Two in three family GPs refuse to follow NHS advice to give statins to 40 per cent of adults, survey finds
The Telegraph
Two thirds of GPs are refusing to comply with controversial NHS advice to prescribe statins to millions more adults, polling has found.
Family doctors said guidelines from the National Institute for Health and Care Excellence (Nice), advising 40 per cent of adults to take the pills, were “simplistic”. They insisted they would not allow the “mass medicalisation” of the public.
The guidelines, published in July, say drugs to protect against strokes and heart attacks should be offered to anyone with a one in 10 chance of developing heart disease within a decade.
It means 17.5 million adults, including most men aged over 60 and women over 65, are now eligible for the drugs, which cost less than 10p a day.
A number of cardiologists have defended the guidance, which Nice says could cut 50,000 deaths a year from strokes and heart attacks.
But the advice has divided experts, with prominent doctors accusing Nice’s experts of being too close to the pharmaceutical industry. [Full Text]
The refusal of physicians to prescribe statins as directed would likely be described by most of them as an exercise of “professional” conscience: that is, the exercise of informed medical judgement in reaching a conclusion that statins should not be prescribed as ordered by the National Health Service. It is quite likely that many would distinguish the exercise of “professional” conscience from “personal” conscience on the grounds that the former is determined by medical science and the latter by morality. This common approach to the issue is mistaken. The practice of medicine is an inescapably moral enterprise precisely because physicians are always seeking to do some kind of good and avoid some kind of evil for their patients. However, the moral aspect of practice as it relates to the conduct and moral responsibility of a physician is usually implicit, not explicit. It is normally eclipsed by the needs of the patient and exigencies of practice. But it is never absent; every decision concerning treatment is a moral decision, whether or not the physician specifically adverts to that fact. In this case, the objecting physicians rely upon their medical expertise to arrive at the conclusion that it would likely be harmful to patients – or at least not in their interests – to prescribe statins as ordered by the state regulator. They believe that it would be wrong to do that – a moral or ethical judgment – and it is on the basis of that moral or ethical judgement, informed by medical expertise, that they refuse to prescribe. What is also of interest is the fact that physicians who refuse to prescribe hormonal contraceptives may rely upon exactly the same kind of reasoning, whether or not they are additionally motivated by other religious or moral considerations. See, for example, “NO MORE CHRISTIAN DOCTORS”.