Sexual health staff can refuse to provide contraception
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Trainee sexual health doctors and nurses can refuse to provide emergency contraception if it is against their religious beliefs, according to new guidelines.
This comes after opposing organisations accused the Faculty of Sexual and Reproductive Healthcare (FSRH) of discriminating against Christian doctors who may be pro-life.
Guidelines have therefore been updated that allow trainee medical staff to opt out of prescribing emergency contraception providing alternative arrangements can be made and there is no judgement towards patients.
President Dr Asha Kasliwal, president of the FSRH, said: ‘The heart of the new guideline is that we welcome members with a range of views, and we will award the relevant qualifications to those who fulfil all training requirements and are willing to show that they will put patient care first, regardless of their personal beliefs.’
Around six per cent of women in the UK use emergency contraception every year, particularly those in their 20s.
Trainee sexual health doctors and nurses can refuse to provide emergency contraception if it is against their religious beliefs, according to new guidelines (stock)
WHAT IS EMERGENCY CONTRACEPTION?
Emergency contraception can prevent pregnancy after unprotected sex or if contraception fails, such as a split condom or missed pill.
There are two types: the emergency contraceptive pill, or the ‘morning after pill’, and the IUD, or the ‘coil’.
Different brands of pills vary with how soon after sex they need to be taken.
They work by preventing or delaying the release of an egg.
The IUD is inserted into the uterus within five days of sex, and prevents eggs from being fertilised or implanting in the womb.
No emergency contraception protects against sexually transmitted infections (STIs).
Side effects of the pill can include abdominal pain, headache and irregular periods.
IUD complications can include pain, infection and damage to the uterus.
Emergency contraceptives are available from certain GP surgeries, sexual health clinics and pharmacies.
Source: NHS Choices
‘There is a wide spectrum of views’
The first set of guidance for trainees, produced in 1999, recognised the legal right of healthcare professionals in the UK to opt out of abortion care.
It was updated in 2014 to include nurses who by then had become eligible for Faculty membership.
Yet the Christian Medical Fellowship (CMF) accused the Faculty of discriminating against Christian doctors as the guidance stated healthcare professionals must be able to provide all forms of contraception in order to be awarded the Faculty’s diploma.
The campaign was picked up by certain individuals in the US and a handful of members of both houses of the British parliament.
Dr Kasliwal said: ‘Believing the CMF article to be inflammatory and largely inaccurate, we felt comfortable “defending” our stance as it seemed entirely reasonable that as a training organisation we should expect a Diploma-qualified member to be willing to carry out full and effective contraception consultations and prescribe all forms of contraception.’
She added, however, ‘the challenge did give us pause for thought’ and it ‘became apparent that there is a wide spectrum of views in the sector – from overt “conscientious objection” to delivering abortion care or fitting IUDs as emergency contraception, through to a belief in “conscientious commitment” to delivering the care that women need regardless of personal beliefs.’
‘Through discussion, we came to understand that we could not cover all circumstances in which healthcare professionals provide care, and that the important thing for us as a professional body awarding and governing qualifications is that patient care is provided to the high standards that we support now.
‘Finally we arrived at the key principle that a patient should never be put at any disadvantage as a result of the views of any healthcare professional they see.’
The guidelines state trainees must not judge patients requesting such contraception (stock)
‘We welcome members with a range of views’
These guidelines were put into place and any doctor ‘could decide not to prescribe a particular form of emergency contraception, but would have to agree to be open about this to their service or employer, to enable arrangements to be made to ensure that there was no delay to the patient in being provided with that care.
‘Furthermore, whatever arrangements are made by the clinician, they should not in any way suggest a judgement about the patient.
‘So the heart of the new guideline is that we welcome members with a range of views, and we will award the relevant Faculty qualifications to those who fulfil all training requirements and are willing to show that they will put patient care first, regardless of their personal beliefs.’
Dr Kasliwal and FRSH’s chief executive Jane Hatfield explained the reasoning for the guideline update in the journal BMJ Sexual & Reproductive Health.