The same duty of openness that is expected of doctors in person also covers printed information such as practice leaflets. Literature must detail any treatments or procedures that you may have chosen not to provide or arrange due to a conscientious objection, but which are not otherwise prohibited. So in the case of a doctor with a conscientious objection


to termination, he or she clearly has a duty to inform the patient of the treatment options available and make the necessary arrangements for her to access the care she is entitled to. For trainees, in practical terms, this would involve discussing the matter with your GP trainer and coming to an agreement as to how to manage this situation appropriately. It is always better to discuss this hypotheticallybefore it arises in a live consultation.


A fine line And now for Mrs Brown – should the doctor disclose her faith in an attempt to support the patient through this difficult time in her life? The guidance from the GMC is very clear on this matter in warning doctors that they must not talk to patients about their personal beliefs – whether they are political, religious or moral – in a way that might exploit their vulnerability or cause them distress. However it then goes on to state that, for some patients,


acknowledging their beliefs or religious practices might form an important part of a holistic approach to their care. In some cases, discussing personal beliefs in a sensitive way may be beneficial and allow the doctor to work in partnership


with the patient to address their treatment needs. But there is a fine line to be tread. On the one hand,


doctors are advised to respect patients’ rights to hold religious beliefs and to take those beliefs into account whenever they may be relevant to treatment options. But


"Personal belief must not influence assessment of clinical need"


on the other hand, doctors must respect a patient’s wishes if it is clear they do not want to discuss personal beliefs. Back when I was a trainee I was advised by my trainer


to use this gem of an open question that I have employed many times since: “Do you have a faith that would help you cope at a time like this?” This question allows the doctor to sensitively explore


the patient’s own beliefs, if they wish to share them, without imposing their own beliefs on to a patient when they are feeling most vulnerable. If Mrs Brown were to answer yes to this question, the


doctor could explore the support her faith could provide her. If she says no and has no interest in such things then that is the end of the matter. Either way her wishes are respected.


Dr Susan Gibson-Smith is a medico-legal adviser at MDDUS


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