1 July 2009 is a date we may come to see as seminal in the history of spiritual issues and healthcare.

CMF Breakfast at the ARM

For the first time since 1892, when the Medical Prayer Union (one of the two organisations which merged in 1949 to form CMF) began these annual outreaches, the Breakfast was not a formal part of the BMA programme at its Annual Representative Meeting. Nevertheless, about 40 gathered to hear Trevor Stammers speak on A dangerous cocktail? - Religion, Belief and the NHS.

After quoting part of Matthew Arnold's poem Dover Beach, written in 1867 and prophetic in its prediction of the slow demise of Christianity - at least of the vast edifice of Victorian Anglicanism and at least in the UK - he described how in many parts of the world Christianity is growing rapidly. Referring to current hostility in Britain he quoted: 'if religion is such a busted flush, secularists should surely stop being afraid of its influence'. Nevertheless, he reported growing insistence in political correctness that God must not be mentioned, particularly it seems in the NHS.

After reviewing the Caroline Petrie case and another, he read from 2008 GMC guidelines Personal Beliefs and Medical Practice: 'All doctors have personal beliefs which affect their day-to-day practice. Some doctors' personal beliefs may give rise to concerns about carrying out or recommending particular procedures for patients.

Discussing personal beliefs may, when approached sensitively, help you to work in partnership with patients to address their particular treatment needs. You must respect patients' right to hold religious or other beliefs and should take those beliefs into account where they may be relevant to treatment options. However, if patients do not wish to discuss their personal beliefs with you, you must respect their wishes.'

Trevor stated: 'This applies as much to the atheist seeking to encourage assisted suicide as a possible option as it does to the Christian seeking to dissuade a patient from it. Both could give rise to concerns if undue pressures are exerted but to try to discriminate against one set of values alone is hardly compatible with any meaningful concepts of equality and diversity. The GMC clearly understands this.'

Just before lively discussion, he mentioned a BBC poll of over 1,000 people in the wake of the Caroline Petrie case, where 62% agreed that religion had an important role to play in British public life and 63% felt our laws should respect and be influenced by those religious values.

ARM 1: Safeguarding spiritual care

Bernadette Birtwhistle is a cancer specialist in Yorkshire who'd already received much media coverage even before two hours later she proposed a composite motion, the first two parts of which recognised the importance of spiritual care, and supported GMC rejection of inappropriate discussion. The last three asked that doctors and other health professionals should not face censure for offering prayer and other spiritual support. The Meeting supported the former but rejected the latter, although as ARM Chair Peter Bennie reminded everybody, even if the Meeting did not pass a motion, it did not mean that the opposite held.

ARM 2: TV advertising of abortion services

Mark Pickering was heckled for proposing that TV advertising for abortion services was unnecessary - there were other sources of information; discriminatory - only abortion providers would be able to afford TV advertising; and sent the wrong message - women watching would perceive an alleged safety net being promoted. Emphasising TV's power, he advocated values-based education instead. After brief debate the Meeting rejected the motion, but the issue had been aired.

ARM 3: 'Assisted death'

In this motion, so critical the week before the Coroners and Justice Bill, the proposer essentially made two points -  because no relatives accompanying Britons to Dignitas were prosecuted, the law was unclear and should be changed; and changing the law altogether was an important matter of human choice where there could be adequate safeguards.

Baroness Ilora Finlay spoke powerfully against: numbers were tiny; there could be no effective safeguards; the law worked well; and passing this motion would go against two medical Royal Colleges, disability groups, and the Association of Palliative Medicine. A speech in favour pleaded patient autonomy, and Helen Grote spoke against on patient safety grounds. Tony Calland, Medical Ethics Committee Chair, argued against, and Chair of Council Hamish Meldrum pointed out that the latest survey of doctors' opinions in March 2009 showed 2/3 against. He said he had found Ilora Finlay 'compassionate and compelling'.

The vote about decriminalisation for relatives accompanying abroad was lost by 44.4% to 52.6%, and changing law altogether on euthanasia and PAS was clearly lost by show of hands.

ARM 4: Conscientious objection

That employers should have protocols to deal with issues of conscientious objection without any individual being disadvantaged passed narrowly, and that trainees were responsible for informing employers of any conscientious objection issues in advance of taking up a post passed easily.

ARM 5: Membership of Medical Ethics Committee

A motion inspired by continuing concerns about balance in the membership of the BMA's MEC was not reached, but will be followed up by correspondence.