Dilemmas facing a Christian GP
A woman in her late teens attends requesting an abortion. She is in a relationship, contraception has failed and she is six weeks pregnant. She was planning to go to college and does not feel ready for a family. Despite counselling she is adamant that she wants an abortion and I refer her to another GP. Several weeks after her abortion, she returns to see me, tearful and upset, concerned she has made the wrong decision. What would you say to her?
When it comes to responding to this difficult issue, there are a number of different perspectives:
In recent years much has been made of autonomy and the patient’s right to order her life according to her own values and desires.
The Bible teaches that all people have been made in the image of God and therefore have innate value and dignity. Although I have a degree of independence my life is not mine to do with as I please. We have a God given ability to choose and exercise free will; however, as Christians we must make choices within God-given boundaries.
General Medical Council rules
They state that doctors must make the care of the patient their first concern. While recognising that doctors have personal beliefs which affect their day-to-day practice, they state that they must be prepared to set these aside when this is necessary1,2. Unfortunately making the patient your first concern is sometimes confused with giving them whatever treatment is requested regardless of its consequences.
Under the 1967 abortion act3, doctors can opt out of providing an abortion due to conscientious objection. This means that I do not have to refer a patient for an abortion; however I am required to inform the patient of her right to see another doctor who is known not to hold the same conscientious objection. Is this as bad as referring the patient myself?
As a doctor, I have the privilege of discussing the situation with the patient and informing her of all the options including fostering and adoption. I often find that these mums are unaware of how developed the baby is. At twelve weeks a baby looks like a miniature human being. Talking about ‘the baby’ rather than ‘it’ can help the woman accept the reality of the situation. There are risks associated with abortion. Although medical complications do happen, more common are psychiatric problems including guilt, depression, substance abuse and suicide4. Since caring for my patients is my priority, I have a duty of care to ensure they are fully informed. This sometimes leads to the women deciding to continue with the pregnancy, but not always. Whatever their decision, they need our compassionate care.
While we are protected by law for abortion, when it comes to other medical interventions things are not so clear cut. I believe that life begins at conception; therefore any medical intervention that destroys a very early embryo would be considered an abortion. This affects my prescribing of the ‘morning after pill’ (emergency contraception) and some other forms of contraception.
A further problem is that there is no consensus among doctors as to how exactly emergency contraception works. In addition some Christians will prescribe emergency contraception believing that life starts sometime after conception. It is easy to feel pressured into doing something we later regret. We need to be honest with ourselves and come before God knowing that we have a heavenly Father who is gracious, understanding and forgiving.
We are continually confronted with the consequences of fallen human sexuality; for example, teenage sex, sexually transmitted disease, abuse, and broken relationships. The humanist dogma of harm reduction in sex education has only exacerbated the situation. How would you deal with a fifteen-year old girl requesting contraception? These are difficult areas that need to be dealt with sensitively and wisely.
A good death
An area where we are going to face increasing difficulties is at the end of life. There is growing pressure for the legalisation of euthanasia and physician assisted suicide, from the media, parliament, and various pressure groups. Euthanasia is the intentional killing of a patient when the patient’s life is felt not to be worth living. This does not include allowing terminally ill patients to die when there is nothing more that can be done to treat their illness.
Proponents of euthanasia argue in terms of compassion and the patient’s right to die. These arguments can be very seductive, but what they are really arguing for is a ‘right to have one’s life ended’5,6. These views are morally wrong as purposefully ending someone’s life is murder. They are also dangerous as they place undue pressure on the most vulnerable in society. They are also unnecessary. We have one of most developed palliative care and hospice services in the world.
As a GP I have a long-term relationship with the patients, their family and the wider community. This is particularly important when patients are coming to the end of their life. While there are occasional requests from patients and their family to just give ‘something to stop their suffering’, these are rare. More often people welcome the efforts made not only to manage their pain but also their emotional and spiritual concerns. These people are often vulnerable and may feel a burden to their loved ones. While we should not unnecessarily prolong life, neither should we hasten their death nor suggest this is a legitimate solution. Here lies the real challenge – a good death rather than a speedy death.
While these issues are important in general practice, there are many other areas where our faith and witness are tested.
This includes the challenge of dealing with the vulnerable, for example; those with psychiatric illness, drug and alcohol problems, and the elderly. Society often wants little to do with these people but as patients they can take up a disproportional amount of a GP’s time due to their complex needs. In this age of target driven medicine, it can be easy to side-line them. Christ’s attitude to the lepers, tax collectors and sinners ought to be our model.
Many of the challenges facing a Christian GP are no different from those in other professions. As Christians we should be salt and light in our workplace. How do we behave with other colleagues? Do we have a reputation for being moody and work-shy? We may be good at patient confidentiality but what about workplace gossip? Our aim should be to glorify God in all these areas.
What can you do?
Many of you reading this article will not be directly affected by these issues, but they are faced by people in your families, churches and wider communities. As Christians we need to be aware of what the Bible says and be prepared to make a stand for the truth.
Please pray for Christian GPs, that they would seek to uphold biblical values even when this may cost them their reputation or their jobs. Pray for those doctors who have strategic roles in the NHS and as government advisors, and also for those more directly involved in foetal medicine, clinical research and palliative care.
Current UK law and professional guidelines respect the right of doctors who object on grounds of conscience, but there is pressure for this to change. Pray that this freedom would be upheld.
Rosie Rees is a part-time GP and a member of Caersalem Baptist Church, St Mellons, Cardiff.
References and Useful Resources
The Christian Medical Fellowship (www.cmf.org.uk) have a number of publications on a wide range of medical ethics (CMF Files) and The Christian Institute (www.christian.org.uk) have produced some useful resources.
- GMC Good Medical Practice: Paragraph 8; 2006.
- GMC Personal Beliefs and Medical Practice: Paragraph 1; 2008.
- Abortion Act 1967.
- Dr A. Ferguson and Dr P. Saunders; 2007. CMF Files: 35 Consequences of abortion.
- Maughan; 2003. CMF Files 22: Euthanasia.