Speech from the Chairman of the Medical Ethics Committee, Dr Michael Wilks
Thursday 3 July 2003
I remember a previous chairman of what was then the Central Ethics Committee saying that the work of the committee was limited to the size of the plate outside a doctor’s surgery and whether going to bed with patients was always a bad thing. We now have a few more things to think about.
The work of the committee in the last year has been dominated by the completion of the latest edition of “Medical Ethics Today”. The last edition was published in 1993, a very long time in medical ethics, and the new edition is a new book, not a revision. We have subtitled it “The BMA’s handbook of ethics and law” as the legal and ethical aspects of medical practice now go absolutely hand in hand.
We have also engaged in some crystal ball gazing, although doing so is a risk. New technology arrives accompanied by new dilemmas. In the field of fertility treatment they seem to occur on a daily basis. But there are themes that are common to developments in embryo research, pre-implantation genetic diagnosis, stem cell technology, insurance and end of life treatment. These are to do with the eternal tensions between individual choice and legal or regulatory control. We have seen this most recently with the ability to select in a child – though pre-implantation genetic diagnosis – for donor matching, as opposed to the main purpose of this technology, which to date has been to select out an embryo with genetic defects.
In this area, as with so many others, a line is drawn that allows the maximum individual autonomy – the freedom to choose – while protecting patients and populations from exploitation and harm. In our debates here, and in the Committee, we visit these lines, sometimes redraw them, and sometimes make them more distinct. It is the job of the committee, and of its chairman, to make the policy of this Association clear at every opportunity, but also to signpost the future, and show how it might change. This is not always easy.
Ethics is also politics. I am proud that over the last two year we have persuaded the government to undertake legislation in two crucial areas, organ donation and mental incapacity. We are also beginning to see the consequences of our considerable involvement in getting regulations passed to allow stem cell research.
Apart from writing the book, the ethics department has carried on with its usual awesome workload. The greatest privilege of being chairman has been to work with a team of the highest ability. They support the committee, prepare reports, advise members, consult with government departments, all with apparent ease. I want to thank Ann, Veronica, Julian, Tricia and Fenella for all they do. On this occasion I particularly want to thank Gillian, the committee secretary, who (you may have observed) has put on an alarming amount of weight recently. Gillian – thank you for all your hard work, and we wish you all the very best for the future.
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