Why sexual and reproductive health policies might fail

Richard Ma, General Practitioner and GP Champion,
May 18, 2017

Strickland's paper in the JME highlights one of the key barriers to any policy on sexual and reproductive health matters: the attitude of the doctor to sexual health interventions.

Although the study only involved four medical schools and the sample was not powered or stratified to be deemed representative, the views of 733 medical students out of an estimated 7,600 due to graduate this summer may be important.

Doctors may choose career paths that do not regularly compromise their beliefs. However, as the author pointed out, foundation year trainees may not have a choice of training posts; doctors working in general practice and A&E are in contact with a wide range of population groups regularly and get no choice who they see.

Referral for and performing abortions will always provoke ethical discussions for doctors and is nothing new; the more surprising fact from the study is that some students would object to giving contraception to a woman who is deemed competent, and treating a patient who may be using drugs or alcohol.

There is no question that medical students and doctors are allowed a moral view on any matter. What concerns me is that this might take precedent over a person's right to basic reproductive choices such as contraception. Would similar attitudes extend to refusing testing and treatment someone for sexually transmitted infections or HIV? What message does this send out to the public about sensitive issues like sexual and reproductive health?

Sexual and reproductive health is already a highly stigmatized area without doctors making unfair judgements about a person's lifestyle and refusing appropriate treatment, resulting in serious consequences including unplanned pregnancies, complications from STIs, onward spread of STIs and HIV.

Thankfully, the students might have been at a stage where they could be taught how to adhere to their beliefs without compromising patient care. We must have assurances that future doctors understand this before they practise medicine. Without this safeguard, the sexual health statistics of the nation would only get worse, and it is the health of the public that suffer.

Conflict of Interest:

GP Champion, London Sexual Health Programme

Conflict of Interest

None declared