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GMC warns GPs not to discuss personal beliefs with patients

Doctors may only discuss their personal beliefs if a patient asks or makes it clear they are receptive to it, a rewrite of the GMC’s Good Medical Practice guidance is expected to say.

The revised guidance – due to be published next month – comes after the GMC came under intense pressure to clarify its guidance on expressing personal beliefs following a controversial case where a Christian GP in Kent was given a formal warning after discussing his faith with a patient.

Previous guidance advised that doctors ‘should not normally’ discuss their personal beliefs with patients, but the new guidance approved by GMC Council last month makes it clear that doctors must not breach ‘professional boundaries’ and should restrict discussions to those that are ‘relevant to the patient’s care’.

GMC Council minutes said the regulator had had a ‘huge response’ to proposed changes to the guidance, with nearly 600 submissions to its consultation, which closed in June.

Following the response, the GMC has redrafted the guidance as part of a wider revision of Good Medical Practice due to come into force next year.

The final guidance will be published in November after final approval from the GMC chair.

The GMC claimed the guidance will protect patients’ rights and prevent offence, but critics said it would further restrict the freedom of doctors to practise as they see fit.

The GMC Council minutes said: ‘The draft guidance on personal beliefs was the only guidance to provoke a large response, and a substantial challenge to the principles on which the guidance was founded.’

The new guidance says: ‘You must be very careful not to breach the professional boundary that exists between you, and must continue to exist if the trust is to be maintained.

‘You may talk about your own personal beliefs only if a patient asks you directly about them or the patient indicates they would welcome such a discussion.’

The regulator was forced to clarify in 2009 that it endorsed ‘tactful’ offers of prayer from doctors, after the high profile case of Dr Richard Scott.

Dr Scott, who practises in Margate, was finally issued with a warning earlier this year after admitting he discussed religion as a way of helping a patient at the end of a consultation.

Dr Scott said the news marked a ‘terrible day’ for the profession.

He said: ‘If a doctor feels this is an appropriate way for a consultation to proceed, but is unable to do so unless a patient initiates this line of discussion, not only is the doctor hampered in his efforts but the patient is denied access to a proven benefit.’

But Dr Richard Vautrey, GPC deputy chair as well as a practising Methodist, welcomed the new clearer guidance on personal beliefs.

He said: ‘If a patient asked me, I would be open with them as I would be about any aspect of my own life. But I think it would have to be appropriate for that particular context.

‘You always have to be mindful of the power relationship between a doctor and a patient.’

 

What has changed?

‘You may talk about your own personal beliefs only if a patient asks you directly about them or the patient indicates they would welcome such a discussion.’

Draft version of Good Medical Practice approved by GMC Council last month

‘You should not normally discuss your personal beliefs with patients unless those beliefs are directly relevant to the patient’s care.’

Personal beliefs and medical practice – GMC guidance for doctors March 2008

Readers' comments (18)

  • I welcome this guidance - as a health professional, you should keep your personal beliefs to yourself unless the patient asks you directly. As a patient, I would be offended if any healthcare professional tried to discuss their faith with me during a consultation.

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  • This is welcome news. Doctors should not impose their religious beliefs on patients.

    The Secular Medical Forum's input to the consultation stated that:

    "The SMF and NSS are regularly contacted by patients who have been harmed by the imposition on them of somebody else’s religious belief. These harms range from relatively minor irritation at religious intrusion through offers of prayer which may cause distress to patients already upset and lacking the confidence to assert their unwillingness to participate, to denial of competent patients’ wishes at the end of their life. The harms include difficulties accessing emergency contraception and abortion services, discredited attempts to convert homosexuals to heterosexuality and the lifelong physical and emotional distress caused to many adults whose bodies were subjected to ‘religious’ or ‘cultural’ surgery to satisfy someone else’s religious or cultural beliefs"

    The full SMF document is available online:

    http://www.secularmedicalforum.org.uk/2012/06/smf-nss-response-to-gmc-consultation-on-personal-beliefs-2012/

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  • Nhsfatcat

    After a difficult consultation, a patient told me that I must have been a christian to behave and act with patience and understanding; insightful that she was a total pain! I asked her why she felt someone of another or no religion could not act in the same way- she waid it was because God must be guiding me and would only ever guide a christian. I will never divulge my faith. (I swear by the god Apollo!)

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  • Vinci Ho

    Practically , do we still have time to discuss anything else other than checking whether PHQ9 , smoking history and advices , HBA1c , urine ACR , COPD and asthma annual review etc have been done ???

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  • I'm just waiting for the day I get sued for causing upset by having a picture of my daughter on the desk.

    "But sir, the GP should have known not to have a picture of a child on his desk as my client lost her child....."

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  • I have a very strong aversion to alternative medicine and a very strong belief in science and evidence based medicine. I frequently share my views with patients. Am I at risk?

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  • I agree and happy with GMC clear guidance. I did not come across any proven evidence of benefit of religious beliefs. My understanding is if you believe in some thing you may benefit to certain extent whether it is religion or some thing else like placebo. This does not mean religion helps I dont think studies have been done as Dr Scott believes. Religion and god is controversial subject as every body is aware. Sticking to professional boundaries within evidence is non controversial and peaceful to all practitioners and patients. If they believe in religion they would have go to church, temple, mosque etc. They believed in senescence and medicine so came to GP surgery. We are sitting in surgery as doctor not as priest.

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  • I am concerned that my conversation with patients should not be censored. I am receptive to learning about my patients' religion in case it affects my care of them. I would never push my religion, but it may be relevant to certain GPs; for example, if they were unable to refer a patient for a termination because of their religious beliefs; they would at least have to explain their reason for referring them to another Doctor.
    Our consultations are private, and should be treated with respect. We have a duty of care to our patients, and religion is part of the holistic care we offer as GPs. We cannot ignore our patients' religion, just because we are told not to discuss it by the GMC. I do not wish to give treatment to patients that causes them offence. The GMC must be very careful to stay relevant in this day and age. If we cannot discuss religion with our patients, our duty of care may well be compromised. I wholeheartedly accept that I should not try to recruit patients to my religion, but I must try to understand how their religion may affect their care.

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  • ok ! how about arguing organisations such as christian aid and other charities with religious affliations cannot, throught their charitable beliefs , provide medical aid to reciepients averse to provider beliefs ?

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  • Tom Caldwell

    Well I hope this will help to make it clearer to anyone who was in doubt where the line is considered to be by our regulatory body.

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