The ethics of strike action: CMA position on the Junior Doctors Strike
The CMA (UK) was asked by the Tablet newspaper what our position on the Junior Doctors Strike is. Below is the full text of what we said.
WHERE THE CMA (UK) STANDS IN THE DISPUTE BETWEEN THE SECRETARY OF STATE FOR HEALTH AND THE JUNIOR HOSPITAL DOCTORS.
The CMA (UK) has no official position on the Junior Doctors’ Strike and members will have a wide range of views. Medicine is a very high calling and the CMA acknowledges the severity of the present situation which has brought those involved in what is generally a self sacrificial profession to the decision to temporally leave their clinical responsibilities in order to attempt to secure a future for a National Health Service which is so often shown to the public to be in a state of near crisis. Strike action must always reflect the gravity of the situation. Many CMA members feel this strongly, and see the new contract, which will in effect be open ended and at the discretion of the employer to administer as is deemed fit (Clause 22), being forced upon junior hospital staff, and this ultimately will jeopardise sound treatment for the patient and hence patient safety. On the other hand from an individualistic Christian perspective, such a high calling should be accompanied by a willingness to walk every extra mile and turn every cheek by putting the care of each individual patient before all personal inconveniences, even to the point of laying down one’s own life. Viewpoints between these extremes all have valid ethical foundations.
Catholic Social Teaching helps unravel what could be seen as a medical ethical dilemma. In CCC 2435 it is stated that "The Church’s social doctrine recognises the legitimacy of striking “when it cannot be avoided, or at least when it is necessary to obtain a proportionate benefit”. The official Compendium of the Social Doctrine of the Church also teaches that neither unions nor the state should abuse their positions of power and that both should always work for the universal common good. The Church also teaches that, based on the principle of human dignity, workers have rights which include the right to a proper family life.
There are some other facts that could be mentioned, to date there are few if any reports that strike action has led to any patient’s life being put to serious risk, the strikes so far have had overwhelming support from 98% of junior doctors and have been supported by senior doctors who have covered their duties, and there is increasing concern that such an imposed new contract will lead to an increasing Exodus from the NHS at training level with unparalleled disastrous consequences.
In addition to this, the essential practicalities of the seven day NHS week have still to be elaborated and the exact costs revealed. We cannot help but wonder at the enormous cost of a properly funded TOTAL week where all staff and all departments remain open. It would seem only fair that it should be in order to guarantee the smooth running of such a vast machine, but as far as we are aware this is not at the moment being proposed.
Although difficult, we pray for a good outcome.
Dr Robert Hardie
(Past President of CMA UK)