Dr. Weeks’ Comments: Medical boards are now being attacked for over stepping their purview.
Medical Board accused of trying to silence doctors
Proposed changes to the doctors’ code of conduct have sparked a debate over their role in society, with some accusing the Medical Board of trying to silence health professionals and others concerned that cultural sensitivities will undermine patient safety.
The board wants to make a series of changes to the code, which came into effect in 2014. While its proposals were detailed in a consultation paper released six months ago, the 700 submissions in response to the review have only now been released.
One of the most contentious proposals is to expand the professionalism requirements to require doctors to consider their public comments, “acknowledge the profession’s generally accepted views and indicate when your personal opinion differs”.
“Behaviour which could undermine community trust in the profession is at odds with good medical practice and may be considered unprofessional,” the draft code states.
In a submission, the Australian Medical Association raised its concern over the move, arguing that “just because a doctor does not hold ‘the profession’s generally accepted views’ on a particular social matter does not indicate a lack of medical professionalism or substandard medical practice”.
“Many doctors do not personally agree with abortion, contraception or voluntary assisted dying,” the submission states.
The Royal Australian College of General Practitioners said it would be unreasonable for doctors to be required to routinely acknowledge where their views differ.
“The medical profession’s ‘accepted view’ is not always a clear consensus, especially given the fast evolving nature of the medical environment,” states the RACGP submission.
Catholic Health Australia suggested the proposal “could be misused to coerce doctors to act against their conscience”.
Sydney GP Pansy Lai, whose campaign against same-sex marriage attracted criticism last year, told the board personal opinions did not undermine clinical practice.
“A doctor may have a personal opinion that differs from popular cultural beliefs or the beliefs of most people in the profession, due to his or her studies and research, personal convictions, upbringing, cultural background, political leanings, or religious beliefs,” Dr Lai wrote in her submission.
A group of 54 doctors made a submission that the change could be “used against free speech and free debate on medical matters and social/cultural matters that impact good medical practice”.
The board also picked up on elements of the Nursing and Midwifery Board’s revised code of conduct referring to the need for Aboriginal and Torres Strait Islander patients to be afforded culturally safe and respectful healthcare.
That has again proved contentious and the AMA has urged the board to recognise “that a practice that is ‘culturally safe’ is not necessarily ‘medically safe’ ”.
The Royal Australasian College of Physicians suggested another rewrite so “no one considers that ‘culturally safe’ or ‘patient-centred’ could be interpreted to mean that a practitioner would be expected to accede to requests or demands for unsafe, inappropriate or illegal therapy or intervention”.
The Royal Australasian College of Medical Administrators noted the lack of guidelines for managing any conflict between safe medical practice and culturally safe medical practice, which could find a doctor in breach.
The Rural Doctors Association of Australia highlighted the cultural or religious background of doctors, saying “this is particularly challenging in areas of women’s health in some locations”.