Doctors and doctrine

[nolegion]

I am a devout Pastafarian and would most vigorously object to any GP's trying to substitute his or her beliefs for mine during a seven-and-a-half-minute-if-you-are-lucky appointment.

 

Nobody would disagree with this, surely?

 

(Ref. eg

https://docs.google.com/document/d/1IJv7fXTdzaEK8LOk3FG0AWQqVZNoygxrqy_CLy0_gi4/edit?hl=en_US)

[nolegion]

Some people imagine that if you ‘get a doctor to the General Medical Council‘, it’s like a civil trial and you can argue your case in front of it. That’s not how it works. It’s like a prosecution - but the GMC is both the prosecutor and the judge.

 

So yesterday the GMC ‘dithered’ because it’s not sure it should go on with this case if it can’t get the principal witness - the patient - to turn up. He has some personal issues including a high level of anxiety, it would appear, and has always said that nothing will induce him to attend, we are told. The case can proceed onthe basis of written testimony from him or not all. But the GMC are now going to have another go at getting him to attend. The adjournment could last for weeks if not months, and the matter may never actually proceed to ’a verdict’ at all.

 

You really would have thought that this was something the GMC would have thought about a great deal earlier.

 

This case interests me very greatly because, as I mentioned some months ago in another thread, one of the few half-satisfactory results from the Healthcare Commission (as it then was) I was ever involved with, was about exactly this: the extraordinary behaviour and fantastic arrogance of a GP towards a vulnerable man, precisely because he wanted to impress his sectarian brand of religion on him. The patient was very distressed about it indeed, but we couldn’t get the GMC interested. Lack of evidence. Patient’s word against the doctor’s. (Perhaps the PCT would want to consider whether the GP might have been a bit rude…for goodness sake)

 

That was several years ago. I wonder if much has really changed.

 

Should you share any such interest, of all the commentary with which the net was rife yesterday, this article struck me as the clearest and most sensible by a long chalk:

 

http://www.newstatesman.com/blogs/nelson-jones/2011/09/patients-scott-christian

 

and I would be very interested to learn of the experience of any other patients in such regards.

Edited September 24, 2011 by nolegion

[nolegion]

This quotation from C. S. Lewis is unashamedly filched from the astuteness of a couple of contributors at a bbc-related site where the Scott situation has been vigorously discussed:

 

“ Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It would be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end for they do so with the approval of their own conscience.”

[sophiegreece]

Greek greetings to this noble thread.

 

For noble 'tis to fight prejudice, challenge stereotypes, drag consciences from darkness into the light of logic and free will.

 

In the olden days, well, even in the sixties in our hellish Hellenic heliotropic case, when the majority of people in villages were still illiterate, they would consult the doctor, the priest or the teacher when it came to serious issues, even ones not in their jurisdiction. That status has still not been lost, it seems, and continues to plague the very sensitive relationships with the aforementioned 'servants of the people'. When in need, one tends to succumb to the power of the one with power over one's life or afterlife(!). Unfortunately, abuse may ensue.

 

I can see how some doctors, taking Wilde completely out of context, might argue: "How else but through a broken heart may Lord Christ enter in?" (Ballad of Reading Gaol, no?), and make it their business to 'save souls' rather than treat ailing bodies. The presumption!

 

 

[sophiegreece]

[This is the third time I'm trying to post this as the site keeps telling me that I'm not allowed to post links. Here it goes:]

 

Thinking of the issue at hand, I wondered whether we should post the Hippocratic Oath here. We should and here it is, in its original version (this might sound anachronistic and a tad Monty-Pythonesque but it was written 2500 years ago and in those days everyone was expected to sound quaintish) and the modern one which should be closer to our idea of the physician.

 

Oath text

 

The Hippocratic Oath has been updated by the Declaration of Geneva.. In the United Kingdom the General Medical Council provides clear modern guidance in the form of its Duties of a Doctor and Good Medical Practice statements.

Modern version

 

A widely used modern version of the traditional oath was penned in 1964 by Dr. Louis Lasagna.

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and

therapeutic nihilism

.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

 

[honeybee13]

Hello Sophie. The reason you can't post links is that you don't have the requisite number of posts here yet, I think it's 20, to stop spammers posting unwanted links on the forums.

 

My best, HB

[sophiegreece]

Thank you, Honeybee13. Now all I have to do is come up with ideas of my own for the next 16 posts, rather than steal from the ancient Greeks? Preposterous. Will do my best though.

[honeybee13]

Thank you, Honeybee13. Now all I have to do is come up with ideas of my own for the next 16 posts, rather than steal from the ancient Greeks? Preposterous. Will do my best though.

 

Hello again. I'm sure you'll find something to say .

 

I think it is better to have the oath in your last post rather than a link to it, but if you do need a link sometime before you hit the magic number of posts, someone will probably post one up for you. If I notice you need one, I'll add it.

