High Court Battle - pronouns

[PigeonLittle]

Not sure if this is being discussed here, couldn't see it after a brief look.

www.dailymail.co.uk/news/article-10507853/Christian-doctor-David-Mackereth-sacked-trans-views-fight-High-Court.html

If a male patient hates women and calls them all "whore", as a female doctor or nurse can I be forced to treat him without being able to opt out and leave it to someone else, or is that considered an unacceptably hostile environment given that I also have a protected characteristic under the EA? Genuine question, which I don't know the answer to.

Here you go, @ScrollingLeaves.

If it was now then yes, I expect there would be a crowdfunder and help from Joanna Cherry for him.

As it is, he now has autism, a learning disability and a criminal conviction which is particularly nasty in nature. And the movement who encouraged the officer want me to be sympathetic to the trans man because they feel that people don't like them very much.

Well, how about you stop taking people with learning disabilities to court? FFS.

www.walesonline.co.uk/news/wales-news/teen-prosecuted-after-asking-whether-17651755

@Ereshkigalangcleg - yes, you can withdraw from a patient for any reason. You would have to find them someone else.

It is usually done for violence, stalking, aggression or sexually inappropriate behaviour and is very unusual. In 30 years I have refused one patient.

Thank you for the clarification vivarium. I just wanted to understand whether it was a requirement to treat people or whether you could argue it wasn't compatible with your own rights.

@vivariumvivariumsvivaria
Thank you for that link.
It certainly seems unfair to have convicted him given he was autistic. No account seems to have been taken of that at all. I hope it would be different now.

If you feel unsafe with the patient you won't be able to build a therapeutic relationship with them. And everyone deserves excellent care, so if something is getting in the way of you providing that it's compassionate to find someone else.

I have treated dangerous people who attended with escorting staff and were cuffed and didn't bat an eyelid. I have been in all manner of mix ups with all manner of people and been totally comfortable. I have treated people who verbally abused me because of my sex, shape, faith, accent - HCPs are well used to that. The one person I refused was someone that I just didn't want to be alone in a room with and there was nothing specific about them, but I did not trust them and so got a man to deal with them.

All I had to do was record that I passed the care onto a colleague.

@ScrollingLeaves IIRC there was some comment from Autism UK about the case.

It should have been a huge story and a national outcry and an appeal.

A midwife who doesn't believe in abortion is protected in law to not play a part in any termination services.

Their obligation is to find another HCP to take over caring for that patient. As far as I read this article, that's what he was asking to do.

Exactly, I am a pro choice feminist but I don't believe people should be compelled to do something they personally believe is deeply unethical. This ideology can be considered in certain aspects to meet that description.

I agree the Welsh case is appalling. As is the mammogram case further upthread. And how Scottish rape victims are treated is appalling.

But rights don't exist in a vacuum. Yes, this doctor has the right of freedom of belief. His clients have the right to be treated fairly, with dignitiy and respect, and without disadvantage due to their beliefs.

It's always a balance.

If you said to me that that balance has sometimes swung too far in the TRA direction I would wholeheartedly agree.

I just don't think this is that case.

Sometimes taking a principled stand has consequences. The military offers (or at least used to?) university scholarships to my profession. Worth literally tens of thousands. To take one up means committing to serve; they are, for obvious reasons, not open to pacifists. I happen to know that the local butchers offers the best paid apprenticeship opportunity in the region. I'm vegetarian - I wouldn't expect them to modify the role so I only cut tofu steaks in order to avoid disadvantaging me. Following a religion carries costs. Christ, after all, was crucified.

I also don't agree with compelled speech. I do agree with courtesy. Particularly from a doctor to their patients or clients. There are places to challengs the trans view. Either in public, like Sir Winston and Question Time. Or with an individual patient, where clinically relevant.

A 40 minute assessment on benefits eligibility is not that place. It achieves nothing except further distressing someone who is already distressed. Treat your clients with courtesy and fairness, even when you don't agree with them. Or accept this is the wrong job for you.

@Ereshkigalangcleg

If a male patient hates women and calls them all "whore", as a female doctor or nurse can I be forced to treat him without being able to opt out and leave it to someone else, or is that considered an unacceptably hostile environment given that I also have a protected characteristic under the EA? Genuine question, which I don't know the answer to.

