Former GP Sarah Benn was suspended by the medical practitioners tribunal service (MPTS) after an arrest for her involvement in climate protests. In The BMJ today, two experts debate the question of when and whether doctors in such cases should be sanctioned.
The recent case of Sarah Benn has sparked debate, partly because of a perception that the GMC referred her to a MPTS tribunal for taking part in peaceful protests, says Andrew Hoyle, assistant director at the GMC.
In reality, he explains that the referral was made because she repeatedly breached an injunction order, was found to be in contempt of court, and received an immediate custodial sentence.
He acknowledges that all doctors have a right to their personal opinions, and nothing in the GMC's Good Medical Practice prevents doctors from exercising their rights to lobby the government, campaign on issues close to their hearts, or take part in public protests.
"But when protesting involves breaking the law, doctors—in common with people in many other regulated professions—should understand that consequences may follow," he writes.
It's been suggested that doctors who break the law in an act of civil disobedience should be exempt from sanction if the law is unjust. But Hoyle argues that the justness of a law is the business of parliament, not the regulator.
It's also been argued that doctors involved in climate change protests are acting in the public's interest, rather than against it, and that they have a moral imperative to protect patients and the public from climate harm.
Without question, climate change poses a significant threat to health and wellbeing, notes Hoyle, "but an erosion of the public's trust in doctors, and in the system that regulates them, could also have significant consequences for public health."
Doctors aren't above the law—and even the most strongly held convictions can't elevate them to that position, concludes Hoyle. "They must always consider how their actions may be perceived by the public and how they may affect wider confidence in the profession."
But Rammina Yassaie, a medical doctor and ethicist, argues that civil disobedience is a core part of political activism and that positive social change frequently occurs on the back of actions deemed unlawful at the time.
In Benn's case, the use of privatised civil law to quash necessary and peaceful actions that sound the alarm on the existential threat of climate devastation "can't reasonably be argued to be a moral or just use of the law," she writes, "especially when fossil fuel companies continue to profit obscenely, while knowingly destroying the planet and in turn the health of those who live on it."
She disagrees with the GMC's argument that Benn's actions erode trust in the medical profession, saying patients' trust in doctors "is upheld and strengthened when doctors advocate for action on important causes, particularly when these relate to health."
Crucially, she says the GMC must avoid conflating the rule of law with rule by law—the latter being where those in power can arbitrarily agree and apply law as they choose, without accountability.
"That's not to say that doctors have carte blanche to break the law, but decisions regarding suspension must acknowledge the context and motivations in which such actions are taken," she writes.
What's more, she says debating whether doctors should be suspended for breaking the law diverts attention from examining whether it's right for public money to be spent on prosecuting doctors for whistleblowing on climate inaction in the first place.
She notes that in recent cases, juries have decided not to convict health professionals who were able to explain that their professional codes of conduct required them to raise the alarm about the health implications of the climate crisis.
"Shouldn't we instead demand that those responsible for climate devastation, and other social injustices, face legal consequences themselves," she asks?
