Trying times for GMC

Trying times for GMC

356 invention should not be excluded on the sole grounds that it is composed of or uses biological material—or is intended for use on biological matt...

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invention should not be excluded on the sole grounds that it is composed of or uses biological material—or is intended for use on biological matter, the committee seeks to exclude patents on inventions "contrary to public order or morality’ ’-as in animal modifications involving needless suffering or

physical handicap. MEPs are likely to insist that they are not solely to blame for the slow progress in developing a coherent EC policy on biotechnology. The Commission itself has been criticised over the multiplicity of Brussels directorates involved. This prompted the creation last year of CUBE (Co-ordination Unit for Biotechnology in Europe)--a group of experts within the Commission set up to orchestrate policy across the whole field of Community legislation. However, a recurring theme of the EP findings is the need for a system allowing a wide range of outside opinion-agricultural, consumer, religious, moral, research, Third World, environment, and animal rights-to influence both research and exploitation. In Strasbourg, MEPs will press the Commission on how this requirement can be met by Delors’ panel of "six wise men". The debate will be the assembly’s main opportunity to influence the final shape of the draft directive, which could become law in 1993. By the time the draft returns for its second reading, the Council of Ministers ministers will have reached a common position on the directive. Strasbourg would then have only limited powers to impede the measure by mustering a majority vote of its 518 members.



Germany: Doctor spies How many doctors actively collaborated with the East German security police (Stasi)? The Stasi files-or more precisely those parts that escaped destruction by the communists-have recently been made generally available and can now be read by the victims. The archives, which are under state control, can hardly cope with the number of applicants who want to find out whether they have been spied on, and by whom. In addition to its 90 000 official members the Stasi maintained a much larger numberperhaps even a substantial fraction of the population-of unofficial spies. Thus colleagues, supposed friends, relatives, even a husband or wife, were routinely monitoring all aspects of a victim’s life. The head of the Stasi archive in Berlin, the former East German priest Joachim Gauck, has warned that many will need psychotherapy after reading the files. The Secretary of State in Saxonia, Jurgen Eggert, is one of the best known cases. He was a university priest before the fall of the Berlin wall and disliked by the Socialist regime for his dissident opinions. In the summer of 1983 he became very ill with gastroenteritis, contracted during a camping holiday. Since nobody else in the camp suffered from the same disease Eggert suspected that he might have been infected by the Stasi. After his recovery Eggert became very depressed, even suicidal. From studying his 2800-page file Eggert didn’t find any direct evidence that the Stasi infected him at the holiday camp. But it was clear that the Stasi had directed him towards the psychiatric clinic Gross-Schweidnitz. The director there, Reinhard Wolf, had been recommended by Stasi informants as being especially trustworthy. Wolf, himself a Stasi collaborator, treated Eggert with powerful psychotropic drugs, making him immobile. A second

psychiatrist led him to believe that he would never be fit again to take up his job as a priest. Therapy sessions were nothing but preplanned spying on the most intimate details of Eggert’s life. Eggert recovered because he did not take the prescribed medication after he left the hospital. Both psychiatrists involved have been suspended. The psychiatric hospital Waldheim, where unruly citizens

maltreated, had been thought to be an exception (Lancet 1990; 336: 1434-35), but it is now were

expected that as more files are opened other doctors guilty of cooperating with the Stasi-spying on their patients or even worse-will be identified. Prof Uwe Henrik Peters from Cologne, President of the German Psychiatric Society, is still certain that psychiatry has not been systematically abused. Unlike the Soviet Union, East Germany did not have ideological reasons for persecuting dissidents by psychiatric means. But there might have been several isolated cases, Peters admits. Those Stasi doctors, he says, should not be allowed to practise any more.

Annette Tuffs

Noticeboard Trying times for GMC The UK General Medical Council (GMC) may be acting unlawfully by delegating its responsibility for accreditation of junior hospital doctors to the Joint Committee on Higher Medical Training (JCHMT). In December, 1991 (see Lancet Dec 14, p 1516), the High Court held that the decision by the GMC-after taking advice from the JCHMT-to grant Dr Anthony J. Goldstein European certification in rheumatology, but not UK accreditation, was "perverse". Dr Goldstein now claims that the GMC has been operating against a fundamental principle of UK administrative law. When Parliament delegates a function to another organisation (in this case, the GMC), and bestows on it the powers necessary for it to complete that function, those responsibilities must not be further delegated to another body. This rule ("delegatus non potest delegare") means that if such further delegation of responsibility does take place-for instance, by the GMC to the JCHMT-then the intentions of Parliament will have been thwarted. The GMC may be acting beyond its statutory powers, thereby rendering decisions on UK accreditation unlawful. A 1975 European Community directive (75/362/EEC) states that UK doctors seeking evidence of formal training qualifications must obtain a "certificate of completion of specialist training issued by the competent authority recognised for this purpose". This document attempted to defme and harmonise recognition of formal medical qualifications throughout Europe. By inserting the word "completion", implying a defmed period of supervised training, the council directive tried to remove any arbitrariness from accreditation. However, in an Executive and Education Committee meeting of the GMC in October, 1976, the specialist training bodies were said to have "expressed anxiety" about the use of the words "completion of’. These words were subsequently deleted from GMC guidelines. The result of this action was that the GMC reasserted an element of arbitrariness (based on word of mouth and confidential references) into the decision-making process leading to accreditation. The GMC’s policy on accreditation of junior hospital doctors is now in disarray, and further legal action by individual doctors is likely. The British Medical Association (BMA)--the representative body of all grades of UK doctors, including juniors-has been curiously silent during this important debate. The BMA seems to be having difficulty in deciding on its position: its choice is between defending junior doctors’ interests against what amounts to restrictive practices and coming to the rescue of an organisationthe GMC-that has been a bulwark of the medical establishment.