I'm a female clinician who used to treat sex offenders amongst others. I fundamentally disagreed with what they had done; I treated them as any other patient.

If an individual patient is abusive to an individual clinician, then the NHS has a zero tolerance policy. If a transwoman were abusive to this doctor of course he could decline to treat them.

But there's nothing to suggest that this was the scenario here.

@Ereshkigalangcleg

Thank you for the clarification vivarium. I just wanted to understand whether it was a requirement to treat people or whether you could argue it wasn't compatible with your own rights.

Sorry - fast moving thread so didn't see this til after my previous response.

You can't refuse to treat someone due to a protected characteristic. So I can't decline to treat black patients, or gay patients.

If an individual is abusive you can decline to treat, yes.

In practice it's rare, and I'm amazed his A+E job allowed him to decline to treat all trans patients, which is what the tribunal determination says happened.

I've got splinters on my arse from the fence sitting, which smarts a bit, but I agree with both points of view and am enjoying this discussion.

I think there's a further nuance - how willing I'd be to concede pronouns is probably dependent on how vulnerable I thought the person was. For instance, if I thought the person was a fetishist I'd be less inclined to be willing to work with them because I don't want to be part of their fetish. If I thought the person had dysphoria I'd be likely to use them without hesitation.

Ouch. There's another splinter up my hole.

I've got splinters on my arse from the fence sitting, which smarts a bit, but I agree with both points of view and am enjoying this discussion.

Agreed.

Here's a non-EA compliant statement coming up. I can't imagine a discussion of this nature not descending into abuse on the typical, male-dominated discussion forum. One up for mumsnet!

Definitely!

It's always a balance.

Yes. We've mentioned the right not to participate in an abortion. Do you think a HCP should be able to opt out of say, assisting with giving a female child who identifies as a boy a mastectomy, as happens in the US? Or in fact any sex reassignment surgery?

It's always a balance, the difference is where you draw the line.

IMO the reasonable adjustment for both positions was that Mackereth found someone else to see the patient, as discussed.

For me it's such a nuanced area.

I'm appalled by how many teenage girls are identifying as trans, and that schools seem to blindly accept it.

I'm equally appalled by the thought that a gender-fluid teen might have to wait longer in A+E because the available doctor didn't want to see them.

The three letter acronym we are not allowed to say leaves me feeling sick, to be honest. And the thought that middle aged men might access female changign rooms and relish the sense of 'gender euphoria' that brings leaves me feeling angry and helpless.

But I'm also horrified by the thought that that middle aged man might have care for his heart attack delayed because of the religious views of A+E staff.

I entirely agree with @vivariumvivariumsvivaria that stifling debate has been hugely damaging. For both sides, actually.

There are some areas I can be very black and white about ('No men in women's prisons') and some I can't. And I think where I fall on any particular issue depends on where I see the balance of power as lying. Prisoners are vulnerable; patients are vulnerable; benefits claimants are vulnerable. So, generally, if there is a conflict of rights then I would tend to prioritise those.

There are some areas I can be very black and white about ('No men in women's prisons') and some I can't. And I think where I fall on any particular issue depends on where I see the balance of power as lying. Prisoners are vulnerable; patients are vulnerable; benefits claimants are vulnerable. So, generally, if there is a conflict of rights then I would tend to prioritise those.

As I said, I do completely understand your position, I just come down on the side of no compelled speech and I really do think pandering to this ideology is harmful overall.

You can't refuse to treat someone due to a protected characteristic. So I can't decline to treat black patients, or gay patients.

Do people recall the incident a while back in which a white patient refused an South Asian consultant anaesthetist (iirc) and requested a white anaesthetist. The consultant complied and transferred the patient to another colleague. However, he detailed on Twitter that he'd done so to some extent because he felt that his employers in the Trust couldn't be relied upon to have his back.

There was then a flurry of HCPs saying that Trusts should be relied upon and that they (and others) would have refused to accept the care of the patient.

Racism like this is an egregious example. I was troubled at the time because I anticipated that it was not implausible that women who requested a female HCP would also find themselves discharged without care.

