13 August 2018

Draft code raises free speech fears

AHPRA Ethics Medicolegal

The Medical Board has been accused of taking on an Orwellian tinge with a draft code of conduct that seeks to censor doctors’ expression of personal and political views.

The board’s consultation paper on the update of Good Medical Practice starts out as promisingly dull, stating that it is “not proposing significant changes to the current code”.  

But critics are alarmed by the implications for free speech, references to “culturally safe” practice, and the use of vague and confusing language which the AMA says could add to doctors’ anxiety about possible breaches of the code. 

In this scenario, Queensland GP Dr David van Gend says the board’s enforcement arm, AHPRA, has kicked “an own goal” by serving him with a notification alleging he engaged in discriminatory conduct. 

The doctor, who spearheaded last year’s No campaign against same-sex marriage, drew a complaint from a member of the public after he retweeted – without comment – two posts by a conservative political candidate in April. 

Dr van Gend told The Medical Republic he was taking on the “discomfort” of speaking publicly about the charge to highlight the regulator’s bid to “expand its powers” through the code-of-conduct review.

“The only reason I went public on this was in order to get attention for the board’s grab for further power, to essentially censor and coerce conformity among doctors even in their private political involvement, which I think is an appalling thing,” he said.

The AMA said it had fielded concerns from several members in relation to Section 2.1 of the 30-page revised draft of Good Medical Practice.  

Members had pointed to proposed amendments “that could be seen as stifling doctors’ right to publicly express both personal and professional opinions, while also undermining doctors’ contribution to the diversity of public opinion, debate and discourse”. 

“As with any private citizen, doctors are subject to the law in regard to the public expression of opinion – for example, anti-discrimination legislation, defamation, et cetera,” an AMA spokesperson added.

In its written response to the Medical Board, revealed only last week, the AMA counselled the board on the importance of context. 

“Just because a doctor does not hold ‘the profession’s generally accepted views’ on a particular social matter does not indicate a lack of medical professionalism or substandard medical practice,” it said.

“For example, many doctors do not personally agree with abortion, contraception or voluntary assisted dying.” 

The AMA also advised caution on Section 4.8, dealing with culturally safe and respectful practice. 

It called for recognition that “culturally safe” was not necessarily medically safe or generally accepted medical practice in Australia.  As examples, it cited female genital circumcision and abortion for the purpose of sex selection. 

On the AMA’s urging, the board has extended the consultation deadline by two weeks until the 17th of August. 

The draft is now the target of a campaign by conservative groups lobbying Federal Health Minister Greg Hunt, including the Australian Christian Lobby. 

Rumblings about “thought police” first appeared in The Weekend Australian in July, with former AMA Tasmania president Dr Chris Middleton saying the planned revisions to the code would stifle free speech.

“If you have an alternative view and you dare to mention it in public, you could be deregistered,” he told the newspaper. 

Dr van Gend said he knew hundreds of doctors who were against the proposed revisions and he had written to Minister Hunt saying the board was “out of control”. 

He expressed disbelief at the charge against him, saying the content of the two tweets – which he passed on without comment – was about education policy, not medicine.  

“I am a bigger target than that,” he said.

The offending tweets, originally posted by Conservative Party Senate candidate Lyle Shelton, both referred to the alleged teaching of “gender-fluid ideology” in schools.   

News Australia’s Miranda Devine, the author of a column in one of the tweets, slammed AHPRA for acting on the complaint against Dr van Gend.  

This, she wrote, was a sign “our culture has reached peak Kafka”.  

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2 Comments on "Draft code raises free speech fears"

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Joe Kosterich
11 months 10 days ago

This is not about “patient safety” , the card generally played by AHPRA. This is an attempt at Soviet Union style state control of the thoughts and words of doctors. I do not agree with Dr Van Gend but he has an absolute right to his opinion and to express them like any other citizen.

Heather McNamee
11 months 10 days ago

I most certainly do not agree with Dr Van Gends views but I equally support his right to express those views as long as he does not misrepresent facts or use hate speech to get those views across.
If his language is respectful and factual it is no business of APHRAs..unless he lets his views affect his practice and discriminates against the patients in the groups he is referring to eg LGBTIQ
Unfortunately many on his side of politics are guilty of discrimination and outright homophobia.