Ethics, a doctor and his hairt-beat

I had several envelopes like this delivered through my letter-box.

Immediately recognisable, even before opening, I felt my heart (‘hairt’ in Scottish) beat much faster.

I shall try and explain why.

hairt-beat

This is another pattern that I wish to present.

Alexander McCall Smith, as an admirer of my films, wrote to me about our shared interest in patterns. He recommended this book “A pattern language” which has inspired some of my recent posts:

026

The envelopes from NHS Forth Valley to my home address were always from Senior Managers and nearly always officially reminded me of “Good Medical Practice” as issued by the General Medical Council.

Here is an example from a letter from the Medical Director of NHS Forth Valley, Dr Peter Murdoch, to me dated 21st May 2014. It was part of a wider letter.  The letter made references to my “behaviour”. The letter summoned me to an “informal” meeting with the Medical Director and General Manager for NHS Forth Valley:

21-may-2014

When I was off sick, due to work stress, the Locum Consultant who covered for me, had the following experience:

annoyed & demanding

The Locum Consultant concluded that this demonstrated:

disregard

This was the Locum Consultant’s experience of the Medical Director, Dr Peter Murdoch. There was no action taken here.

three

I have many interests: interests which remind me how little I know. One of my interests is in ethics.

In my 13 years with NHS Forth Valley my ethical interests were in three broad areas.

In my time with NHS Forth Valley there was no forum to discuss ethics.

The FIRST was:Timely-can-we-do-better

It is fully accurate to say that not one of my consultant medical colleagues in NHS Forth Valley shared my advocacy for a timely approach to the diagnosis of dementia. Today it is the basis to the diagnosis of dementia across Europe

The SECOND was:
transparency1

I share the view of most ethicists and many in academia that education and research should be free of marketing. Free of any distortion created by financial incentives. I have petitioned for a Sunshine Act (or clause) for Scotland. I believe that a central, open-access register would be straightforward and not at all costly to set up.

The THIRD was:
consent

My view is that we need to consider more fully the importance of consent. Any intervention, be it a test, or a “tool”, or a treatment can have potential benefits and potential harms. These need to be shared as best as we can.

The Former Cabinet Minister for Health and Wellbeing, October 2014:

Neil-12-Oct-14

This week, the General Medical Council published:

CropperCapture[1]

This report confirmed that 54% of those doctors who committed suicide had been referred by their employers.

One response to this GMC investigation remarked:

“There is a parallel with whistleblowing here. The stress of the situation caused mental health difficulties and the person concerned is therefore dismissed as being unwell. Which comes first?”

My experience in raising ethical considerations, and thus trying to put patients first, was very difficult indeed.

I do hope other healthcare professionals, if they raise genuine concerns, will not face what I have faced for raising ethical considerations.

I see a pattern here. So did a senior NHS doctor who wrote to me recently:

“No wonder NHS doctors live in fear when threatened with the GMC for raising ethical concerns in the workplace.”

One thought on “Ethics, a doctor and his hairt-beat

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