Ethical dilemmas are the essences of medicine. As doctors, we frequently have to act in our patient’s best interests; when they are confused, demented, or suicidal for example. We have to act fast, and make decisions they can’t, for their own good. At medical school great lengths are taken to prepare us for these situations and GMC guidance and the law are both very clear on this issue. This is our job, it is what we do and its preservation is what we are fighting for.

Whilst some doctors oppose taking industrial action on principle, all doctors absolutely detest it. No doctor wants to strike. In fact no worker is ever “for” industrial action, they are “against” terms and conditions. Like any industrial dispute this began simply as a renegotiation of a contract, then politics intervened and it was conflated with the delivery of a “truly 7 day NHS” election manifesto. Yet negotiations have completely broken down, the contract is being imposed and this is simply unacceptable to junior doctors. Todays sees the unprecedented withdrawal of emergency care by doctors in training, for the first time in NHS history. Despite being accused variously of greed and lassitude, when we already work around the clock and have never asked for a pay rise, it is not in anger that labour has been withdrawn. There is a big difference between passion and militancy. We care about our patients, the NHS, our training, and our future. There is no worse feeling in medicine than wondering if you are out of your depth and unprepared.

So we are left in the worst of all ethical dilemmas. Do we stand down and bear witness to the dystopian future of the NHS we feel certain is ahead, or do we stand firm, and resolute, hoping that our patients will understand that we believe we are acting in their best interest? There will be no pleasure at all, when it is too late, when the detractors and the spinners realise that we were right all along.

We have very dark days ahead, no easy path forward. If we strike we may damage trust in our profession, but if we don’t, we will see the ushering in of a poorly thought out, unplanned, and unfunded junior contract, that will undoubtedly lead to a further decline in morale and haemorrhaging of doctors from the NHS. Working for a negotiated solution must be the answer for all parties; Jeremy Hunt may be surprised what can be achieved if he agrees.

Taryn Youngstein is a junior doctor in London‎.

Competing interests: None declared.