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A letter from Sussex Place, June 2012

Ian Currie, Honorary Secretary, writes…

In our specialty we think ethically almost everyday of our professional careers, not only because the fabric of our jobs requires us to do so, but also practicing obstetrics and gynaecology brings with it a uniqueness that challenges our feelings and emotions to the utmost. Every day there is an ethical decision to be made at work, whether that is within an antenatal clinic, oncology clinic or reproductive medicine unit. We are constantly faced on a day-to-day basis with many types of personal, moral and ethical dilemmas.

Ethical issues can actually seem very personal and intimate at times, and so one person can easily take offence by another acting in a way that the other thinks is fundamentally wrong. Even daring to suggest or hint that the other person’s viewpoint is wrong can sometimes inflame intense emotional responses! Our ethical issues can be very deeply held within; embedded and bound up with our personal ideals. Trying therefore to get a consensus statement on a difficult subject can be quite difficult when both parties’ views may be rather polarised at times.

However, the fact that we spend so much time agonising about what is the right thing to do in a situation, suggests that we think we may get it wrong some of the time. In which case, although ethical issues seem to be in some way a personal matter that each person ultimately decides for him or herself, it is not so if this means that it doesn’t matter what stance we take up externally. We all feel terrible if we have done something that we later come to think of as wrong. There is therefore a collective responsibility, a uniformity of opinion that most of us recognise. This is a kind of personal compromise or bridging the gap. Sometimes we cannot bridge that gap mentally because the personal feelings inside are so strong.

The RCOG has an ethics committee that is tasked to try and come to a collective opinion on issues that quite often provoke high emotions. It deliberates over difficult topics and then advises Council and ultimately the professional body as a whole. It is a highly skilled committee that is made up of ethicists, philosophers, lay members, clinicians and academics and sometimes getting uniformity of opinion can be rather challenging. The committee does not profess to have all the answers; moreover the discussions that take place often generate more questions than answers. Often there is no right or wrong.

Topics such as the resuscitation of the extremely premature infant, the medical care of women in detention centres, as well as female genital cosmetic surgery are amongst subject matter the committee has tackled recently. The committee itself really values the opinion of its Members and Fellows, recognising there is a vast amount of collective knowledge and experience within those clinicians that wrestle with difficult ethical issues every day of their lives. Knowing what issues are important and relevant will direct a committee such as this to assist us in helping to think through those areas of our discipline that challenge us to the limit.

If you personally have any thoughts on subjects that you feel you would like the committee to consider please channel your ideas through myself. 

Ian Currie
RCOG Honorary Secretary

If you have any comments, please write to letterfromsussexplace@rcog.org.uk