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Doctors and nurses can 'conscientiously object' to prescribing contraception, new guidelines say

Consultants, GPs, and nurses who specialise in sexual health will be able to “conscientiously object” on religious or moral grounds to prescribing contraception, under new professional guidelines.

The decision comes from the Faculty of Sexual and Reproductive Health (FSRH), which is the training body for NHS consultants in community and sexual reproductive health.

The FSRH also awards a diploma to GPs and nurses to fit long-lasting reversible contraception, such as the contraceptive “coil” or hormonal implant, and advise around birth control and fertility issues. 

Its previous guidelines meant that for a doctor or nurse to receive the diploma, they had to be “able to to prescribe all forms of contraception”.

This could include fitting a intrauterine device, like the coil, as an alternative to the morning-after pill, which can be effective up to five days after having unprotected sex.

This stance had been criticised by a religious group, the Christian Medical Fellowship, for being discriminatory against doctors who object to emergency contraception as being a form of abortion.

A legal right to conscientiously object to providing aspects of abortion care is enshrined in UK law, and the FSRH had modified its guidance to reflect that for doctors and nurses, but it did not previously extend to contraception.

An explanatory editorial in the journal BMJ Sexual and Reproductive Health, by the FSRH president Dr Asha Kasliwal and chief executive Jane Hatfield, sets out the faculty’s reasons for updating its guidance now.

After being challenged by the Christian Medical Fellowship, they initially rejected the criticism.

The article says: “It seemed entirely reasonable that as a training organisation we should expect a Diploma-qualified member to be willing to carry out full and effective contraception consultations and prescribe all forms of contraception.”

However, on consulting their members, the editorial says there was a “wide spectrum of views”, ranging from objections to providing emergency contraception and abortion, to a “conscientious commitment” to delivering care regardless of belief.

The article says that patients ”should never be put at any disadvantage as a result of the views of any healthcare professional they see”.

However, it adds: “A doctor wanting to qualify for or re-certify the FSRH diploma could decide not to prescribe a particular form of emergency contraception, but would have to agree to be open about this to their service or employer, to enable arrangements to be made to ensure that there was no delay to the patient in being provided with that care.

“So the heart of the new guideline is that we welcome members with a range of views, and we will award the relevant Faculty qualifications to those who fulfil all training requirements and are willing to show that they will put patient care first, regardless of their personal beliefs.”

The General Medical Council, which licenses doctors to practise in the UK, said the FSRH guidance was in line with their core “good medical practice” guidance.

It added: “You must explain to patients if you have a conscientious objection to a particular procedure. You must tell them about their right to see another doctor, and make sure they have enough information to exercise that right.”

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