More than 130 doctors and members of the public joined a debate aimed at redefining the medical profession's relationship with patients.
In the first of a series of five nationwide public meetings in Manchester, the General Medical Council hosted an expert panel meeting, which discussed three hypothetical ethical dilemmas touching on issues ranging from informed consent and human rights to violent workplaces and the patient choice initiative.
The audience voted on each of the scenarios before and after hearing the panel's views and contributing their own thoughts from the floor.
The discussion, on Friday, was chaired by broadcaster and former Factory Records supremo Tony Wilson and the panel was made up of comic and Private Eye columnist Dr Phil Hammond; Guardian journalist and broadcaster Dea Birkett; BBC GMR presenter and former mental health nurse Allan Beswick; and Manchester university professor of bioethics John Harris.
The first scenario asked people to consider whether, if they needed a heart operation, it would matter to them if their extremely well-respected and successful surgeon was alleged to be a pornography-using adulterer who had recently punched and kicked his 16-year-old mistress.
The second asked if a GP with a manic depressive patient who had been violent and racially abusive towards practice staff should remove him from his list, even if there wasn't an alternative practice nearby.
The third questioned whether a cosmetic surgeon should operate on a patient she felt might develop complications, if he went private and signed a form declaring that he was aware of all the potential risks.
The audience felt that doctors' private lives were important, but that it was not the place of the GMC to intervene unless their behaviour was criminal. They concluded that GPs should be free to refuse patients so long as primary care trusts took responsibility for arranging alternative provision. They also decided that patients should be entitled to demand treatment against their doctors' wishes, so long as they took explicit responsibility for the consequences.
Participants' views will now feed into an ongoing review of Good Medical Practice, the document which forms the foundation of all GMC guidance; provides the framework for undergraduate medical education; supports the processes for doctors' appraisals and revalidation; and is used to assess doctors' fitness to practice when complaints are made to the GMC.
Good Medical Practice, first published in 1995, was last revised in 2001 and in its current form includes 60 clauses outlining good practice in everything from provision of patient care and maintenance of knowledge and skills, to relationships with patients, working with colleagues, and financial and academic probity.
In June 2004, in the wake of the Bristol, Alder Hey and Shipman inquiries, the GMC's standards and ethics committee launched a review to make the document "up-to-date, fit for purpose and contain principles that are held to be important by doctors, patients and the public".
A draft version of the new version of Good Medical Practice is currently out for consultation, and Northern Irish GP Dr John Jenkins, the chairman of the Good Medical Practice review, assured the Manchester audience that their views - and those of participants in the four forthcoming meetings - will feed into the consultation, which is set to end on November 30.
"A lot of the comments we've heard today add to debates we've been having long and hard since the review was announced," he said. "I can assure you this is a genuine consultation and not a PR exercise."
· The next open GMC panel meeting will take place in London on October 27; followed by Cardiff on November 21; Edinburgh on November 22 and Belfast on November 23. To attend, send your name and postal address to one of the following email addresses: gmplondon@gmc-uk.org (for the London meeting); gmcwales@gmc-uk.org (for Cardiff); or gmcscotland@gmc-uk.org (for Edinburgh or Belfast).
