Catholic Medical Quarterly Volume 70(2) May 2020

In Haec Tempora

A letter from CMA (UK) President to all CMA (UK) members – 23rd March 2020

Corona Virus

Dermot KearneyThese are unprecedented times. As healthcare professionals, we are facing a crisis never experienced before. The experience from Italy and Spain should inform us that the crisis in the UK is only beginning and will certainly continue to accelerate in the days and weeks ahead. Many more will die despite the country’s best efforts. Many doctors and nurses and health care assistants will become seriously ill. Some will die. Possibly some members of the Catholic Medical Association (UK) will die. Yet we must face these challenges with great hope. As people of faith, we can bring consolation to so many. As Christians, we can help others to carry their crosses and to face suffering with renewed hope. We can both serve Christ by sharing in the suffering of others and we can be the face of Christ for others by our courage and sacrifices. While these may be frightening times, we know that there is no need to be afraid. We know the final outcome and are assured of the victory of Life over death.

There is a danger that some in the medical profession may use this opportunity to promote a utilitarian ideology in rationing appropriate care to those who need it.

There is a danger that some in the medical profession may use this opportunity to promote a utilitarian ideology in rationing appropriate care to those who need it. We may need to be vigilant to ensure that all patients we encounter, especially the weak and vulnerable, receive appropriate care. There is no doubt that some difficult decisions will need to be made. There will be some patients who, quite appropriately, will not be considered for, and will not receive, interventional ventilatory support for genuine reasons related to true futility. This, for example, will include patients with end-stage respiratory or cardiac failure. In many cases, such decisions to withhold invasive supportive measures will be correct and ethical, although difficult for some to accept. In some cases, patients who continue to deteriorate, despite full supportive measures initially employed, will have their supportive treatment withdrawn. Sometimes that will be the correct, although painful, decision that will need to be made.

There may be attempts, however, to deny patients appropriate treatment with decisions made on the basis of age or perceived disability or a perceived poor quality of life, even when such patients may have reasonable prospects of survival if given time with supportive therapy including invasive or non-invasive ventilatory support. Even worse, we could see cases where patients, already receiving ventilatory support, have stabilised and are considered likely to recover but who have supportive treatment withdrawn purely to allow other, perhaps younger, patients receive the assistance of the support system that has been taken from them. Those of us in a position to influence clinical decisions need to remain alert to ensure that unjust discrimination in healthcare provision is not allowed to happen.

Whatever may happen, we all need to take all possible precautions to protect our own health and lives and the health of our loved ones and colleagues. A little extra time devoted to prayer and spiritual reading will bring tremendous personal and community blessings. With churches now closed, we have been provided with a wide variety of means to continue participating in the Sacramental life of the Church through live streaming services from all over the world. We might also consider making efforts to devote more time to family prayer and perhaps some traditional devotions such as daily Rosary, Divine Mercy chaplet, personal novenas and participating in a personal manner in the planned re-dedication of England as the Dowry of Mary on Sunday 29th March.

Update on “Abortion Pill Reversal”

Since the last newsletter in August 2019 and following a positive response from the GMC, we were once again disappointed that further attempts to encourage the Royal College of Obstetricians and Gynaecologists and NHS England to support an “abortion pill reversal” programme were ignored by both of these bodies. No response from either organisation was received to the two latest letters sent to them. It is clear that no support will be forthcoming from them, possibly because of a perception that any challenge to the notion that abortion is always wanted by women in crisis pregnancy situations must be resisted. We have had an offer of support from SPUC with our plans to proceed with this programme. Following negotiations, a leaflet to be distributed to doctors throughout the UK is being developed. It will contain all of the necessary information on the background for this programme, the scientific basis for Progesterone therapy, results from studies in other jurisdictions, preparations and dosing regimens that can be effectively used, safety information and relevant references. The leaflet will be available for distribution later this year. We hope that a number of doctors in each part of the nation will be prepared to participate and offer women hope in situations where they have changed their minds about proceeding with abortion after having taken the first abortion pill, Mifepristone.

Concerns over GP contract and the issue of contraception provision

In recent months, we have been involved in discussions with the BMA and NHS England over a change in the GP contract relating to General Practice and contraception provision. In the past, contraceptive services were considered “additional” and there was no problem for individual GPs or GP practices to opt out from providing artificial contraceptive services. Last year there was a unilateral decision made, without any consultation, that contraception was no longer “additional” or optional but instead must be considered “essential” and mandatory. In effect, it meant that all GP practices must provide such services to clients if requested or should make provision for contraception to be provided by subcontracting others to provide the service. This is not acceptable to Catholic doctors working in General Practice. The problem arises particularly in instances where every doctor in a practice, or a doctor in a stand-alone practice, wishes to faithfully follow Church teaching on this matter.

In December 2019, a letter stating our concerns was sent to both the BMA and NHS England personnel responsible for formulating this “new” contract. A prompt response was received from a BMA representative and, more recently, from a representative of NHS England. The responses were somewhat sympathetic but did not adequately address our concerns. A second letter seeking further clarification and further reassurance has been sent to the BMA (with another to follow to NHS England when the virus pandemic has calmed down). Our reiterated concerns have been acknowledged but a further formal reply is awaited. We stand firm that conscience can not and will not be compromised on this issue.

Assisted suicide / euthanasia

On February 25th this year, CMA (UK) Honorary Registrar, Dr Dominic Whitehouse, delivered a very well received presentation in the Houses of Parliament on “Palliative Care not Assisted Suicide”. The event was co-sponsored by SPUC and was attended by twenty-four sitting MPs. Other parliamentarians, unable to attend, sent representatives to the meeting. Feedback from all who attended was very positive.
Following on from the Royal College of Physicians poll on the question of “assisted dying” (assisted suicide in effect) in 2019, the Royal College of General Practitioners held a similar vote among its members this year with the results revealed on March 11th. The largest group, as in the case of the RCP poll, were opposed to a change in the law (47%). The second largest group (40%) supported a change in the law to legalise assisted suicide. A small minority of 11% felt that the RCGP should adopt a position of neutrality on the issue. The remaining 2% who took the trouble to vote abstained from supporting any of the above positions. Perhaps the most significant revelation from this exercise in democracy (as with the RCP poll) is the level of apathy regarding this issue among doctors. Of 49,539 members invited to participate in the poll, only 6,674 took part. That represents a poll turn-out of 13.5%. This suggests that organisations such as the Catholic Medical Association (UK) and others who value the sanctity of life face tremendous challenges in convincing others that life is truly precious. The results of a more recent poll on this issue conducted by the BMA are still awaited.

May God Bless you all,
Stay safe and continue to be the face of Christ for all those you encounter,

Best wishes
Dermot Kearney President Catholic Medical Association (UK)