By Rammina Yassaie.

Doctors with convictions from taking part in climate-related peaceful protests are at risk of being “struck off” by the General Medical Council (GMC), as tribunals are set to determine whether they can keep their license to practice.

Increasing numbers of climate-related arrests have occurred recently, with doctors engaging in non-violent direct action to draw attention to the urgent need to transition from fossil fuels.

Whilst the GMC are legally obliged to refer doctors who have been convicted of a criminal offence to the Medical Practitioners Tribunal Service for investigation, it is worth noting that over recent months, arrests for peaceful actions have been far more likely, due to draconian changes in the law, which the United Nations described as “alarming”. Moreover, yet another key defense of climate protests was lost in the Court of Appeal recently, meaning the risk of convictions for non-violent climate action continues to increase.

It’s worth noting that history tells us that neither the law, nor medical regulators are always right, with the GMC recently offering a full apology for taking regulatory action against at least 40 doctors who received criminal convictions under homophobic laws in the 1980s.

Let us now consider what might form an ethical defense of doctors facing Fitness to Practice proceedings for climate activism:

• The case of the last resort

Slow, incremental attempts to raise the alarm have been exhausted with little progress, combined with the escalating urgency expressed by scientists who have alerted us to the “rapidly closing window of opportunity to secure a liveable future for all.”

• A proportionate response to a just cause

Climate-related deaths are expected to escalate with profound generational and societal injustices of climatic events unfolding before our eyes. The survival of humanity is argued to be at risk, so any utilitarian calculation of proportionality is likely to conclude that short-term non-violent disruption from, for example, blockades, is a lower threat and proportionate response to the far greater threat of climate devastation

• A realistic chance of success

History tells us that civil disruption is a powerful tool of social change, with medical history full of examples where doctors’ engaging in such action has led to profound change, including medical women imprisoned for suffrage activities. In fact, the medical voice is trusted by the public, and there is an air of expectation that doctors should campaign on health issues.

It may be, however, that some disruptive actions are more justifiable than others, with a strong case made for greater success if sustained pressure is placed on elite sectors (such as banks) who have more power to force governments to confront the climate crisis, than members of the public going about their day.

Perhaps, there is also a responsibility of those engaged in these actions to encourage others into the movement, thereby increasing the likelihood of reaching the level of engagement (“the tipping point”) needed for social change.

• Legitimation

The Overton window is known as the window of actions that can be recommended without appearing too extreme, and the widening of the window in the climate movement is underway. The UK Health Alliance on Climate Change, which brings together representatives from royal colleges, the BMA and The BMJ has offered a welcome intervention by urging the GMC to be “lenient” to doctors facing Fitness to Practice proceedings for their climate activism and have offered a template letter for health workers to provide their employers if they are convicted for climate-related offences.

Moreover, health curriculums have incorporated ‘activism’ as part of what students may need to engage with in their professional careers, with the Allied Health Professional’s curriculum for sustainable healthcare discussing the role of “climate action and political agency” and specifically naming the role of Extinction Rebellion as having been effective in this space.

Thus, we are already seeing the shift in what may have once been deemed as radical, normalised as core business for health professionals.

When does such climate action become a duty?

GMC’s Good Medical Practice mandates doctors “take prompt action” if they think patient safety “is or may be seriously compromised” which is exactly what these protestors would claim they are doing.

Does this, along with the justification laid out above, mean that all doctors should partake in peaceful direct action? Arguably not, as it can be risky and emotive work, that may be too demanding for time-pressured individuals with varying personal circumstances. Indeed, some doctors, namely those of colour, are already unfairly penalised by both the criminal justice system and the medical regulator, so inviting them to take part when they will likely face greater consequences than their white counterparts may be unjust.

Whilst this topic requires further nuanced exploration, it seems reasonable to suggest that engaging in non-violent climate protests may be considered a “supererogatory duty” for doctors – one that could be considered morally good, given the points above, but one that cannot justifiably be seen as required by all.

Whilst the GMC have stated that doctors facing proceedings for these actions would be given the opportunity to “respond fully” to allegations made against them – let us hope, in 40 years’ time they have no need to apologise to more doctors for unjust regulatory action.

 

Author: Rammina Yassaie

Affiliations: Medical doctor, Senior Lecturer in Leadership at the Centre for Leadership in Health and Social Care, Sheffield Hallam University

Competing interests: None declared

Social Media: @ramminay