When is a doctor not a doctor? Unpublished letter to The Daily Telegraph (25 October 2004)

When is a doctor not a doctor?

Anthony Stadlen

Copyright © Anthony Stadlen, 2004, 2020
[Unpublished letter to The Daily Telegraph, 25 October 2004]

Dr Max Pemberton writes (In psychiatry, you never get thanked’, Health and Wellbeing, 22 October): ...if you met Miss Nicholson, you’d want her to be sectioned.’
Dr Pemberton presumes to know not only what is in Miss Nicholson’s best interests’, but also what his readers would want if they were to meet his patient’. But she is not his patient, and he is not her doctor, in any ordinary medical sense. The traditional doctor-patient relationship is a voluntary, contractual one. The drawing of a stethoscope that illustrates his appeal to us to Trust me... I’m a junior doctor is deceptive. It is emblematic of a doctor’s friendly, skilled response to a patient’s request for professional advice and help.
A doctor may well be right about what is in the best interests of his patient’s health. However, in ordinary medical practice, she would be free to reject his advice, perhaps because she values some other quality, such as freedom, faith, or fun, higher than health.
If Miss Nicholson has broken any laws, then this is a matter for the law. But how can Dr Pemberton know that, because she is homeless, it is in her best interests that he incarcerate her in a home not of her choosing? Even if, in some limited respect (such as health), it could be shown that this were so, by what right does he abdicate his ethical responsibility to his patient’s autonomy? And how can he presume to know that this is what all readers of this traditionally freedom-loving newspaper would want him to do?

Anthony Stadlen

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