 

My best, HB

[Sarahrookley]

Whilst speaking as a humble counsellor, rather than a Mighty GP, even we lesser practitioners are instructed from the first day of our training that we must never impose our personal beliefs, religious or otherwise, on our clients. The people who come to me, in common with many who consult their GPs, are often vulnerable, emotional and afraid. I feel strongly that any healthcare professional who sees such a fragile being as a potential "sponge" who might just be ripe for a bit of brainwashing into their personal way of thinking, would not appear to be worthy of their position.

[nolegion]

I am in the perhaps temporary but nevertheless happy position of agreeing with everything anyone has said here.

 

Taking sarahR’s professional counsellor’s point in particular, here’s a clip of a radio interview Scott gave earlier this year. What he is vigorously affirming he does (and has done ‘thousands of times’, despite complaints) seems to me a parody of that:-

 

 

Staggering. 'First, do no harm.'

[nolegion]

Further to sophieG’s posts here’s one translation of the original classical text:

 

Hippocratic Oath

 

I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses as my witnesses, that, according to my ability and judgement, I will keep this Oath and this contract:

 

To hold him who taught me this art equally dear to me as my parents, to be a partner in life with him, and to fulfill his needs when required; to look upon his offspring as equals to my own siblings, and to teach them this art, if they shall wish to learn it, without fee or contract; and that by the set rules, lectures, and every other mode of instruction, I will impart a knowledge of the art to my own sons, and those of my teachers, and to students bound by this contract and having sworn this Oath to the law of medicine, but to no others.

 

I will use those dietary regimens which will benefit mypatients according to my greatest ability and judgement, and I will do no harm or injustice to them.

 

I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.

 

In purity and according to divine law will I carry out my life and my art.

 

I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft.

 

Into whatever homes I go, I will enter them for the benefit of the sick, avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves.

 

Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to bespoken of outside, I will keep secret, as considering all such things to be private.

 

So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time. However, should I transgress this Oath and violate it, may the opposite be my fate.

 

Translated by Michael North, National Library of Medicine, 2002.

 

Note for purists. ‘First do no harm', stems from a latin tag to do with ethics (primum non nocere), not directly from para. 3 of the oath above.

Edited October 12, 2011 by nolegion

[nolegion]

“…, as a Christian, he was certain that God existed.

 

He added: “Being certain of this, it would be impossible to relate to patients pretending that science could answer their deepest needs when I am fully aware it cannot.”

 

More from the beam-me-up-Scotty GP?.

 

No. Extraordinarily, it appears that one of the prize GPs the subject of the Dispatches investigation (linked in audio-recording thread atyesterday’s date) has also been the subject of quite separate complaints from patients about his introduction of his religious views into the consulting room: Dr Mark Huckstep GP

 

See:-

 

http://www.oxfordmail.co.uk/news/9315368.Complaints_made_over_GP_s_use_of_religion/?ref=rss

 

There have clearly been significant and serious, concerns about this man over an extended period, duly referred to the various supposedly supervisory or regulatory bodies. However if you check his registration status at the GMC website there is no indication whatsoever that anything could possibly be wrong.

Edited October 28, 2011 by nolegion

[nolegion]

Dr Scott has specifically acknowledged in broadcast interview that he considers his religion superior to the (unpublished) religion of the patient concerned, and indeed told his patient that.

 

So what about Huckstep’s level of religious tolerance? Well….

 

2001

 

" Four residents who objected to plans by the Oxford Centre for Islamic Studies to construct a building in Marston on land owned by Magdalen College launched a High Court challenge last year. They were refused permission to seek judicial review of the city's decision to approve a planning application, and ordered to pay the council's legal costs - which they reckoned would be between £5,000 and £7,500.

 

Oxford put in a bill of £16,000; the residents offered £12,000, and the council then put up its bill to £21,000 - almost £1,500 of which will go to the costs draftsman retained by the council to work out the numbers

 

 

Dr Mark Huckstep, a local GP and one of the protesters, accuses councillors of trying to "crush local democracy". The council says: "If we did not pursue our costs, the burden would fall on all our council-tax payers."

 

from :

 

http://www.telegraph.co.uk/news/uknews/1330301/Brief-encounters.html

　

 

 

 

2007

 

"...a spokesman for the Central Mosque said that Muslim's [sic] also have the right to summon worshippers...

 

Dr Mark Huckster [sic], who lives in Stanton Road and works at East Oxford hospice Helen House, told the Oxford Mail: "The proposal to issue a prayer call is very un-neighbourly, especially in a crowded urban space such as Oxford.

 

"I have lived in the Middle East and a prayer call has a very different feel to church bells and I personally found the noise extremely unpleasant, rather disturbing and very alien to the western mindset…

 

… Cowley Road would have a Muslim flavour and could become a Muslim ghetto which is contrary to what we want in a multicultural society."

 

Dr Huckster was among six residents speaking in opposition to the plans, revealed in the Oxford Mail in November."

