Reflecting on my fourth audience appearance on The Big Questions

The Big Questions on BBC One took place today in
the Scottish capital of Edinburgh.

Wow. Four appearances on BBC One's The Big Questions. It hasn't frankly sunk in, but I still love coming back to the show when it comes to Scotland. Yet today's programme proved to be the most difficult one yet in terms of the topics discussed.

The show took place at the Leith Academy, the very same venue as last year's programme in the Scottish capital. I made a contribution to the debate on assisted dying in today's programme. Last night, I informed you that Margo MacDonald MSP (Independent in the Lothians region) is relaunching her assisted suicide bill in the Scottish Parliament for the second time.

Hearing Lesley Close's story (from 18:42) about her brother John at the beginning of the debate on this issue was a very potent experience and I can certainly show sympathy with her and many others who have suffered from the fact that members of their family or friends have had to face up to the difficult reality of living with a deteriorating condition resulting in diminishing the quality of life. But I stated (from 36:37) my opposition to enabling assisted dying, because healthcare professionals, like myself, have a duty of care to protect the health of patients.

I fear that enabling assisted dying through legislation will contradict the principles of the code of ethics, for pharmacists and nurses, and good medical practice for doctors in terms of the care of patients (the list of healthcare professionals/healthcare professions is not exhaustive). Yet some people have pointed out to me that a patient's autonomy and decision making is also vital (and that is something I totally respect and agree with also). I certainly agree that a patient has an absolute right to be enlightened appropriately on issues surrounding their health, but does this necessarily equate to enabling assisted suicide when it can be argued that such a measure could be acting in contradiction of the general principles of protecting health and ensuring appropriate care.

This is a very difficult issue for everyone and should not be approached lightly. I deeply thought about the details of the bill that Margo has brought to Holyrood late last night and into the early hours of this morning, but yet if I were an MSP voting on that bill then I wouldn't be able to support it for the reasons outlined above. 

However, I shall continue to follow the latest developments and, despite my disagreements, have to commend Margo MacDonald MSP for her effort and the way she has put her arguments forward. Genuinely, she is a very much valued member of our public life here in Scotland, regardless of what stance you take on this debate.

On another note, it was absolutely wonderful to meet so many familiar people from last year's debate in Edinburgh. What I love about programmes like this is that you tend to find many like minded people, despite the difference in opinion on a variety of issues. That is what I find so appealing about programmes like The Big Questions and it's a very much valued programme on our television screens which really gives everyone, audience member of viewer, the opportunity to really discuss and explore the issues that really affect all of us in this world, let alone here in Scotland.

I'm hoping to come back once again to this show's audience. But next time, I really would love to gain a front row seat, because I genuinely feel that I can offer a lot more to those debates. Yet I genuinely don't know how I can specifically achieve this, other than just continuing to engage with the issues through this blog and in other ways. 

I encourage people to try and attend shows like The Big Questions. You will be more than welcomed by the whole team from Mentorn Scotland (who produce the programme) and you will be looked after well especially by the show's presenter, Nicky Campbell. It's important to hear a variety of people's views. Once you attend for the first time, you will want to come back. It's a unique experience.

Should the "Conscience Clause" be abolished?

Image courtesy of Idea go / FreeDigitalPhotos.net

"Our greatest happiness does not depend on the condition of life in which chance has placed us, but is always the result of a good conscience, good health, occupation, and freedom in all just pursuits." (Thomas Jefferson)

And how that above quote and principle one of the Medicines, Ethics and Practice Code of Ethics marry so romantically. Pharmacists are there to support patients and make them their first concern, no matter what else is going on.

As a qualified pharmacist and a man of Islamic belief, I don't ever intend to use the opt out option. That's not to say that I wouldn't enquire with a local doctor about the clinical effectiveness and safety of a patient's prescription, but when it comes to services like the emergency hormonal contraception then, as long as a legitimate need is there for EHC and the legalities of making a sale or supply are fully adhered to then there isn't a problem. 

So why isn't it a problem for me? As far as my religion is concerned, the vast majority of scholars permit contraception. And think about the name of the service provided - Emergency Hormonal Contraception. Conception is stopped by inhibition the process of ovulation. The pregnancy begins when the implementation process has taken place. EHC, such as levonorgestrel 1500mcg, cannot be taken after 72 hours since unprotected sexual intercourse has taken place. Although it isn't exactly known when implantation takes place, it is very unlikely to be in that 72 hour period.

When the pharmacy code was reviewed a few years ago, the decision was made to continue to opt out option for pharmacists who may want to take the option of refusing to sell or supply certain medicinal products. It left organisations such as the National Secular Society disappointed as they had called for the clause to be removed.

But think about it. How many pharmacists have you seen, either as a patient or whether you are involved in the profession, actually refuse to supply a medicine because of personal beliefs? In my experience, the answer is none. I imagine there may be a handful of pharmacists across these islands and beyond who opt out of providing certain services. But again, its only merely a handful and this has provoked some people in the profession to question the legitimacy of there being a "conscience clause". In fact, some may ask what is the point of having one?

But there is no need to abolish the "conscience clause" because we already have a strong code of ethics that actually guides us and defines the number one priority is as a pharmacist - our patients. And what's more, it is not my place to turn around and start dictating what a person's personal beliefs should be. It is our collective responsibility to ensure that we are acting in the patient's best interests but it is also the responsibility of the individual to reflect on past actions and critically examine whether they possess a legitimate reason not to provide a certain service or whether their personal beliefs compromise patient care. Pharmacists who choose not to provide EHC are still strongly advised to refer any patient in need of the service to the nearest pharmacy who provide it or, in some cases, an appropriate healthcare practitioner. 

It is a controversial issue that will never go away, whether it stays or goes. But what's certain is that nothing can compromise principle one of the code of ethics. Not even a person's own set of personal beliefs.