Leading Article: Doctors: a prescription for retaining our trust

Share
Related Topics
Oh, doctor, I'm in trouble. Well, goodness gracious me. For every time that certain man was standing next to Sophia Loren, a flush came to her face. Peter Sellers (for he it was) made the pulse race principally because he was a doctor, and men of medicine are sex objects. Reassuring, authoritative physicians have an erotic pull much stronger than cognate professions, such as teaching or the law. Male doctors are the stuff of white-coated fantasy, stock Mills and Boon heroes; breathless women succumb to their soothing bedside manners, in fiction at least, as to no other masculine type.

That paragraph is couched in terms of male doctors because when members of the British Medical Association debate whether to change the rule of automatic suspension when charges of sexual relations with a patient are made, they are discussing a male problem. Women doctors are not prone to seducing patients: men occasionally are.

On the surface, even men having sex with patients is not much of a problem. The number struck off because they are found to have breached professional ethics by carrying on such a relationship is a small proportion of the total number of cases. But underneath lies a more profound question, not only for doctors, but also for the other great professions: how far can and ought they to stand out against the culture and stick with rules that may seem fussy and antiquated?

The case for changing the suspension rule is not strong. In the BMA's own words, there is an emotional inequality in the relationship between a doctor and patient which can easily lead to abuse and exploitation. Patients are, by definition, vulnerable, otherwise they wouldn't be in a waiting room at all: they are not well. The fact that words such as "seduce" are a little old-fashioned in describing most modern sexual relations is immaterial: whether they are seduced, or seducing, or mutually attracted, patients need to trust their doctor, as absolutely as any human relations allow.

A female patient might say: I have entered an affair with this man in full agreement; my consultation was a mere precipitating event. But the rules do not exist for her sake. They serve other patients, other doctors and the maintenance of a general confidence in propriety. Each and every GP belongs to a class of person who, empowered to press and prod other people's bodies, must never treat consultation as the antechamber to the bedroom. Patients have a uniquely individual relationship with their doctors, not encountered in any other profession, and anything that undermines their confidence in that relationship will ultimately undermine the doctor's ability to carry out his or her work.

If a doctor and a patient do embark on a relationship outside the consulting room, there is a simple remedy: change doctor. It may even - though probably rarely - be necessary to protect doctors against patients, enabling doctors to move patients from their register where their position is threatened by a patient's compromising behaviour.

The prohibition against medical liaisons is a good one, and members of the BMA should follow their leaders' advice and reject any change, even symbolical. However, they could ask for a little more flexibility on the part of the GMC. The GMC, of course, deals only with complaints. Doctors, too, are vulnerable; they enter affairs at their peril. Injuries to the heart can be more devastating than physical ailments. The ending of an affair can be a time when, however consensual it has been, lovers are out for revenge, and the GMC is to hand. Its panels need the wisdom of Solomon to judge the nature of relationships. Clearly a doctor who has had a series of short-lived affairs with patients deserves harsher judgement than one who, at the ending of a grand and long-lasting passion, has been denounced, say, by a lover's husband. The GMC procedure exists, let us not forget, for the sake of the public's assurance. That can as easily be served by the fact that proceedings take place as by any particular punishment. Breaches of ethics can and often should be marked by knuckle- rapping and fines as much as by suspension and the ultimate sanction of forbidding a doctor to practise.

In recent years, professions have been bated and battered. Government ministers never tired, it seemed, of quoting that passage from Adam Smith about how whenever butchers and bakers or apothecaries and lawyers got together in private they were conspiring against the public's interest. That attitude corrupted health and education policy, and thwarted the Conservatives' own efforts to reform the legal system.

Professionals should not be emancipated from constraints on their costs or measures of their effectiveness. But professional autonomy, including strong influence over their own ethical standards, is one of the cornerstones of a society that is not and is never going to be dominated by the state. Most of all, we entrust professional associations with the responsibility to ensure that their members can, indeed, be trusted.

That trust runs two ways. We extend our confidence to teachers, doctors, lawyers, engineers, architects. We give them our minds, our bodies, our possessions for repair, enlightenment or better disposition. We trust the organisations to which professionals belong (less so in the case of teachers, sadly) to regulate their members. We collectively assent to generous rewards and, especially for doctors, the highest esteem. We expect in return performance and sincerity.

