ARM TUESDAY

SPECIAL SESSION ON ABORTION AND THE CRIMINAL LAW 

A special session took place with a facilitated discussion on the role of the criminal law in the provision and administration of abortion. This was in relation to healthcare professionals and to women who procure and administer abortions for themselves.

Representatives were asked to familiarise themselves with the discussion paper Decriminalisation of abortion: a discussion paper from the BMA

Discussion Focus 1

In what if any circumstances should health professionals who participate in the provision of abortion be subject to criminal sanctions

Discussion Focus 2

In what if any circumstances should women procure and/or self-administer an abortion be subject to criminal sanctions

 

Reports were received from

BMA medical ethics committee chair (John Chisholm).

Medical Ethics Report for ARM 2017

BMA committee on community care chair (Gary Wannan).

Report from committee on community care for ARM 2017

Andrew Dearden was re-elected as BMA Treasurer

 

MOTIONS PASSED

MEDICAL ETHICS                                                                                     

Motion 50 proposed by Coral Jones THE CITY & HACKNEY DIVISION:

That this meeting:-

  1. supports the principles set out in part three of the February 2017 BMA discussion paper on decriminalisation of abortion;
  2. believes that abortion should be decriminalised in respect of health professionals administering abortions within the context of their clinical practice;
  3. believes that abortion should be decriminalised in respect of women procuring and administering the means of their own abortion;
  4. believes that decriminalisation should apply only up to viability in respect of health professionals (as a reference);
  5. believes that decriminalisation should apply only up to viability in respect of women procuring and administering the means of their own abortion (as a reference);
  6. believes that abortion should be regulated in the same way as other medical treatments.

Motion 52 proposed by Stuart Blake LOTHIAN DIVISION:

That this meeting:-

  1. believes that the Human Rights Act is fundamental to the primary role of doctors in advocating and caring for patients;
  2. urges the UK government not to repeal the Human Rights Act.

 

Motion 53 proposed by Zoe Greaves NORTH EAST REGIONAL COUNCIL:

That this meeting is concerned by limitations to healthcare provision in immigration and detention centres in the UK and calls for government:-

  1. to invest further in provision for those who must be detained; (as a reference)
  2. to limit the use of detention to only those cases where not doing so represents a threat to public order and safety; (as a reference)
  3. to replace the use of immigration detention completely with alternate more humane means of monitoring individuals facing deportation.

Chisholm discussion is of interest to Forensic Medicine Committee of which I am a member

Motion 54 proposed by Zoe Greaves NORTH EAST REGIONAL COUNCIL:

That this meeting opposes the use of isolation for children and young people who have been detained within the criminal justice system, save where such measures are used for their safety or protection, and calls for the government to similarly condemn this practice.

PROFESSIONAL REGULATION, APPRAISAL AND THE GMC 

Motion 56 proposed by Cristina Costache THE SALISBURY DIVISION:

That this meeting notes the recommendations from the review of revalidation by Sir Keith Pearson and:-

  1. particularly welcomes the recommendation that local organisations should “avoid using revalidation as a lever to achieve local objectives above and beyond the GMC’s revalidation requirements; and
  2. calls on the BMA, medical royal colleges and GMC to reflect these recommendations in their guidance on appraisal;
  3. demands that the appraisal process is made simpler and less time-consuming;
  4. requires that the revalidation process be equally accessible to all doctors, regardless of the context of their medical practise;

Peter Maguire said there has been a better consultation and working with the GMC working party. Mark Porter discussed the meeting with Sir Keith Pearson

Motion 57 proposed by Mary McCarthy WEST MIDLANDS REGIONAL COUNCIL:

That this meeting demands, following the statement from the GMC and the joint statement from the BMA and the RCGP, that the government enacts legislation such that within the Medical Register general practitioners are treated equally with doctors in other specialties and are listed as specialists in their own right.

Motion 58 proposed by Amir Landeck of the EDGWARE & HENDON DIVISION:

That this meeting, with respect to Care Quality Commission inspections, calls for:-

  1. the BMA to challenge unrealistic standards;
  2. recognition of the context and resources in which services are delivered;
  3. clarity of requirement for necessary data collection to be undertaken before the inspections.

