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Church supports guidelines on doctors’ personal beliefs

5 October 2007

The Church of England has supported General Medical Council guidelines on personal beliefs for doctors, while suggesting there could be greater recognition of the potential benefits of doctors being open about their religious beliefs and those of their patients. The suggestion comes in the response of the Church’s adviser on medical issues, Claire Foster, to the GMC’s consultation on Personal beliefs and medical practice.

“Current guidelines,” says Claire Foster, “simply call on doctors to be non-judgmental in the area of faith but being open about beliefs could encourage a greater human relationship between doctor and patient.

“The guidelines need to recognise more explicitly the distortion in a relationship where there is an imbalance of power, and help doctors operate better to equalise the imbalance. Reducing their engagement to neutrality and a rule-keeping version of professionalism are a start, but don't do enough to recognise the human factor in the healing relationship.”

 

 

Response to General Medical Council consultation on personal beliefs and medical practice from the Church of England

 

Article : Personal Beliefs and Medical Practice

1 : Do you think the guidance is clear?

Yes

: Comments

The guidelines are, overall, reasonable balanced and helpful to some extent.

2 : Is the guidance helpful in further explaining the relevant paragraphs of Good Medical Practice (paragraphs 7, 8 and 33)?

Yes

: Comments

The document, as it stands, has some gaps - it stresses that religious and other beliefs may be central to doctors' motivation and helpful to the therapeutic process but gives no guidance on how doctors can best engage with people whose beliefs differ from their own. The content is almost wholly negative in the sense that it says what doctors should and shouldn't do but not how they can best act with real professionalism as opposed to following the rule book. For example, if a doctor needs to discuss the medical implications of a patient's beliefs, is it appropriate for the doctor to reveal his/her own beliefs as part of a real human engagement? Or should the doctor maintain a façade of neutrality as if they have no beliefs? Is that what a non-judegmental approach requires? Is it the case that the doctor's beliefs should remain hidden because the doctor is in a position of power and privilege which means that they can't reveal their beliefs without being seen to push them on the patient? There's nothing in this document (except implicitly) about how the power relationship distorts the human relationship - but while it pays some attention to the human level of doctor/patient interaction, and to medical professionalism, it also seems to risk reducing professionalism to rule-keeping. In other words, the guidelines seem to be philosophically superficial - but maybe that's what you have to have if they're to be guidelines - the key may be in whether guidelines are treated as rules or as ways to get doctors to think about their practices. We fear they come to be treated as the former anyway.

: Comments

We affirm the statement about the centrality of personal beliefs in doctors' motivation but suggest that there is danger in imagining the doctor to be a deracinated, anonymous individual whose own context cannot be admitted within the relationship - again, with the safeguards that doctors are not in the relationship as the equal of the patient. The draft has got this about right, but it is a delicate matter and we would stress the risk of getting it wrong. Guidelines have a tendency to devalue the human relationship in favour of a 'safe' model of professional anonymity and neutrality. The draft reads a little as if doctors' rights and patients' rights are being balanced (we think the balance is about right) whereas a more helpful way of approaching it might be to speak openly of power, its imbalances, and the problem of abusing power - and of giving reassurance that power is not being abused.