All through last winter the longest disciplinary case in the General Medical Council s history was being heard. It resulted from two cardiac surgeons in Bristol having continued to operate on children long after evidence had been presented to managers and others that their results were much poorer than in comparable units.
Medical ethics is a growth industry.
When there is no professional left in the NHS to bandage a wound, mend a fracture or fetch a bedpan, we shall have a lavish supply of ex-doctors, nurses and midwives who have written theses on beneficence and autonomy, and who will parrot their empty phrases with endless confidence. No one, so far as I know, has written a study of the ethics of medical care embodied in the guidance issued by the General Medical Council, how it has evolved, and how it has affected the care patients actually receive. As a former member of the Standards and Ethics Committee of the GMC, which drafts the ethical code, I am only too well aware of the delicate backstairs manoeuvring that takes place to balance skilled protection of the profession with genuine ethical concerns. Successive editions of the GMC code not only document the changing ethos within the profession, and how it responds to public and political pressure, but can also have direct effects on patients. It appeared under the heading Advertising, canvassing and related professional offences and followed a preamble urging doctors to refrain from self-advertisement .