The Telegraph recently reported on a story about a doctor who is in trouble for talking about religion with one of his patients. The story is here - GP rapped for talking about God with patient. According to the Telegraph, Dr Scott shared his faith with thousands of patients in the past because he believes that there is a spiritual element to healing.
People visiting an NHS doctor are expecting to see just that, a doctor of medicine, a general practitioner who will diagnose the problem and prescribe conventional western medicine. They are not expecting prayer or to be referred to an alpha course. They didn’t choose to go to a faith healer, just as they didn’t choose to go to a homeopath or seek out traditional Chinese medicine. A person is of course free to choose those treatments if they so wish, but the point at which they are already talking to a doctor is not, in my opinion, the time to bring it up. A patient talking to a doctor is vulnerable and suffering, and may not make rational choices as a result. Since there is a trust relationship between patient and doctor, if a doctor suggests a treatment that is not within the bounds expected, that trust is violated.
The General Medical Council has said “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.“ Perhaps surprisingly, I believe the GMC to be wrong. I do not think that the GMC has any right to say that no doctor should ever talk to his patients about God. What I do think is that the NHS doctors should refrain from introducing any religion into the treatment. (Or anything that isn’t medicine, come to that.)
In the case of Dr Scott, it was not completely obvious that there would be a religious aspect to the treatment. In their defence, the practice stated three things:
- The name of the GP practice, Bethesda, is a biblical reference.
- There were Christian posters on the wall of the practice.
- The NHS web page for the Bethesda practice states ”The 6 Partners are all practising Christians from a variety of Churches and their faith guides the way in which they view their work and responsibilities to the patients and employees. The Partners feel that the offer of talking to you on spiritual matters is of great benefit. If you do not wish this, that is your right and will not affect your medical care. Please tell the doctor (or drop a note to the Practice Manager) if you do not wish to speak on matters of faith.“
Unfortunately, none of these reasons are adequate. The name of the surgery, Bethesda, may be obviously a bible reference, but that is only obvious to Christians. The website states that spiritual advice might be given, but even in the modern age most people would not visit the website of their doctor before visiting. Finally, although there were Christian posters on the wall of the surgery, a patient absorbed in their problems might not read or take in such posters, or might easily look down throughout their visit and miss them. In addition, someone looking for an NHS doctor would simply enquire about the nearest doctor with space on their books. An NHS helpline would happily send patients to the Bethesda doctors without anyone being aware of their religious aspects. Basically, unless the patient was read a statement informing them that they would receive Christian prayer and referrals and asked to agree to it, I would not count the surgery as having obtained proper consent.
I believe that an NHS doctor would be wrong to pray with a patient or to refer them to a religious organisation because that treatment is not within the remit of the NHS and is not funded by the NHS. An NHS doctor would certainly be wrong to introduce these treatments without consent obtained at a time when the patient is able to make an informed choice. Despite this, I disagree with the GMC in their statement that doctors may never discuss religious beliefs. If a privately funded doctor in a practice which clearly advertises their religious aspects and obtains the proper consent shares their faith with a patient, I think they are within their rights to do so. As long as the patient has had to make a conscious choice to visit that doctor while fully aware of the religious aspect, there is no problem. Because of this, I think the GMC should modify their guidance and should drop this case, but also that the doctors at the Bethesda practice must cease to offer religious treatment unless they no longer accept NHS funding and obtain full consent in advance of registration.