By Rammina Yassaie
In an unprecedent move in UK medical history the first working doctor, GP Patrick Hart, has been suspended from the medical register for 10 months following his imprisonment for actions he took to draw attention to the role of oil and gas companies in driving the climate emergency, and its associated health consequences. Two retired doctors, Dr Sarah Benn and Dr Diana Warner, who engaged in similar climate action protests were also suspended last year.
On Monday of the same week that Hart’s fitness to practice was deemed ‘impaired’ by the Medical Practitioners Tribunal Service (MPTS), it was reported that the world had entered a ‘new reality’ due to irreversible, widespread death of coral reefs resulting from human-induced climate change. On Tuesday, insurance companies announced that millions of homes would become uninsurable due to increased flooding from climate breakdown, making it likely that many UK towns would have to be abandoned. By Wednesday, independent climate advisors were warning the UK Government to prepare for increased heat waves, flooding and wildfires as a consequence of a warming world. Alongside these reports, Mary Lawlor, UN special rapporteur for human rights defenders, accused the UK government of paying lip service to climate targets while criminalising activists who were whistleblowing government inaction.
Yet this alarming reality failed to prevent the General Medical Council (GMC) from not only overlooking the well-known health consequences of the climate emergency as motivation for Hart’s actions but also claiming (as they have done for previous climate protester cases) that such actions risk undermining public confidence and trust in the profession, with zero evidence to support such a claim. Is it not reasonable to expect an institution that governs an evidence-based profession to be guided by evidence themselves?
The GMC maintained that it was Hart that ‘lacked insight’ despite their own apparent cognitive dissonance; where their actions are inconsistent with the science they claim to support. The regulator publicly recognises that the climate crisis is a health crisis, but continues to discipline the very doctors who are sounding the alarm.
It may, however, be worth noting that these are not normal cases for the Medical Practitioners Tribunal Service to investigate. Rarely do fitness to practice proceedings involve doctors who have unblemished clinical practice records and whose sole motivations for their actions are an expression of conscience, driven by a sharp sense of moral imperative to act on what has been described by scientists as ‘the greatest threat to human health’. The outcomes of these cases therefore expose moral failings in medical regulatory processes which are clearly not designed to deal with cases of doctors who act for a purpose higher than themselves. Attention has already been drawn to the deep flaws within existing regulatory processes with recent analysis in the BMJ identifying that the GMC ‘is being soft’ on doctors guilty of sexual assault. No reasonable person could convincingly argue that sexual predators are less of a risk to patient safety and trust in the profession than climate protesters, yet this is the inexplicable reality the GMC’s failing regulatory processes have left us in.
Instead of meaningfully reflecting on how patients are benefitting from their continued persecution of climate protesters, the GMC merely offers hollow statements about being constrained by the Medical Act which mandates automatic referral of all doctors who receive custodial sentences to the MPTS for investigation. Whilst this may be true, the GMC’s own Sanctions Guidance recognises that there may be ‘exceptional circumstances’ where no action against doctors need be taken. It is hard to work out what on Earth could be more exceptional than the collapse of essential ecosystems on which all health depends?
As the climate emergency escalates with health consequences becoming plain for all to see, the moral duty of healthcare professionals will undoubtedly come into sharper focus as their duty to act in the interests of public health will come into ever more apparent conflict with the lack of meaningful climate action by both political leaders and health institutions. This tension is already apparent with recent research from the Royal College of Physicians identifying that whilst majority of doctors are increasingly concerned about the health consequences of the climate crisis, less than 16% feel confident that health services are prepared for the devastation that lies ahead. Just as we saw escalating rates of moral injury during the pandemic, it is possible to expect healthcare professionals to similarly suffer in response to the escalating (and entirely preventable) health impacts of the climate emergency that they will have to respond to.
With the GMC positioned as an ethical compass, one would assume it would stop to consider whether its continual suspension of doctors who are whistleblowing climate inaction upholds the ethical principles at the heart of medicine and, crucially, whether it is truly acting in line with its own legal and ethical duties to protect public health. However, it seems that despite petitions, protests, open letters and statements from both the British Medical Association and the UK Health Alliance on Climate Change in support of these doctors, the medical regulator appears to have actively chosen to double down on the wrong side of history.
Author: Dr Rammina Yassaie,
Affiliation: Senior Lecturer in Leadership for Health and Social Care, Sheffield Hallam University
Contact: R.Yassaie@shu.ac.uk
Conflicts of Interest: None to declare,