Education And Debate

ethical pitfalls can be hard to avoid

BMJ 2004; 329 doi: (Published 12 August 2004) Cite this as: BMJ 2004;329:399
  1. Duncan Forrest, retired consultant paediatric surgeon (,
  2. James Barrett, consultant psychiatrist1
  1. 1 Health Professionals' Network, Amnesty International UK London EC1R 4RE
  1. Correspondence to: D Forrest

    Many clinicians will have memories of slightly disturbing encounters—perhaps while in training—when they felt that a patient was suffering unnecessarily thoughtless, humiliating, or frankly brutal treatment. It is difficult for junior doctors to make a complaint. Perhaps it becomes slightly easier with growing experience and seniority, but it is never straightforward and many encounters go by without protest. Although ethical norms have improved in recent years, there are still many working environments where doctors daily witness doubtful practices and have to decide whether to confront or ignore them.1 When should you blow the whistle?

    Doctors whose work involves divided loyalties, such as police surgeons, prison doctors, or medical officers in the armed forces, are most likely to encounter these ethical problems. Of course, in countries where torture is practised, doctors in such jobs face more serious choices and risks than doctors in the NHS. If they do not cooperate with their employers, they can risk dismissal or even physical danger to themselves or their …

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