CR spoke with Dr Peter Saunders about the new Medical Defence Union guidance

Dr Peter Saunders

Following a number of high profile challenges and warnings given to people working in the medical profession after they'd offered prayer to their patients, the Medical Defence Union, backed by the General Medical Council, issued guidance earlier this year saying that GPs can pray with patients, as long as it's 'tactful'. To find out more Rebecca Duffett spoke with Dr Peter Saunders.

Rebecca: What does the guidance actually say?

Peter: Well, it's been issued by the Medical Defence Union which is one of the main organisations that insures doctors against malpractice and so they put out guidance about the way that doctors should behave.

This has come out in the light of the recent case of a GP, Doctor Richard Scott who refused a formal warning from the General Medical Council about a complaint that did discuss religion with a patient and the guidance MDU put out is about prayer and it's saying that GP's can pray with patients as long as it's tactful to do so.

They seem to have given an awful lot of weight to a letter from the General Medical Council in the Telegraph a couple of years ago, written by Jane O'Brien, who is the Assistant Director for standards and fitness to practice of the General Medical Council. What she said was that nothing in the GMC guidance stops doctors from praying with their patients, but it says that the focus has to be on a patient's needs and wishes and that any offer to pray, when it comes, should follow on from a discussion which establishes that the patient might be receptive and it has to be tactful, so that the patient can decline without embarrassment, if they want to.

It's really striking quite a good balance and the GMC has always been quite strong on the fact that doctors should never impose their beliefs on patients or cause distress by inappropriate or insensitive expression of their beliefs, whether those be religious or political or whatever and they shouldn't judge patients and they shouldn't normally discuss these sorts of things unless these beliefs are directly relevant to the patient's care.

On the other hand the GMC has always recognised that doctors have personal beliefs which affect their practice and that patient's have personal beliefs that affect the way they live their lives and that personal beliefs and values are central to the lives of doctors and patients and that a patients personal beliefs are fundamental to them to their sense of well-being and that discussing these sorts of things, if it is approached sensitively can really help doctors to work in partnership with patients to address their particular treatment needs.

At the Christian Medical Fellowship we're reasonably happy that this guidance is quite balanced. It gives a lot of latitude to doctors. It recognises the position of power that doctors have, but it also recognises that patients have spiritual needs. There has been a lot of emphasis recently amongst doctor's leaders about the importance of addressing spiritual care and recognising that patients are not just biological machines or clever monkey's; they are actually human beings who live with a set of relationships and ask questions about meaning and purpose and these sorts of things can have a big bearing on their health.

Rebecca: Do you think it might be quite difficult in some situations to define tactful?

Peter: The General Medical Council has always taken the view that the vast majority of doctors, whether they have faith or not, know how to talk to patients and they know where patients are at and that they can sense when it is appropriate to go ahead. Obviously there will be errors made, but I think they have always given a lot of latitude.

The GMC have had only two complaints about this sort of issue. The Medical Defence Union say that they have had only seven enquiries in the last two years or so, so it's not something that comes up very commonly at all and that suggests to me that most doctors are getting it pretty much right.

Rebecca: And perhaps those patients are quite open to prayer during treatment?

Peter: Well, two thirds of people in this country believe in God and people of course, are asking questions about meaning and purpose. A lot of illness does have its roots in spiritual factors and lifestyle choices and so part of practice in whole person care that really addresses not just physical needs but psychological, spiritual and social needs as well means being willing to go into these areas when it is appropriate to do so.

As you say, many patients do actually welcome this kind of exploration when it's done sensitively and we know from a vast amount of medical research that there are real beneficial affects for health from faith. Four out of five of over 12,000 research studies and 400 reviews and peer reviews and medical journals show that there is a positive correlation if you have a faith and most of the research has been looking at the Christian faith; that it does have, generally, good ramifications for your health and a lot of that is related to the fact that when people come to faith and come to know Jesus Christ, their lives are changed and then they make different lifestyle choices which are good for their health.

Rebecca: That sort of evidence is very encouraging that Christianity won't be pushed out of medicine.

Peter: Yes, I think Christians do worry. We are told in the New Testament aren't we both by Jesus and the apostles that we have got to expect persecution of various degrees. That there are some people who won't like our faith and they will try to discriminate against us and we have to be up for that and be faithful to Christ whatever the cost. At the same time it's encouraging to see doctor's leaders saying encouraging things about spiritual care and how important it is. In fact when this ruling came out of the Medical Defence Union, Clare Gerada who is the chairman of the Royal College of GP's, which is the largest royal college in the UK with 44,000 members, she said it's wonderful to see that good sense is prevailing at last, so she, as a person as far as I know without faith, felt that prayer, if it was done tactfully was quite an appropriate part of good whole person care and I think that's great.

Rebecca: Do you think in the future doctors will be better protected to offer prayer and we'll see less cases brought forward against people for offering it.

Peter: There will always be cases where the question's been raised about whether the lines have been crossed. There does need to be guidance about these things, but I think that when groups like the Medical Defence Union and General Medical Council put out guidance that does offer some latitude and flexibility for Christian doctors and others to move into these areas then I think that's encouraging and as long as that guidance is in place, it's going to offer protection for doctors to share faith appropriately and also for patients to be able to seek good spiritual carers out of general practice.