conference in Manchester backed a statement by me, as Chairman of the Central Ethical Committee, to the effect that "if doctors refused to supply the pill or give guidance on contraception to girls under the age of 16, they could face disciplinary action by the General Medical Council," the conference was entirely concerned with the preservation of the traditional confident iality between doctor and patients in those exceptional cases in which, despite the best efforts of the doctor, the young person adamantly refuses to involve her parents in decisions about contraception.
It was in a press conference later that questions were raised about the doctor's responsibility to provide appropriate advice and treatment to a patient.
I explained that no doctor was under any obligation in normal circumstances to give advice or treatment to which he had a conscientious objection: but he should inform the patient about an alternative source of advice.
I added that only if a doctor turned a patient away without any advice at all could he be at risk of a charge of disregard of responsibility to the patient, i.e., of professional misconduct.
The interpretation placed upon my remarks has caused needless anxiety and has led to intemperate comments by critics who seem determined to misconstrue the profession's position.
To return briefly to the issue
of confidentiality, which was debated at the conference. No Catholic doctor who was present could possibly reeard the tone of the debate as threatening to those doctors who find it difficult to accept the profession's policy.
They should have been reassured by the affirmation of the doctor's responsibility to try to persuade young patients to involve their parents. It was also emphasised that the doctor must be satisfied that the patient is fully capable of understanding the situation before he prescribes any contraception.
Finally, I quote from a paper
of mine in the Journal of the Royal Society of Medicine: "There will always be exceptional cases in which breaches of confidence would be justified and the parents should be involved against the express wishes of the patient. It is inconceivable that a doctor who acted in good faith and for good reasons in such cases would be censured by his colleagues."
Alexander W. Mama University of Bristol, Bristol BS8 2PR