I’ve known you for a while. We see each other when you come in with a chest infection, or some work stress, or if you’re worried about your child’s breathing. Sometimes I see your mum in the nursing home when she’s sick, and change her meds so that she’s more settled, and doesn’t get side effects, doesn’t end up in hospital. Remember the time I cried with you when your wife had a miscarriage, because we’d been through that too? Or how about the time I put it to you gently that, really, you need to try and get your weight down, because I don’t want to see you diabetic in 10 years? We respect each other. I get concerned for your health and wellbeing, and do my best to treat you to the best of my knowledge and ability.
I like to think you listen to my advice a bit, but I know it’s only advice. I understand when you’re looking an antibiotic for that viral head cold, and I try hard to explain why you don’t need it – and I hope that you don’t get annoyed when you don’t get it. Sometimes we disagree – quitting the cigarettes is so important, and you’re not ready to stop, but you can come back to me when you are. You want that unsightly lump removed from your face, but I think it’ll scar badly, and I’m not going to do it, because I’ve seen what they can end up like. We agree to disagree. It doesn’t spoil our relationship.
I am a professional. I have studied long hours for many years to gain qualifications. I have spent years working in many different jobs to gain a range of experience, so that I can treat most things which come through my door. I am wise because I’ve made many mistakes; I listen hard because I’ve ignored too many cues; I am careful because I have been careless; I am diligent because I’ve seen what happens when the job doesn’t get done. I work hard, and I usually run late because I don’t think people are 10minute-appointment-shaped. I try hard to treat every single person who comes through my door with dignity, respect, and kindness. I don’t discriminate. Every one of my patients is a human, and deserves the best I can give them.
And I am a human too. I get angry when I hear about injustice. I get tired when my kids have been up all night. I get annoyed if things don’t go to plan. I get sad whenever people tell me their worries and suffering, because I take that on board and feel their pain, if only for a while. When my patients get suddenly unwell, I am worried and concerned for them. When they die, I am sad, because it’s the end of a relationship, and it reminds me of the ultimate futility of what I do this side of glory.
I became a doctor because I firmly believed that I was called to do this work. The skills and the intelligence that I was given made me able to do this work. My faith makes me the doctor that I am – every day I spend in work is the outward manifestation of my belief in my God and my love of every single one of the creatures that He has made. I have a weighty responsibility – to care for, to treat wisely, to build up the weak, and not to harm those who are vulnerable. That faith makes me who I am. It is as inseparable from my person as my heart and lungs and brain are from my body. I am not a robot, nor a machine. I am not merely an agent of the state, tasked with improving the cardiovascular health of my patients by 0.5% over the next ten years. I am a moral agent, just as you are. There are some clinical problems which worry me deeply, and there are some situations which I find my conscience pricked. I worry about promoting poor health behaviours – if I give you more stomach tablets, then you’re not going to stop eating a fry every morning, sure you’re not? Just the same way as I take those same stomach tablets to enable me to drink five cups of coffee every morning! I worry that if I prescribe the contraceptive pill to a young teenager, she’s going to get abused by someone older. If I know that you’re cheating on your wife, but you want some Viagra tablets, am I facilitating your infidelity? Because these things are important to me, and I’ve thought about them. My actions affect the lives of people all around me, just as theirs’ affect me. But I don’t want to discriminate.
What do I do? My profession allows me to have these beliefs and concerns, and offers protection for my conscience. So when I decide that the fairest thing for my patients is not to prescribe contraception to anyone, not to prescribe Viagra to anyone, but to pass you over to my colleague down the corridor, who has a different set of beliefs and concerns, don’t think I am discriminating against you – I am doing this in order not to discriminate. I’m sorry if it makes things a bit awkward, if it delays you getting your prescription. I am not judging you. This allows me to work within the constraints of my beliefs. But what about when the condom splits, and she really doesn’t want to be pregnant again, not now, not at her age, not after last time – I feel for you, I really do. I can see the dilemma. But I’m afraid I have a dilemma too. For me, my science shows me, and my belief teaches me that, once that sperm hits the egg, what we have is a human being – another me or another you, – and I have no right or desire to harm that person. But I know that I am not the sole gatekeeper to services out there that will allow a pill to be taken that will take away your dilemma. Some of my colleagues do not have these issues – we each know where we stand, we agree to disagree – they can assist you. The pharmacist can assist you. But I have to step back momentarily.
I am not happy about abortion. Some of my patients have had abortions. Some come to me with the long term after effects of abortions. They are human too. I treat them just like I treat you – carefully and kindly. Sometimes frightened girls or women come to me about their pregnancies, and I try to reason with them, with love and gentleness, and explain what I think is best. Sometimes they listen, sometimes they don’t. I do not compel them to a particular course of action – I cannot, nor would I, if I had the power to. They already know the options that lie before them, but we talk and think and listen. If they ask my opinion, I give it; with their permission I explain why I believe what I believe. But there’s only so much that I can willingly do. If a woman wishes to end her pregnancy, then I apologise – I can’t help her with that, because my conscience would not allow it. I would have the weight of that decision on my conscience every day for the rest of my life. I would lie awake at night, regretting that decision. It would give me pain – nothing in comparison, perhaps, to the woman’s pain – because I would know, deep down, that I was responsible, if only in part, for something that I felt to be utterly dreadful. That is why I can’t give you the number for Marie Stopes. That’s why I can’t prescribe you a pill, or refer you for an abortion. But there are many others who can. I don’t agree with them, but I respect them.
All I ask is that I be respected too.