Professionalism: Lessons from the Shipman Inquiry

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ProfessionalismLessons from the Shipman Inquiry

• Aneez Esmail
• University of Manchester

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By nature, men are nearly alike. By practice they
get to be wide apart. Confucius
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When a doctor goes wrong he is the first of
criminals. He has nerve and he has knowledge
Conan Doyle A. The Speckled Band London,1891
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The prosperity of virtue

• Who controls the ethics, behaviour , training and
  qualifications of the medical profession.
• Is self-regulation sufficient?
• What role for professionalism?

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Lessons from Shipman

• Power
• Arrogance
• Lack of integrity
• Professional isolation

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Professionalism

• The conditions of medical practice are tempting
  physicians to abandon their commitment to the
  primacy of patient welfare.
• the principle of primacy of patient welfare
• the principle of patient autonomy
• the principle of social justice

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Alternative approaches

• New Zealand
• Enhancing consumer rights
• Bill of rights
• Right to be treated with respect
• Right to be treated with care and skill and
  receive well co-ordinated services
• Right to dignity and independence
• Right to complain about services which must be
  taken seriously

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New Zealand (2)

• Professional regulation interpreted through Bill
  of Rights
• Is this a loss of self-regulation?
• Is this how we should interpret professionalism?
• Is it possible to implement this in the UK?

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. This inquiry is about power the power of the
medical profession and the patients lack of it.
This is the framework in which events of the past
must be placed. Changes in the future must have
as their aim the equalisation of this power
imbalance, by dismantling the power of the
profession and strengthening patients rights.
Only then will we be confident of claiming never
again Bunkle P. Side-stepping Cartwright. In
Coney S ed, Unfinished business. Auckland. Women
Health Action, 199354. (Quoted in Paul C,
Internal and external morality of medicine
lessons from New Zealand. BMJ 2000499-503.
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The situation which is confronting Medicine today
is a contest of two forces in Medicine itself.
One holds that the most important thing is the
maintenance of our vested historical interest,
our private property, our monopoly of health
distribution. The other contends that the
function of Medicine is greater than the
maintenance of the doctors position, that the
security of the peoples health is our primary
duty, and that our human rights are above
professional privileges. So the old challenge of
Shakespeares character in Henry IV still rings
out across the centuries Under which King,
Bezonian, stand or die. Norman Bethune in The
Wounds (1930s)