That warmth and esteem are precious. It is because of them that doctors are subject to tight rules about their conduct. When they debate the standards expected of their peers, members of the BMA should bear this in mind. The rules inhibit a small number of individual doctors from a kind of self-indulgence. That is a small price to pay for retaining the public's deep respect.

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

IT Security Advisor – Permanent – Surrey - £60k-£70k

£60000 - £70000 Per Annum plus excellent benefits: Clearwater People Solutions...

English Teacher (Full time from Jan - Maternity Cover)

£100 - £160 per day: Randstad Education Leeds: This good to outstanding school...

MI Analyst – Permanent – West Sussex – £25k-£35k

£25000 - £35000 Per Annum plus excellent benefits: Clearwater People Solutions...

Geography Teacher

£100 - £160 per day + mileage and expenses: Randstad Education Leeds: This out...

Day In a Page

Read Next
Abortions based solely on gender are illegal in Britain  

Abortion is safe, and it should be as available as easily as contraception

Ann Furedi
Photo issued by Flinders University of an artist's impression of a Microbrachius dicki mating scene  

One look at us Scots is enough to show how it was our fishy ancestors who invented sex

Donald MacInnes
Two super-sized ships have cruised into British waters, but how big can these behemoths get?

Super-sized ships: How big can they get?

Two of the largest vessels in the world cruised into UK waters last week
British doctors on brink of 'cure' for paralysis with spinal cord treatment

British doctors on brink of cure for paralysis

Sufferers can now be offered the possibility of cure thanks to a revolutionary implant of regenerative cells
Let's talk about loss

We need to talk about loss

Secrecy and silence surround stillbirth
Will there be an all-female mission to Mars?

Will there be an all-female mission to Mars?

Women may be better suited to space travel than men are
Oscar Pistorius sentencing: The athlete's wealth and notoriety have provoked a long overdue debate on South African prisons

'They poured water on, then electrified me...'

If Oscar Pistorius is sent to jail, his experience will not be that of other inmates
James Wharton: The former Guard now fighting discrimination against gay soldiers

The former Guard now fighting discrimination against gay soldiers

Life after the Army has brought new battles for the LGBT activist James Wharton
Ebola in the US: Panic over the virus threatens to infect President Obama's midterms

Panic over Ebola threatens to infect the midterms

Just one person has died, yet November's elections may be affected by what Republicans call 'Obama's Katrina', says Rupert Cornwell
Premier League coaches join the RSC to swap the tricks of their trades

Darling, you were fabulous! But offside...

Premier League coaches are joining the RSC to learn acting skills, and in turn they will teach its actors to play football. Nick Clark finds out why
How to dress with authority: Kirsty Wark and Camila Batmanghelidjh discuss the changing role of fashion in women's workwear

How to dress with authority

Kirsty Wark and Camila Batmanghelidjh discuss the changing role of fashion in women's workwear
New book on Joy Division's Ian Curtis sheds new light on the life of the late singer

New book on Ian Curtis sheds fresh light on the life of the late singer

'Joy Division were making art... Ian was for real' says author Jon Savage
Sean Harris: A rare interview with British acting's secret weapon

Sean Harris: A rare interview with British acting's secret weapon

The Bafta-winner talks Hollywood, being branded a psycho, and how Barbra Streisand is his true inspiration
Tim Minchin, interview: The musician, comedian and world's favourite ginger is on scorching form

Tim Minchin interview

For a no-holds-barred comedian who is scathing about woolly thinking and oppressive religiosity, he is surprisingly gentle in person
Boris Johnson's boozing won't win the puritan vote

Boris's boozing won't win the puritan vote

Many of us Brits still disapprove of conspicuous consumption – it's the way we were raised, says DJ Taylor
Ash frontman Tim Wheeler reveals how he came to terms with his father's dementia

Tim Wheeler: Alzheimer's, memories and my dad

Wheeler's dad suffered from Alzheimer's for three years. When he died, there was only one way the Ash frontman knew how to respond: with a heartfelt solo album