Doctors, as individuals, are capable of impressive acts of understanding and compassion. Yet, when they get together in a group, they are capable of public acts of extraordinary insensitivity. In October 1987, thirteen international experts met in Alborg in Denmark for a ‘consensus meeting’ on the prevention and treatment of osteoporosis – a thinning and fragility of bone that can afflict women after the hormonal changes that occur during the menopause.
The idea of consensus meetings is commendable. In Alborg, the experts listened to presentations of the published scientific data about osteoporosis before going into a huddle and emerging with a ‘consensus statement’ which defined the forms of treatment they believed had been established by reputable research as opposed to treatments that might be advocated by enthusiastic hobby-horse jockeys.
Their statement included a recommendation that postmenopausal women should take regular doses of hormones, even though this might increase their risk of getting cancer. When the experts presented their conclusions at a press conference, a journalist – male – pointed out that this recommendation came from a panel of which every member was a man.
The chairman agreed that this was ‘unfortunate’ but explained that the panel needed experienced experts, ‘and, when research started in this field, only men were involved’.
‘But all your patients are women,’ said the journalist. ‘Why not invite a couple of patients to join the group?’ The reaction of the ‘experts’ suggested that the journalist had lost his mind.
Insensitivity to the implications of gender has a long and dishonourable history in medicine. Yet attempts in the 1990s to eliminate discrimination created a strange new problem. NHS bureaucrats discovered that in addition to facing their traditional enemies – grammar and syntax – they now had to grapple with the notion of ‘correctness’ without quite understanding what it was.
In February 1999, Dr Dick Ford, a GP in Bideford, wrote to the then secretary of state for health, Frank Dobson.
I was amazed to read your missive (Statutory Instruments 1999 No 326) which refers to all doctors as he, and all nurses as she. When I was a child, I wallowed in the misbelief that all dogs were male and all cats were female. It didn’t take me long to discover otherwise. I can assure you that not all doctors are male and not all nurses are female. Perhaps in this era of political correctness, regulations ought to be couched in these terms.
Dr Ford got a reply not from Frank Dobson but from M A Garley (sex and administrative position undisclosed) at the NHS Executive.
I should explain that Section 6 of the Interpretation Act 1978 provides that any reference in legislation to the masculine includes the feminine, and similarly any reference to the feminine includes the masculine. Consequently all references in the Statutory Instrument to male or female include the other sex, and the regulations, of course, apply equally to all doctors and nurses. In this particular case, the regulations were drafted to refer to male doctors and female nurses solely to avoid any possible confusion and to make it absolutely clear when the reference was to the nurse and when to the doctor.
Dr Ford, a charitable man, wondered if he might have stumbled upon a bureaucrat (a word which may or, on the other hand, may not include the feminine) with a sense of humour.
I fear not.