From the Revd Dr John Hare

Sir, - Before your readers rush to join the Bishop of Dover, the Rt Revd Trevor Willmott (Comment, 22 June), in his support for Dr Richard Scott and condemnation of the General Medical Council (GMC), may I ask them to consider the details of the case with great care.

As a Christian doctor and now an ordained priest, I would like to guide them through the Minutes of the Investigation Committee, which are freely accessible on the internet.

As Bishop Willmott notes, doc­tors are not forbidden to discuss their personal beliefs with their patients; far from it. No competent doctor of any faith or of none would treat a patient as "a biological specimen", as suggested by him. What the GMC guidance does state is as follows: "You must not impose your beliefs on patients, or cause distress by the inappropriate or insensitive expression of religious, political or other beliefs or views."

Also: "You must not express to your patients your personal beliefs including political, religious or moral beliefs in ways that exploit their vulnerability or that are likely to cause their distress."

These are the criteria under which Dr Scott was judged, and I suggest that they are eminently reasonable.

At the inquiry, oral evidence was heard from both the patient (Patient A) and Dr Scott. Both the GMC and Dr Scott were represented by ex­perienced barristers. While the committee agreed that both parties tried to be truthful, and that there was an understandable difference in the perception of each of what had been said, in general they considered Patient A's account to be more ac­curate. They also noted, with regret, that Dr Scott appeared evasive when answering questions.

As Bishop Willmott states, Patient A was a suicidal young man await­ing a specialist psychiatric consul­tation. It is stated that Dr Scott had not met him before, although this is slightly unclear.

The committee found the follow­ing allegations proved (the refer­ences are to the paragraphs of the allegations):

Para 4(b)(i) Dr Scott told Patient A that he would not offer him any medical help, tests or advice. Dr Scott stated he did offer medical help, but, as he made no record of this in the notes, the committee accepted the patient's recollection that no such offer was made.

Para 4(b)(ii) Dr Scott told Patient A that he had something to offer him that would cure him for good. Dr Scott accepted that he had said this.

As this was a medical consulta­tion, paid for by the NHS, I con­sider these words, which referred to religious conversion, totally in­appropriate.

Para 4(b)(iii) Dr Scott told Patient A that if he did not turn towards Jesus and hand Jesus his suffering, then he would suffer for the rest of his life. The committee found that, although these actual words might not have been used, there had been words to that effect.

I find this totally unacceptable: it is in essence a veiled threat. It also undermines any subsequent attempt by a psychiatrist to provide effective treatment.

Para 4(b)(iv) Dr Scott told Patient A that his own religion could not offer him any protection, and that no other religion in the world could offer Patient A what Jesus could offer him.

No doctor has the right to denigrate a patient's faith. Would Bishop Willmott uphold the right of a Muslim doctor to insult the faith of a Christian patient in this way?

Para 4(b)(vi) Dr Scott told Patient A that the devil haunts people who do not turn to Jesus and hand him their suffering. Again, it was agreed that might not have been the actual words, but it was noted that, when it was put to him in the hearing, Dr Scott admitted introducing the devil into the con­sultation.

To me, this is the most serious aspect of the case. These words are highly threatening, and invite this seriously disturbed young man to regard himself as devil-possessed. This action goes well beyond any limit of competent and compassion­ate medical practice.

Para 4(b)(viii) Dr Scott identified a number of people in a large pic­ture on the wall of his consulting room as former addicts who had been cured by turning to Jesus.

Unless each of them had specif­ically consented to the making of this identification, this represents a serious breach of patient confiden­tiality.

Para 4(d) Dr Scott told Patient A that he was not offering him any­thing else, because there was no other answer, and that he would keep suffering until he was ready to hand his suffering to Jesus. Again, this may not be the exact form of words used.

This again can only be a deliber­ate undermining of any future at­tempts by psychiatric specialists to provide help to Patient A.

Para 5. Dr Scott knew, or ought to have been aware, that his views expressed in para 4(b) and 4(d) were not directly relevant to Patient A's clinical care, and could poten­tially cause distress to Patient A.

Para 7. Dr Scott's actions and/or omissions were inappropriate and clearly not in the patient's best interest.

In fact, Patient A was distressed by the consultation and felt abused. The committee specifically stated that Dr Scott "went beyond the limit of such spiritual guidance as would have been appropriate". Given that Dr Scott's advice to this non-Christian, very disturbed, and vulnerable young man was that his only hope of psychiatric cure was conversion to Christianity, and that he would be plagued by the devil if he did not accept this, I cannot conceive that any competent and compassionate Christian doctor could disagree with this finding.

Dr Scott does not agree, and appears to be blind to the damaging potential of what he has done. He admits that his words carried risk, but for himself, not for his patient. He remains totally un­repentant.

For Bishop Willmott to support him in this position does harm to Dr Scott himself, to the Church, and to the standing and understanding of religion in our society.

JOHN HARE
The Q Tower, 14 South Hill
Felixstowe, Suffolk IP11 2AA

Feature