 

COMMUNITY AND MENTAL HEALTH          

Motion 63 Motion by NORTH WEST REGIONAL COUNCIL:

That this meeting believes that mental health is in crisis, and that there has to be a root and branch review by the UK government of commissioning arrangements, beds and community provision

Motion 64 proposed by Alex Freeman SOUTH CENTRAL REGIONAL COUNCIL:

That this meeting notes that the BMA safeguarding vulnerable adults toolkit was last reviewed in 2011 and recognises that the Care Act 2014 placed adult safeguarding on a statutory footing and makes certain requirements of local authorities as the lead agency. We therefore call for:-

  1. the BMA safeguarding vulnerable adults toolkit to be updated to reflect new legislation, case law, and standardised processes as required by the Care Act 2014;
  2. the BMA to be a participant in any update of the national framework for adult safeguarding (Association of Directors of Social Services 2005).

 

The Victor Horsley Scientific Session II

This took place in the Tregonwell Hall during lunch time on Tuesday at ARM. The subject was “Emergency Medical Humanitarian assistance – is any help better than no help” given by Professor Anthony Redmond.  His bio can be found at Tony Redmond. He is Professor of International Emergency Medicine at Manchester University and President of The World Association for Disaster and Emergency Medicine (WADEM) a multidisciplinary professional association whose mission is the global improvement of prehospital and emergency health care, public health, and disaster health and preparedness. Professor Redmond is Deputy Director of HCRI See www.hcri.ac.uk and  https://wadem.org/  and facebook https://www.facebook.com/wadem.pdm/

 

Below are bullet points from his talk

  •  The popular moral belief that “any help is better than no help”, Professor Redmond identified this as  one of the causes for the severity and widespread nature of the problem.
  • That there is an ethical requirement for all healthcare workers who respond to disasters and major emergencies to ensure that what they do is evidence based, open to scientific scrutiny and framed in such a way as to reduce the vulnerability and increase the capacity of the affected communities.
  •  

    any help is not always better than no help, especially when delivering medical care, but altruism blended into skilled preparation and training can go a long way to ease the suffering of those most in need.

  • Many patients treated by these doctors undergo unnecessary procedures, such as amputation, due to a lack of specialist skill or knowledge, this is in comparison to local doctors and those who work as part of more established relief efforts.
  • The principle that Emergency Department are no longer places where those in need of training go to gain experience from those in need of care but rather those in need of care go to gain from experience of those already trained needs to be extended outward to the management of large scale international emergencies.
  • The 1988 Armenian earthquake was the first occasion were there was a request of large scale international response. INSARAG and UNDAC were formed after this.
  • INSARAG includes registration, classification,accreditation training and retraining
  • In terms of rescue
    • Most are people rescued by fellow survivors
    • Remainder resqued by local and national team
    • Few if any are rescued by international search and rescue
  •  In the Haiti earthquake the most vulnerable could not easily select what they needed
  • In the 2008 Sichuan earthquake there was the need to be authorised to practice but this was efficiently done
  • He discussed Global Health Cluster’s Foreign Medical Team Working Group regarding classifications and standards and a 2010 report were the amputation rates varied bewtween less than 5% to greater than 45%. A sad example shown of a patgient with a guillotine amputation of the leg with poor rehabilitation outcome.
  • He discussed issues of consent and authority to practice.
  • Medical teams are cost effective
  • His involvement in the response to the Typhoon in Philippines which included HMS Daring and HMS illustrious
  • The pressure to medivac patients
  • The need to work with the local health authority and incorporate local workers into the team, do not put people out of work
  • There is a GP Humaritarian Fellowship also upcoming one in Emergency Medicine
  • Registration and verification process for international medical emergency team UK-EMT
  • Can the resource be deployed nationally ? NHS passport being developed .

The Following were referred to

See also

 

 

ARM ADDITIONAL PROGRAMME

Professor Pali Hungin, BMA President gave a Presentation and led a discussion on

“The changing face of medicine and the role of doctors in the future”

(hyperlink to the report)

Pali Hungin introduces the project in BMA News

Read the news report from a recent symposium

 

Documents from yesterday’s ARM not  linked to in my blog (requires BMA membership)

Report from Armed forces committee

Report from Medical academic staff committee

 

 

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