This article appears in the August 2007 edition of the Catholic Medical Quarterly

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The end to Britain’s leading Catholic Hospital ?

An agreement for a lease allowing the local NHS practice to operate within the hospital of St. John and Elizabeth in London has now been signed and at the recent Annual General Meeting, Lord Bridgeman (Chairman), announced that the re-structuring of Brampton House, the former nurse’s Home, was proceeding satisfactorily and it is expected that units will start moving in November. The new structures include extensions of the out patients and radiological services, together with new consulting facilities. The ground floor is allocated to the general practice which has five partners. The partners have declared publicly they will continue to refer patients for abortions, if deemed necessary, as in their opinion the Hospital’s Code of Ethics, both the old one and a newly revised version, conflicts with their NHS contract and the GMC guidelines. It seems that they have chosen not to accept that in both the NHS regulations and the GMC guidelines the only actual obligation, when a patient’s life is not imminently threatened is to inform the patient of her rights to seek another doctor who will take over her care. If this were not so it would be impossible for an orthodox Catholic, Muslim or Jewish doctor to practise as an obstetrician, gynaecologist. or general practitioner in the NHS. If the partners are not prepared to accept the Hospital’s Code their activities will include a full contraceptive service, the morning after pill and in the future abortion itself ( if direct abortions become permissible n primary care units). This would all be taking place in a Catholic Hospital.

The other great ethical issue in the Hospital which has been concentrating many members of the Guild over recent months is the question of Gender Reassignment operations (GRO’S). Evidence was presented to the management that these operations were taking place over two years ago ( the surgeon conducting the operations had admitted it to a Guild member). The chief executive denied this despite the fact that in reply to a question in the Commons the Secretary of State last year replied that St. John and St. Elizabeth’s Hospital was on the list for gender dysphoria surgery from female to male. At the recent AGM evidence was presented to the management from another ( surgeon who had served on the ethics committee ) on 18 cases operated on from May to December. Two were designated in the surgical logbook as pubic Phalloplasty and Hysterectomy. The management (who had denied that this procedure was being performed) announced that the surgeon who conducted the operations is now finishing his term at the Hospital.  Previously when challenged by the Charity Commission the Hospital claimed that phalloplasties, for reasons such as trauma , were done at the Hospital ; hysterectomies and breast removals were done elsewhere. For a woman to have a phalloplasty it is the intention that matters, and we are informed the procedure has continued this year. Surely co-operation in gender reassignment operations. which may have to be done in various stages, incurs the same ban as referrals for abortion ?

It is not just the apparent flouting of the Code of Ethics that is at issue but that the Hospital has never admitted that Gender Reassignment operations were taking place and told the Charity Commission accordingly. There has been a refusal to allow a proper independent inquiry. If the truth has not been told in this case how can the Hospital expect people to believe them on other matters?

It is now apparent that the hospital seeks to be free from their legal operations to administer the hospital in accordance with Catholic moral teaching on the grounds that it cannot survive otherwise. This was unambiguously pointed out by Professor John Finnis, a member of the Brennan Committee who advised the Cardinal on the hospital

‘ If the hospital’s management were now to seek to be free from their legal obligations to administer the hospital in accordance with Catholic moral teaching, they would be seeking to purloin it and betray the purposes of the donors and the legitimate expectations of the faithful. It would in my personal opinion be quite wrong for the Archbishop of Westminster to allow it’ The Tablet 21st April 2007

The Cardinal, in his response called for the establishment of a new Ethics Committee, upon which he placed three eminent clerics. The committee has approved a Code of Ethics little changed from the previous one. It remains strictly in compliance with Catholic Ethics and in accordance with the Cardinal’s edict of March 2006. The Medical Advisory Committee of the Hospital. A body from which all Catholics have been removed, has claimed that the Code has been uniformly rejected by the clinicians of the Hospital. The procedure by which this extraordinary claim was reached has not been revealed. As a consequence the Chairman of the Ethics Committee, Dr, Martin Scurr, informed his Committee that when the Board meets to consider the decision of the MAC they can be expected to accept it, for he says;

‘ It is to be anticipated that the Cardinal will withdraw his patronage from the hospital, and the Knights of Malta will withdraw from the campus. The hospital

will continue as a non-Catholic hospital, with a Catholic heritage, and a new Ethics Committee will subsequently be formed which must evolve a Code of Ethics which is acceptable to the secular cadre of clinicians of the hospital, in alignment with the jurisdiction of the General Medical Council

We are grateful to Dr. Scurr, who has now been promoted to the Board, for so clearly forecasting what the future of the Hospital is likely to be. Allegedly the letter was not authorised be the Chairman of the Hospital but when asked about it at the AGM he said ‘that is now in the past, it has been overtaken by events’

The management in defending their position refer to the fact that other Catholic Hospitals both in Europe and America have managed to work in a liberal fashion in regard to these problems. Lack of Catholic Consultants is often blamed and the existing consultants are not prepared to accept the Catholic Ethic. Viability is the other great point ; the hospital cannot survive without making concessions to current views.

These are weak arguments. Catholic Ethics, which after all are based on natural law. certainly raise problems in pro-Life situations but there are many other specialities in which such disagreement does not exist. It is also well established that a growing section of the population is beginning to feel safer within a hospital which respects life in all its stages. Admittedly the hospital is heavily in debt to the banks at present but it has chosen this course and the contribution from the local PCT for the general practice will not make a significant reduction of this debt. Words 1150