The four doctors who voted against Medevac

When a bill to repeal the Medevac legislation passed the lower house last week, four medical professionals, who are also Coalition MPs, were among those who voted in favour of discarding the current legislation.

The current Migration Amendment (Urgent Medical Treatment) Bill 2018 (Medevac Bill), passed last year, takes decisions about the evacuation of seriously ill asylum seekers and refugees on Manus Island and Nauru out of the hands of politicians and bureaucrats. Instead, two independent medical practitioners are required to assess the need or otherwise for temporary medical evacuation to Australia for treatment.

Member for Lyne Dr David Gillespie, Member for Higgins Dr Katie Allen, Member for Bowman Dr Andrew Laming and Member for Reid Dr Fiona Martin MP voted for these medical decisions to be returned to politicians and bureaucrats, rather than remain with their own professional colleagues.

In case you missed the significance of that, four medical professionals, including a paediatrician (Allen) and a psychologist (Martin), voted to give the power to assess the medical conditions of seriously ill adults and children to non-medical professionals.

How does any doctor worth the title ever justify the abandonment of seriously ill patients – your own or anyone else’s – to decisions made by people who have absolutely no medical qualifications?

One would expect medical professionals to be outraged and highly offended by such a proposition, but no. The four doctors in the Morrison Government are voting for precisely that.

In 2006, the Australian Medical Association (AMA) adopted the World Medical Association’s Declaration of Geneva.

The AMA’s commitment to this pledge was confirmed in 2018 in this article by Dr Chris Moy, chair AMA Ethics and Medico-Legal Committee:

As examples, the WMA consistently condemns governments and others who threaten to compromise professional autonomy and clinical independence, as well as those who undermine the role of medical neutrality and fail to protect healthcare workers in areas of armed conflict.

At first blush, it appears that Drs Gillespie, Martin, Allen and Laming are members of a government that ‘threatens to compromise professional autonomy and clinical independence’, as well as a government that ‘undermines medical neutrality’.

The Morrison Government appears to compromise this independence, autonomy and medical neutrality by repealing legislation that puts the responsibility for medical decisions in the hands of medical practitioners and, instead, gives that responsibility to non-medical actors.

It is within the power of these four doctors to behave ethically towards seriously ill people in offshore detention. All four have chosen not to do this.

Not only are the four doctors members of such a government, but they are each actively voting against the ‘autonomy and clinical independence’ of medical professionals, and for the return of medical decisions about seriously ill patients and their need for evacuation, to non-medical actors.

It is difficult to imagine such a situation occurring in Australia. Imagine the outrage if a public servant or a politician had the final say on whether or not you or I were ill enough to require evacuation to another hospital where the procedure we needed to save our lives was available. However, because the people concerned attempted to come to Australia by boat to seek asylum, they are not considered by Drs Allen, Gillespie, Martin and Laming as worthy of the same treatment as any other human being.

The WMA Physician’s Pledge, supported by the AMA, states in part:

AS A MEMBER OF THE MEDICAL PROFESSION:

I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;

THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;

I WILL RESPECT the autonomy and dignity of my patient;

I WILL MAINTAIN the utmost respect for human life;

I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;

Perhaps all four doctors, if challenged, would make the sophist argument that the asylum seekers and refugees are not their patients, therefore they have no obligation to behave ethically towards them or to ensure, when it is in their power to do so, that those patients are treated with the concern, dignity and respect they deserve as human beings.

It is within the power of these four doctors to behave ethically towards seriously ill people in offshore detention. All four have chosen not to do this. This is quite difficult to absorb. Four medical professionals in government have the power to positively affect the well being of seriously ill adults and children, and they have chosen instead to put them at further risk. They have made this choice out of self-interest and loyalty to ideology.

Medical ethics apparently mean nothing to these four doctors.

These same four doctors are part of a government that has permitted a tiny child in immigration detention in Melbourne to suffer unimaginable pain and distress, by denying her dental treatment and depriving her of the sunlight she needs. Two-year-old Tharunicaa’s mouth had been swollen from infection for months, with her new teeth emerging visibly rotten and broken. Her mother had to chew her child’s food before feeding it to her.

The family have been in detention since March last year after being seized in a dawn raid by from their Biloela home by Home Affairs Minister Peter Dutton’s Border Force paramilitary when their bridging visa allegedly expired. The child and her sister have suffered severe vitamin deficiencies since being imprisoned.

Dr Fiona Martin is a child psychologist. She specialises in learning, developmental and behavioural difficulties in children.

It beggars belief that these two highly qualified doctors can vote to abandon the health of children in offshore detention to decisions made by politicians and bureaucrats.

It beggars belief that these two women can remain silent on the plight of a tiny child who has suffered so horribly as a consequence of gross neglect and severe abuse, by the Government to which they belong.

The President of the AMA is Dr Tony Bartone. It would be interesting to hear Dr Bartone’s take on the conduct of the four doctors. On the face of it, it’s tempting to conclude that not one of them should continue to be a registered practitioner.