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Medical Council updates section on conscientious objection in ethical guide

The Medical Council has today issued an updated edition of its Guide to Professional Conduct and Ethics for Registered Medical Professionals. This new version amends the eighth edition of the guide, which was released in 2016, and contains revised guidance for doctors following the enactment of the Health (Regulation of Termination of Pregnancy) Act 2018.

Several sections of the guide were amended as part of the update, with key changes made to paragraph 48 (termination of pregnancy) and paragraph 49 (conscientious objection).

The guide states that termination of pregnancy is legally permissible within the provisions of the Health (Regulation of Termination of Pregnancy) Act 2018.

“You have a duty to provide care, support and follow-up for women who have had a termination of pregnancy,” according to the guide.

On conscientious objection, the guide says doctors may refuse to provide, or to participate in carrying out a procedure, lawful treatment or form of care which conflicts with their sincerely held ethical or moral values.

However, if they have a conscientious objection to a treatment or form of care, they should inform patients, colleagues, and where relevant, their employer “as soon as possible”.

As with the previous guidance, doctors holding a conscientious objection to a treatment must inform the patient they have a right to seek treatment from another doctor; and give the patient enough information to enable them to transfer to another doctor to get the treatment they want.

“When you refer a patient and/or facilitate their transfer of care, you should make sure that this is done in a safe, effective and timely manner,” according to the guide. “You should help make it as easy as possible for the patient. When discussing the referring and/or transferring of a patient’s care to another health professional, you should be sensitive and respectful so as to minimise any distress your decision may cause.” Doctors should also make sure that patients’ care is not interrupted and their access to care is not impeded.

The section on conscientious objection also states that doctors should not provide false or misleading information, or wilfully obstruct a patient’s access to treatment based on their conscientious objection.

“If the patient cannot arrange their own transfer of care, you should make these arrangements on their behalf… In an emergency situation, you must provide – as a matter of priority – the care and treatment your patient needs.”

A new ethics committee has since replaced the working group which devised this latest update, and it is examining other sections of the guide including open disclosure.

Chair of the ethics working group Dr Suzanne Crowe said, “We are pleased to publish this comprehensive resource for our doctors, and hope that the amendments in this edition will prove of value to all who use it. The majority of the amendments made are to be read from the practising of medicine point of view and not in isolation for any one procedure. The ethical guide contains guidance and information on a variety of matters which affect the medical profession on a daily basis, and we urge doctors to consult this edition for the most up-to-date, relevant and inclusive advice.”

“I wish to acknowledge the work of the ethics working group, our stakeholders for their engagement and to the wider profession for their valuable feedback during the process of revising these guidelines,” concluded Dr Crowe.

Dr Rita Doyle, Medical Council President, commented: “When the eighth edition of the guide was launched three years ago, it was envisioned that rolling changes would be incorporated to keep the Guide up to date, and this is the first of these changes. The current medical landscape can be fraught with uncertainty for doctors, and this Guide aims to clarify the Medical Council’s advice in these areas.”

The updated Guide to Professional Conduct and Ethics for Registered Medical Professionals is available for download on the Medical Council website – www.medicalcouncil.ie. ‘

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