 

from:

 

http://www.thisislondon.co.uk/news/article-23429455-anger-over-plan-to-broadcast-muslim-call-to-prayer-on-loudspeaker-in-oxford.do

[grahamengineering]

OP are you the patient in question? If not I'd suggest it maybe isn't any business of yours this case. But to answer your question. The patient in question decided to attend a surgery where christianity was advertised as being disussed with the patient. They are then given the option of opting out of that disucssion.

 

Now lets have a reality check here, would I attend a Dr's appointment where the Dr wants to convert me to his way of thinking? No! But common sensw would tell me not to choose that particular surgery.

[grahamengineering]

PMSL, Just read your religious beliefs OP.

 

http://en.wikipedia.org/wiki/Flying_Spaghetti_Monster

[grahamengineering]

PMSL, Just read your religious beliefs OP.

 

http://en.wikipedia.org/wiki/Flying_Spaghetti_Monster

[nolegion]

LOL! Thank you for seeing the funny side, grahamE.

 

Happy Halloween, everyone.

 

https://docs.google.com/open?id=0B1etSkG73JvjY2Y3NDM3ODktMGJkZS00ZDY2LThiODQtOTRjY2E1NWJhNmY1

[nolegion]

After an adjournment of over 8 months, the GMC hearing of Dr Richard Scott's case is scheduled to resume today – and to last up to 4 days: -

 

http://www.kentonline.co.uk/kentonline/news/2012/june/11/dr_richard_scott.aspx

 

I understand that the patient concerned has agreed to provide evidence to the investigation committee over the telephone.

 

If the matter does in fact conclude on Thursday next, and Scott remains true to form, we will all know all about it one way or another by the end of the week, if not before. Scott is not exactly camera-shy.

[nolegion]

Scott, radio interview, 25 04 11:-

 

"My actual words were, 'You might find that Christianity offers you something more than your current faith does in this situation.' "

 

"You might describe it is as risky…"

 

"I've had a handful of complaints…"

 

 

Patient, via counsel, yesterday:-

 

Dr Richard Scott is alleged to have told the''psychologically troubled'' 24-year-old he was not going to offer him any medication but he did have a cure for the patient's ills, the General Medical Council heard.

 

Andrew Hurst, counsel for the GMC claimed the medic then told the man, known only as patient A: ''He did have a cure, which would cure him for good. His one and only hope of recovery was through Jesus.

 

''If he did not turn to Jesus and hand him his suffering he would suffer for the rest of his life.''

 

The 51-year-old GP, who has worked as a medical missionary in Kenya and Africa, is also alleged to have talked about the ''devil''and ''belittled'' his patient's non-Christian faith, adding: ''No other religion in the world can offer what Jesus can offer.

 

''Unless he turned to Jesus he would eternally suffer.''

 

http://www.telegraph.co.uk/news/religion/9327176/Christian-GP-told-patient-to-put-faith-in-Jesus-or-suffer-eternally.html

[nolegion]

The GMC have today found against Scott on matters of fact and law, and issued him with the official warning which is now open to public inspection in his registration particulars. He has been resisting this since April 2011.

 

The Investigation Committee also determined that his misconduct was only 'just below' the threshold of impairment of fitness to practice at all. (If that 'threshold' had been exceeded, the investigation committee could have referred him to a fitness to practise hearing which in turn could have struck him off for good.)

 

It is plain that the committee was not very impressed with Scott's behaviour at the hearing, e.g:-

 

"The Committee considered that while you sought to answer questions truthfully a number of your responses were in conflict with the evidence. Specifically, the Committee noted that it is unlikely that the very full record of the consultation which you made would have omitted mention of the treatment plan if it had been discussed – since this would have happened before the discussion about religion. The Committee regards it as unlikely that the discussion of your faith lasted only two and a half minutes as you contended, bearing in mind the breadth of material covered during your discussion. Furthermore, regrettably, at times you appeared to be evasive when answering questions".

 

And amongst the facts found proven was:-

 

"Paragraph 4(d):

“told Patient A that you were not offering him anything else because there is no other answer and that he will keep suffering until he is ready to hand his suffering to Jesus.”

Has been found proved

 

The Committee considered that whilst you may not have said the exact words as stated within this paragraph, you did say words to that effect. You confirmed in your oral testimony that you had said that Patient A’s condition was not amenable to standard medical treatment. This is supported by Patient A’s own testimony."

 

For once, the GMC have delivered a clear, firm message. Doctors should not behave as Scott did, and Scott is very unlikely to escape as lightly if he is caught doing it again. Scott will no doubt protest vigorously to the media about this, and it must be odds-on he will appeal to the High Court to see if he can get the decision overturned.

 

One way or another, there will in any event be a lot of (short-lived) hype and hot-air about this, no doubt, much of it stemming from those who will not have not taken the trouble to read and consider the actual case report from the GMC linked below. The wording of the formal warning appears at the end.-

 

http://webcache.gmc-uk.org/minutesfiles/Minutes%20PUBLISHABLE%202890748%20June%202012.doc