Consent and Ethics: Adults
Doctors have a duty to treat their patients in line with recognised best medical practice and should work in partnership with them to achieve this. Occasionally though, a patient may seek an intervention or therapy which the doctor does not agree with, or refuse all or part of an intervention which a doctor believes is essential. If this disagreement is because the doctor has assessed the treatment as not being clinically appropriate or indicated, then the law does not require that the doctor provide it. Where a doctor however objects to a treatment due to their own personal beliefs, but the therapy is a recognised intervention in the patient’s clinical condition, they may exercise their own right to conscientious objection, but must ensure that this in no way compromises or prejudices the care of the patient. Similarly if the doctor believes that a treatment is appropriate (e.g. blood transfusion in a Jehovah’s Witness patient with a very low haemoglobin) then in some circumstances the doctor may opt to not be involved in the care of that patient. The legislation governing this is covered by the Equality Act 2010 and the General Medical Council (GMC) gives clear guidance on what the duties of a doctor are when making a conscientious objection to a particular course of otherwise clinically indicated action. In all scenarios the fair and equal treatment of the patient and the provision of best care must be guaranteed.
Below are links outlining the existing legislation, the GMC and British Medical Association (BMA) stances on personal beliefs in medical practice and a balanced review looking at both sides of the arguments for and against conscientious objection in medicine:
- HM Government – The Equality Act
- Equality and Human Rights Commission – An overview of the Equality Act
- GMC – stance on personal beliefs in clinical practice
- BMA – advice on personal beliefs in clinical practice
- Savulescu J. Conscientious objection in medicine. BMJ 2006;332(7536):294-297
- Association of Anaesthetists – Guidance on anaesthesia for Jehovah’s Witnesses
- Fovargue, S; Neal, M; ‘In Good Conscience’: Conscience-Based Exemptions and Proper Medical Treatment, Medical Law Review 2015; 23(2); 221–241.