Open Letter calls for doctors free speech
18 July 2022
An Open Letter, focused on freedom of speech for doctors, has been sent to all Australian health ministers after being signed by 18 scientists and doctors and 1,400 citizens. The letter seeks an independent audit of the practices of the Australian Health Practitioner Regulation Authority
NOOSA – Earlier this month in The silencing of Covid truth teller, Dr Berger, I wrote of a doctor who has been forced to submit to an unAustralian Communist style re-education program and was publicly humiliated by a government body.
The Australian Health Practitioner Regulation Agency (Ahpra is their preferred abbreviation) is the body that registers doctors in Australia. It also runs one of the clumsiest and user unfriendly websites in the nation.
Ahpra can also deregister doctors and this it was threatening to do to Dr Berger because of his quite justified criticism of how badly Australian authorities were dealing with the spread of Covid and failing in their duty of care to the Australian people.
So Dr David Berger was indeed very critical of the people responsible for the mess that is A ustralia’s response to Covid and his criticism was well targeted and deserved.
Australia continues to botch its management of Covid at the cost of hundreds of lives each week and a thousand more people who develop long-term chronic illnesses.
And as the government authorities give Covid to a free rein to rampage through the country, David Berger has to explain how he has behaved “discourteously, unprofessionally and offended the community”.
If he does not comply, this skilled, ethical and courageous remote area doctor will face deregistration. He can lose his job just because he told the truth to people who needed to hear it.
THE OPEN LETTER
WE, THE UNDERSIGNED, being concerned scientists, doctors and citizens of various diverse professional expertise, with a common interest in humanity and the reduction of suffering, disability and death caused by Covid-19, note with concern that Dr David Berger has a public condition placed upon his medical registration.
He is reportedly required to attend education “in relation to behaving professionally and courteously to colleagues and other practitioners”, apparently as a result of a complaint about his effective, scientifically valid and good faith Covid-19 advocacy in the best interests of Australian people.
We would not wish news of this condition placed upon him to be heard without reference to his clear, honest sustained contribution to public health through his personal and corporate advocacy and his unblemished clinical record, working in remote hardship locations, often with indigenous peoples.
CONTEXT: That the public health approaches which he has questioned are a legitimate subject of debate in Australia and around the world, and thus remain worthy of being discussed critically despite their implementation by governments.
CONSIDERATION: Of the effect that such a condition may have on his future good work as an advocate and that of legion other registrants, who may be deterred from speaking truth to power as a result of such action which could have a chilling effect on open political and scientific discussion.
UNDERSTANDING: That it is critically important for the safety of patients that we speak openly about scientific and clinical matters, and to be polite where possible, but assertive and determined when a message for safety is being ignored by officials or politicians in charge of a health system.
The AHPRA policy assumes government policy is always in the best interests of the people of Australia, and that doctors must be subservient to the State over their concerns for patients.
This is in breach of our ethical and moral obligations outlined in, for example, the Declaration of Geneva.
Governments may formulate public health policies that are not in the best interests of the community, and dissenting doctors may take a position that is for the better interest of population health.
Dr Berger is representative of all of us who take time to think, to care, and to comment in our own diverse way on how to make the public safer, especially to amplify those vulnerable groups such as the very old, very young, or very sick who may not have the resource to be heard.
Current public health settings are not infallible, as evidenced by their constant adjustment and wide variation between jurisdictions.
The “best available advice” is not always that from government advisors, who by definition are limited in number, diversity and expertise.
Even when we might agree with all that these advisors say, it may well not be translated accurately and openly into policy by those in power.
The wording of the AHPRA policy on social media is so broad as to potentially permit discretionary outcomes.
It could be interpreted one way to target some doctors who do not have support of government, and another to allow other doctors who are government spokespersons to behave as they wish on social media, simply because their views accord with the administration.
We are concerned about the potential for AHPRA to lose its focus on patient safety and become a means to persecute doctors and other registrants for political reasons, in the name of maintaining confidence in public health measures.
In fact, it may have the opposite effect if the community distrust a regime that silences medical dissent this way.
If the open discussion of public health settings by registered practitioners is stifled by authoritarian implementation of regulation, leaving the rest of the community to discuss these issues without alternative ideas from those who have the best understanding of disease, that will not benefit anyone.
Australia must not be a country where reputable scientists and clinicians cannot speak for the public good because they fear reprisal from their government regulator.
We stand with David Berger and specifically reject any suggestion that in a democracy we must politely agree with government policy, or stay silent.
We respectfully request the following urgent actions by Health Ministers:
An independent audit of AHPRA’s handling of social media and public advocacy complaints, focusing on parity of responses and a comparison of complaints that were and were not actioned, and which ones did and did not result in conditions being placed on registrants.
The audit should reveal whether the policy is applied consistently.
We request revocation of the conditions placed on Dr Berger on the basis that it is unreasonable to expect all registrants to always support government public health settings, and to be restricted in their tone of communication by a regulator.
The 2021 changes to policy that now enable AHPRA to punish doctors for speaking out should be urgently reviewed, along with the remit of AHPRA as a blanket defender of government health policy.
Removal of the cloak of anonymity from Ahpra complaints where the matter relates to public advocacy rather than clinical practice.
A statement affirming freedom of speech for doctors, in the public interest, and confirmation that expressing a difference of opinion with government policy does not in itself constitute a breach of AHPRA’s Good Medical Practice Code.
"If freedom of speech is taken away, then dumb and silent we may be led, like sheep to the slaughter." - George Washington
Posted by: Bernard Corden | 18 July 2022 at 10:40 AM