NEW: Grounds in support of intervention in the Bell v Tavistock JR appeal published

[ItsAllGoingToBeFine]

twitter.com/RadFemLawyer/status/1354002497753538562?s=19

This is going to fascinating to follow.

GIRES, Stonewall, Brooks and the Endocrine society are intervening.

So BMA is intervening in support of Tavistock
That is appalling.

From the letter:

"The BMA recently passed a motion to campaign for gender self-identification and to ensure that under 18s are able to access healthcare in line with existing principles of consent established by UK Case Law and guidelines published by the public bodies which set the standards for healthcare. The BMA is using this position to support access for gender dysphoric children to puberty blockers based on the so-called “informed consent” model. This ‘urgent’ motion was introduced at the recent, first virtual, annual conference with very short notice. With a late and inadequate briefing paper, barely 20 minutes was allotted for discussion and delegates had no more time to think or consult wider membership about these fundamental changes in medical policy. The motion passed with a small majority, with many delegates abstaining. Since then, and despite opposition, the BMA has submitted a response to a government inquiry, advocating for gender self-identification and changing women's single-sex spaces into mixed-sex.

In the most recent CQC inspection (4), the Tavistock clinic was given an "inadequate" rating, due to widespread failures to meet acceptable standards of care. This included failure to document information relating to informed consent, failures to investigate comorbidities and inadequate rationale for their decisions to refer patients for puberty blockers.

The BMA is seen by politicians and the general public alike to represent mainstream medical opinion. It should be wary of assuming members’ support to intervene on behalf of one NHS organisation and its system of care, which lacks supporting evidence and is not aligned with basic medical principles such as shared decision making, first do no harm and whole person care.

If the doctors have robust comparative evidence that children do better with development-defying and life-long interventions let us see and support it! Partisan political activism and ideological lobbying about controversial medical practice is inappropriate without the extensive debate that is necessary for such major policy change."

It really does seem to indicate that the BMA is going above and beyond its remit which seems to be common amongst captured institutions

They have stated to the court their intention to apply to intervene but haven’t been granted intervention yet. They have been given until 16 Feb to get their application to the court.

The BMA and the BMA membership are often two different things.

A lot of doctors just want a union that does stuff on employment law, contracts, workplace bullying and such like - there is a smaller union for doctors that basically does this but it's only open to certain grades of doctor while the BMA includes everyone.

In the meantime the BMA likes having opinions on things, most famously banning boxing, which a lot of the membership couldn't give a stuff about.

Existing BMA guidance such as below on sterilisation and minors would not seem to fit with supporting a policy position of children being able to consent to fertility-destroying interventions without evidence of benefit/effectiveness for the problem they purport to solve, with known risks of physical and mental harm and without any life-saving or emergency need as a reason to do such an intervention before adulthood.

Eg
‘ Can sterilisation be performed on children and young people?
Sterilisation is occasionally requested for young women with serious learning difficulties. Although considerably rarer, it may also be suggested as an option for a young man with learning difficulties. Sterilisation for contraceptive purposes should not normally be proposed for young people aged under 18 given that there are other options available. In the exceptional circumstances in which there is agreement that sterilisation is the best option for a young person, doctors should seek legal advice in order to obtain a court declaration.’

Taken from p.40 of BMA’s children and young people ethics toolkit
www.bma.org.uk/media/1848/bma-children-young-people-ethics-guidance-2010.pdf

In the exceptional circumstances in which there is agreement that sterilisation is the best option for a young person, doctors should seek legal advice in order to obtain a court declaration

So this has been in their guidance for 10 years, but nobody has suggested that it affects Gillick?

@rogdmum

They have stated to the court their intention to apply to intervene but haven’t been granted intervention yet. They have been given until 16 Feb to get their application to the court.

Is it possible that they have applied and been accepted since the hearing? Or would there be another hearing? The doctors who wrote that letter seemed to believe the bma is intervening.

Good to see BMA members challenging their hard of thinking colleagues about all this. That letter below is excellent.

Interesting thoughts MichelleOfTheResistance.

“it would require a randomly selected control group who were not given blockers but supported in other ways. […]”

”Practical challenges to this would […] be likely. Since the Tavistock often talks about the pressure coming from parents and families for blockers as well as the child (and where this pressure and leadership for parents originates is also a factor to consider) it would be difficult to maintain a randomly selected group who did not seek blockers online or from other sources and were willing to accept other treatments but not blockers. A self selected volunteer group would not give the same quality of data that this would require.“

This, I suppose is true, and it is the direct result of an improperly trialed program being widely introduced, alongside heavy lobbying. Had the very first trials of this protocol been put together properly, parents and patients would have been put in a trial where traditional “Watchful waiting” was the safe option, but that there was a chance to get onto a new and potentially better, but obviously riskier protocol.

You are correct, of course. This situation is now under so much tension that an unbiased, randomised trial is now almost certainly impossible, for the reasons you mention.

Manderleyagain I doubt it- the hearing was just last Friday. I suspect the letter’s authors have just been confused because the intention was mentioned at the court on Friday (by the court- the BMA did.not have legal representation there) and some media reports have been confusing about it.

I’m trying this post again after deletion, sorry if the conversation has moved on by now.

I was shocked that the BMA’s medical ethics committee (MEC) which recommends ethical policy to the BMA has seemingly allowed a BMA conference policy vote position to become official BMA policy, and of a sufficiently well-supported standing that it can be presented to a judge in court... without apparently any scrutiny on this matter by the MEC? (that I can find from any googling)

www.bma.org.uk/what-we-do/committees/medical-ethics-committee/medical-ethics-committee-overview

I would be very happy to have pointed out to me anywhere publicly stating that the BMA’s MEC have in fact already scrutinised the experimental and in all likelihood permanent medical transitioning of kids and have considered the Bell case. I would be interested to see their thinking on this. It’s been a long-standing worry that the BMA MEC are so influential on medical practice yet have appeared not to have investigated this issue of transitioning of children and young people publicly.

It seems very strange though if the BMA executive team is supporting a policy position apparently derived from an annual conference vote as a basis their intervention in this case. Also given that Gillick is not threatened or trumped by the Bell case, it’s disappointing to see the BMA spending their resources on trying to intervene on a case that they seem not to understand sufficiently.

And disappointing in that you’d hope the BMA’s normal policy making process would defer such sensitive ethical issues for nuanced multidisciplinary exploration by their MEC- and that they would not take official BMA position from their annual conference floor which debates and votes on dozens of different issues each year in very short succession.

And surely the legal counsel to BMA, who may not be versed in ethical issues themselves, but do understand the law, are advising the BMA Executive team that Bell supports the proper application of Gillick. All of which makes it very hard to understand what the BMA leadership are looking to achieve here, and on whose behalf?
I guess it will emerge from the case in due course

I genuinely (or maybe not..depending on the answer) would love to know why so many companies/charities are purpsoely misreading, or not reading, the actual judgement and instead are taking the word of people who are heavily invested in the 'trans kids' narrative. surely its not beyond such companies to actually have a bit of a look into the judgement they are trying to fight against, before fighting? This relentless 'it will affect abortion rights' and such is really getting to me now, especially when, a read of the judgement specifically covers this. I am not qualified in law or anything, but even to me..this was blatantly obvious from the second the judgement was available? Its coming across a little sinister now actually, as I will not believe that so many are just not bothering to look into the topic, and instead just liste to other peoples opinions of the judgement, when its so widely available to all.