Tuesday, November 24, 2009

Irish Medical Council Ethical guidelines

The Irish Medical Council, which is the regulatory body for doctors in Ireland, has recently published the 7th Edition of its Guide to Professional Conduct and Ethics for Registered Medical Practitioners. This Guide covers many areas of medical practice, including ‘Assisted human reproduction’, ‘Abortion’, ‘End of life care’, ‘Conscientious objection’, etc.

The Life Institute (Ireland) says that the new guidelines, referring to the X-case judgment, reflect neither the correct current legal position, nor the views of the majority of Irish doctors, and that a political agenda is being pushed through the Medical Council by political appointees. Deirdre Madden, who was appointed to the Council by Mary Harney (Minister for Health and Children), was instrumental in pushing for embryonic stem cell research in University College Cork recently. Although she is not a medical doctor (she is a law lecturer), she was the Chair of the Ethics Working Group which was responsible for drawing up the new guidelines.

Among other concerns about some of the content of the guidelines, the Life Institute draws attention to the clause stating that: ‘In exceptional circumstances, a patient under 16 might seek to make a healthcare decision on their own without the knowledge or consent of their parents.’ The Life Institute asks if this might refer to the giving of the morning-after pill to young girls without their parents’ consent?

One of the clauses under the ‘End of life care’ states: ‘You must not participate in the deliberate killing of a patient by active means.’ This sounds reassuring, but in the light of recent recommendation issued by the Law Reform Commission here, and the ongoing consultations in relation to the ‘End of Life in Ireland’ forum, it is advisable to stay alert at all times!

Under ‘Assisted human reproduction’ it is stated: ‘If you offer donor programmes to patients, you must consider the biological difficulties involved and pay particular attention to the source of the donated material. Such donations should be altruistic and non-commercial. You should keep accurate records for future reference.’
The ‘donated material’ ? Apart altogether from the wrongfulness of IVF, where is the respect for human dignity – is a child to be regarded as a commodity?

The President of the Medical Council, in his address at the annual dinner of the Council in 2007, said: ‘From my earliest days as a medical student in Cork, through every day of my subsequent training, it was ingrained into me that medicine starts and centres on the doctor-patient relationship. To every medical practitioner amongst us here, it is a basic axiom that the good of our patient is our moral compass. The glue in this relationship is trust. It has underpinned medicine and found expression since the Hippocratic Oath of the fourth century BC. ’

To my knowledge, that is the only reference to the Hippocratic Oath that appears on the Medical Council website.