FSRH ban may be illegal
Review by Peter Saunders
CMF Chief Executive
Doctors who object to prescribing 'contraceptives' which act after fertilisation are to be barred from receiving diplomas or fellowships in sexual and reproductive health even if they undertake the necessary training.
The ruling comes in new guidelines issued earlier this year by the Faculty of Sexual and Reproductive Health (FSRH) (1) of the Royal College of Obstetricians and Gynaecologists (RCOG).
Whilst many contraceptives act by preventing fertilisation, there is strong evidence to suggest that some, including most IUCDs (intrauterine contraceptive devices) and the morning-after pill EllaOne (2) (ulipristal acetate), also act by preventing the implantation of an early embryo. They are thereby embryocidal, or abortifacient, rather than truly contra-ceptive.
Many doctors choose to avoid using drugs or methods of contraception which act after fertilisation, a position consistent with the Declaration of Geneva adopted by the British Medical Association (BMA) in 1948. This originally stated, 'I will maintain the utmost respect for human life from the time of conception even against threat'. The RCOG's move is thereby an extraordinary about-face by the profession from its historic position.
The FSRH may argue that they are not barring doctors from practising, but simply from obtaining certain qualifications. But as many job appointments will be conditional on applicants having these qualifications this is effectively also a bar on practice.
This seems extraordinary given that the use of contraceptives which have been proven to act after fertilisation is only a tiny part of the specialty of sexual and reproductive health (SRH) which encompasses a wide range of conditions, treatments and procedures. (3) Surely could not reasonable accommodation be made for pro-life doctors?
After all, doctors who have a moral objection to abortion are still able to complete the Faculty's qualifications because the Abortion Act 1967 contains a conscience clause which protects them. So the College appears to be taking advantage of the fact that there is no equivalent law protecting those who object to destroying human embryos. Or is there?
Under equality legislation, it is unlawful to discriminate against people who have 'protected characteristics' – treating someone less favourably because of certain attributes of who they are. This is known as 'direct discrimination'. These protected characteristics include religion or belief.
Examples of direct discrimination include dismissing someone, deciding not to employ them, refusing them training, denying them a promotion, or giving them adverse terms and conditions all because of a protected characteristic.
This action by the RCOG may therefore be not just discriminatory but also illegal. 4 If so the College could have placed itself in an embarrassing and dangerous position.
