On 12th February 2016, the SMF responded to the above consultation run by the four Royal Colleges of Surgeons.
Our full response is available in the Resources section of this website.
The SMF expressed particular concern where the expression of a doctor’s religious beliefs has a harmful impact on a patient who might not share those beliefs.
In the surgical setting, two such examples are:
i) where the refusal by a trainee to refer or perform an abortion obstructs a patient’s necessary treatment
ii) where the decision to operate on a healthy non-consenting child for religious reasons such as ear piercing or forced genital cutting results in non-therapeutic, non-consenting permanent bodily modification; this constitutes a violation of that person’s fundamental human rights.
Our experience has been that such human rights violations are frequently justified by some parents and some doctors as somehow ‘necessary’ to the expression of the child’s parent’s religious belief.
We recommend that:
-trainees be taught that the overriding principle is that there should be no exception to general ethical principles.
– colleges and curricula are not unduly influenced by considerations of religious dogma or acquiescence with religious privilege.
-the surgical curriculum should include teaching to trainees that they may encounter a few specific areas where children are submitted to surgical procedures, such as genital surgery, ear piercing etc. which are not medically required. Trainees should be encouraged to consider these matters from an open secular viewpoint and should be taught that requests or demands for exceptions from ethical principles and practice citing religious belief should be no more valid than for any other reason and that such practices are unethical.
We note that refusal by some surgeons to perform abortions can sometimes result in a disproportionate workload falling on those surgeons who do not (initially) conscientiously object. Whilst we support the principle of conscientious objection in those areas specified in law, we recommend that:
-appropriate safeguards are put in place to guarantee continuity of service provision irrespective of the religious beliefs of surgical trainees.
-where a surgical rotation includes such work, the onus should be on the applicant to ensure that they declare any unwillingness or conscientious objection during the application process.