I don't have an easy answer. I'm too aware of unintended but predictable consequences.

Motorina
So he refuses to use people's chosen names and titles.

Can you please point to the numbered paragraph which stated that he refused to use or said he would not use the name of any applicant?

Motorina
Society has decided that an applicant can give up some rights in exchange an applicant gets a portion of the redistributed wealth.
I do not believe that people on benefits should have to give up the right to be treated with dignity and respect.
I do not think it okay to address someone on benefits in a way that even Dr Mackareth agrees is offensive, and expect them to accept it as their lot because they're receiving a share of the communal wealth.

Assumptions, assumptions...

Applicants give up the right to medical privacy to provide evidence that they qualify for a specific benefit.

Is dignity and respect sole dependent on a forced affirmation of a belief?
The applicant gets (or should get) the distribution on the basis of meeting the qualifying criteria.
Its not communal wealthy its redistributed wealth from some of a community to others in that community for a communal benefit.

However this case is not about the applicant.

Its about the Employer and employee relationship plus the legislation around the employees rights.

Can the Employee do the job.
Can the Employer make reasonable adjustment to accomadate a PC.
Should the Employer be forced make the adjustment or be allowed sack the employee.

The Service Provider has an opportunity to collect the applicants PC's prior to any appointment.

In this process the employee is an auditor with specialist training.

There was no evidence to imply that the core tasks would not be carried out.

No evidence that the employee would weigh the evidence presented differently for
• women who stated they were men
or
• men who stated they were women
from other women or men.

Dignity and respect goes (or should go) both ways.

In this ruling shows that belief is the poor relation of PC's. Its allowed provided its not integrated into the life of the employee.
Apply that to other PC's its acceptable to be a pregnant radiologist but the employer can sack her if she objects to handling radioactive material.
The woman in a wheelchair can be sacked as her office is allocated to the 3rd floor in the building with no lift.

Demanding that an individual accept and endorse that a factual statement is false and that the opposite is in fact true as a condition of employment is not a sign of a society which can be multicultural.

owlinnahat
I think@SolasAnlasadly speaks for many people when it comes to the benefits system which is why it's got such a terrible reputationthe assumption that benefits claimants are not entitled to compassion or dignity, not to mention the suggestion that they are all fraudsters anyway.

Odd that you choose to speak for me and decided on putting words in my mouth.
Was that intentional?
Or did you not realise that was what you did there?

Your mistake is to give the title "Doctor" more weight than the role, which is loss prevention officer. The job comes with a "posh" title, good pay and the dress code is "business smart".

@SolasAnla your posts have repeatedly shown that you either have not read, or have not understood, the determination, the reasons for the tribunal decision, or the accommodations they considered. Nor are you willing to read or engage with anyone else's perspectives. Given that, I see little point in engaging with you further.

[Simplification warning] As far as I'm aware the books of Leviticus and Deuteronomy (that have been mentioned above) are not only Christian texts. They are part of the Hebrew Bible and central to Judaism, and these laws of Moses are referenced in the Quran.

I don't see why or how the 'Christian right' are the only people being framed as connected to these books of the Old Testament.

If there is 'belief' in Mosaic Law it is relevant to Jusaism and Islam as well as Christianity. Did the original tribunal even acknowledge this?

Just musing, really. Ancient religions are gruesomely fascinating, as are the ways in which modern societies attempt to assimilate and (re)negotiate their manifestations in law and social practice alongside some equally questionable contemporary beliefs about women and their bodies. So much oppression, over thousands of years.

I'd like to understand more about these ancient texts for those reasons too, @SpinningTheSeedsOfLove (great name, by the way)

It's interesting that Posie P and Exulansic both have theological backgrounds. I suspect studying how women were viewed 2-4k years ago seeds many a feminist.

Maybe, as a Christian, he's just choosing not to lie.
Remember the late, great Magdalen Burns, 'I'd rather be rude than a f**king liar.'

Vis a vis lying.

If you've just sworn on the Bible to tell the truth, the whole truth and nothing but the truth, then you can hardly be ordered to lie can you? If makes no sense and turns the law inside out.