Wednesday, 11 September 2013

In the public interest: Law and the healthcare professional

As I understand it from a quick look at the coverage of the CPS's seemingly (wait for it) bizarre decision not to prosecute doctors involved in sex-selective abortions, apparently this relates to two doctors (abortionists) who were asked to carry out terminations on the grounds of the child's sex, but did not do so and were not planning to do so. Prosecution is deemed to be not in the public interest, and better dealt with by the GMC. My Hunt has apparently referred the case to the attorney general. Leaving aside the matter of whether doctors who have not and do not intend to carry out illegal activities need to be disciplined by their regulating body I have been thinking about law, what it is for, and how healthcare professionals should and do see it.
I may be naive, but I have come to the conclusion that any laws we have should, at root, be in the public interest. Whether they protect or promote the rights of a minority, the majority; or regulate the workings of organisations; or stipulate the responsibilities of groups and individuals, all laws serve the public interest. This is not to say that I think all of our laws are right merely because they are laws, but our elected officials have made these laws on our behalf, and therefore they (the laws) presumably exist because of a belief that they are needed and are in the public interest. Therefore it is no great leap to conclude that those who break laws are not acting in the public interest. And, because of the way that the law operates, those who break laws receive some form of punishment, and perhaps the opportunity for public atonement (damages) or rehabilitation depending on the circumstances. (These consequences are, in theory, also in the public interest.) A quick flick through 1897-1927 of the Catechism reassures me that I'm working along the right lines here.
It would seem, then, that prosecuting those who break laws is in the public interest, by virtue of what law itself is. I removed the word 'always' from that sentence because I can see that spending a large amount of public money prosecuting a child who stole a bag of sweets from a supermarket would not be, and there is such a thing as legitimate protest which often necesitates a certain amount of disruption. Of course, in this case the Abortion Act, which permits abortion, is an unjust law and therefore not binding in conscience as authority has broken down (cf. CCC 1903), but I don't think that this immorality clause applies to the parts of the Act which are morally right (that is, abortion is basically illegal, according to the rule of law). I am not a lawyer or a theologian and if anyone would like to expand upon, clarify, or correct any part of this they should do so and welcome.
As an undergraduate I sat through a lot of lectures on Law relating to Pharmacy. Pharmacists are the 'guardians of medicines' and therefore at undergraduate and registration level we are required to pass exams which require intimate knowledge and understanding of the law (it should be noted that while the university standard is 40% for a pass, for the pharmacy law exams it is higher - I think 70% but I can't actually remember). The Medicines Act 1968 arose following the scandal and tragedy of thalidomide; along with the four other Acts we studied, the majority of this law is about making sure that only the people who need and/or are entitled to possess lethal, or potentially lethal, substances are able to do so. For pharmacists, and by extension for other health professionals, the law is important. And not just the law directly relating to our work: last month a pharmacist was struck off for stealing controlled drugs (codeine, morphine) to feed his own addiction, but a pharmacy technician was also suspended from the register for benefit fraud.
Healthcare professionals make life and death decisions on an hourly basis. Sometimes we pharmacists may not even realise the import of our actions, as we re-write the scrawled prescription, annotate the dose, check the patient's allergy status, cross off the duplicated items and manage the drug interactions (collectively known as 'supporting safe and effective prescribing'), but they really are that serious. We need laws which help us in and underpin those decisions because of the magnitude of those decision and the power we derive from our ability to make them. If laws are, in themselves, in the public interest then flagrant disregard of those laws by the very people who should be serving the public, in their capacity as healthcare professionals, is a grave matter indeed. Given that it is held that such people must respect the rule of law outside their professional field in order to function with integrity within their field, then surely a breach of law which impacts directly on their practice must be prosecuted in the public interest and for the public good.

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