In liberal democracies, the legal right to take collective industrial action is denied only to members of the armed forces who are required to defend the state. There is therefore no reason in law why doctors should not behave in the same way as other workers with an unresolved grievance. Indeed, doctors’ strikes have occurred in the United States, the UK, Canada, New Zealand, Israel, El Salvador, Nicaragua, Spain, South Korea, Germany, France, Ghana, and South Africa. Causes include unsatisfactory working conditions, changes to terms and conditions of service, or burdensome malpractice premiums. The outcomes have not usually been positive for the profession.1

However, we are not concerned here solely with legality but with ethics and the nature of the relationship between doctor and patient, both now and for the future. If there is nothing special about this relationship then we can terminate the discussion at this point: might is right, and the patient is a mere fulcrum on which doctors and employers leverage their collective power. Few doctors would adopt this view, recognising that professional status brings particular responsibilities as well as privileges. Therefore …