the first point of contact who, should they prefer not to be involved, could well become the subject of a complaint leading to an enquiry, investigation or disciplinary proceeding.

Similarly, many LGB people find traditional Christian views on sexuality offensive, and some even regard both Christianity and also the Bible as ‘homophobic’. Accordingly some might well feel that the mere expression of orthodox Christians beliefs by a doctor in any public context, inside or outside a medical consultation, warrants a complaint to the official body.

The leaflet interestingly makes no mention whatsoever of a doctor’s right to abstain from undertaking referrals on conscience grounds or to hold or express moral and other beliefs provided it is done sensitively and appropriately in spite of the fact that these rights are acknowledged in other GMC documents. This lack of balance runs the risk of making complaints even more likely.

But what concerns me most about this leaflet is the fact that one minority group (LGB people) seems to be getting special treatment from both the General Medical Council and Department of Health.

The Equality Act 2010 prohibits discrimination on the grounds of nine protected characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation.

Sexual orientation is only one of these nine protected characteristics, and yet the GMC seems not to have produced equivalent documents for any other of these protected groups. This is rather odd and arguably even discriminatory in itself.

I wonder, if asked, whether the GMC would issue similar guidance leaflets in partnership with groups representing every other of the nine protected characteristics listed in the Equality Act, and if the Department of Health would also ‘part fund’ these.

In other words could we have leaflets also for elderly people, children, disabled people, transgender people, married people, single people, people in civil partnerships, pregnant people, non-pregnant people, every racial group, every faith group, and for both men and women?

It seems a reasonable thing to ask for. I think I might ask them.

Posted by Dr Peter Saunders

CMF Chief Executive Officer

I’ve just returned from a fantastic CMF National Conference at Swanwick on the theme ‘heroes of faith’. One of the talks by Pablo Martinez focussed on the three friends of Daniel the prophet who were thrown into a fiery furnace by the King of Babylon for refusing to bow down to a statue he had made.

Three chapters later Daniel himself was cast into a lions’ den for persisting in public prayer to Yahweh after it had been made illegal.

Prayer can be a dangerous pursuit but has been featuring again in the media this week.

I’m grateful to Douglas Noble for drawing my attention to the recent Huffington Post article on the ‘Serenity Prayer’. Adopted by Alcoholics Anonymous as their theme back in the 1950s it was originally written a decade earlier by an American pastor called Reinhold Niebuhr (above).

The words are very familiar – in fact it would be fair to say it is one of the best known prayers in the English speaking world outside the Lord’s Prayer:

‘God grant me the serenity to accept the things I cannot change; courage to change the things I can;and wisdom to know the difference.’

What I did not appreciate, however, is that freedom from substance abuse was not the prayer’s original intent. The Serenity Prayer was originally prayed at the height of the war against Germany in the summer of 1943 at a morning service at Union Church in Heath, Massachusetts where Niebhur was a seasonal pastor.

His daughter, Elisabeth Sifton, author of The Serenity Prayer, Faith and Politics in Times of Peace and War wrote:

‘The Serenity Prayer addresses the inconsolable pain, loss and guilt that war inflicts on the communities that wage it; it goes to the heart of the possibilities and impossibilities of collective action for collective betterment—that is to say, to the heart of the possibilities for peace.’

Sifton told The Huffington Post that her father’s political concerns were the same as his spiritual ones:

‘to pray for the strength to change unjust, illiberal, selfish policies which gave rise to war, social unrest, and economic woe; to pray for the strength to help fashion a more fair, just, and peaceful world, and to work for that end.’

Furthermore, the original prayer was longer and contained a second verse with more explicitly Christian references:

Living one day at a time; Enjoying one moment at a time;
Accepting hardships as the pathway to peace;
Taking, as He did, this sinful world as it is, not as I would have it;
Trusting that He will make all things right if I surrender to His Will;
That I may be reasonably happy in this life and supremely happy with Him Forever in the next.
Amen.

Also in the news this week is David Drew, a Christian doctor, who was sacked in 2010 after emailing a prayer to colleagues at Walsall Manor Hospital, Walsall.

He has just lost his claim for unfair dismissal after a tribunal judge ruled that there was no place for religious references at work.

Dr David Drew, 64, told an employment tribunal that he was made to feel like a ‘religious maniac’ after sending out the prayer by St Ignatius Loyola, founder of the Jesuits, to motivate his department.

Again, St Ignatius’ prayer is one of the world’s most famous, and as Dr Drew suggested in his email, a helpful one to pray in the context of the difficulties faced by those working in the NHS:

Teach us, Good Lord
To serve you as you deserve.
To give and not count the cost.
To fight and not heed the wounds.
To toil and not to seek for rest.
To labor and not to ask for any reward
Except that of knowing that we do Your Will.
Through Jesus Christ our Lord,
Amen.

So that’s two good prayers. And the bad one?

Well that’s the new politically correct prayer of the Gloucestershire County Council, which has had all references to God removed after just three councillors objected.

‘May we find the wisdom to carry out our duties, the humanity to listen to all, the courage to do what is right and the generosity to treat each other with respect. Amen’.

Well the sentiments are OK I guess, but a prayer that is directed to no one is not a prayer at all.

As for me, I’ll use Niebuhr’s prayer with more vigour now I know its context and ending, pray Ignatius of Loyola’s prayer with more devotion and encourage those who work in the NHS to do likewise, and skip altogether the empty platitudes of Gloucester Council.

Posted by Dr Peter Saunders

CMF Chief Executive Officer