Should Doctors Be Allowed to Strike?

by Mahir Asef

(image: BBC)

Many will argue that as doctors have a duty of care towards their patients, and that they should not be allowed to strike as this could lead to the deaths of patients who had entrusted the doctors with their care. But do doctors deserve the right to strike as after all they are citizens of the same country and have the same rights as you and I?

Doctors point to the 4 pillars of medical ethics (non-maleficence, beneficence,  autonomy and social justice) as their cornerstones for action in the field and so strike action can be seen as going against the pillars of beneficence and nonmaleficence. This is because when striking, doctors are not acting in the best interest of their current patients and therefore they are betraying the pillar of beneficence. In fact they are actively jeopardising patient care. Furthermore by striking they are betraying non-maleficence as their actions will have negative impacts on their patients, showing that they are not limiting their harm to the patient to a minimum. Surely if you are not fulfilling two of the pillars of medicine, the pillars that have built the profession, striking should not even be considered?

However, one may argue that when striking doctors are acting on behalf of the other two ethical pillars of medicine, autonomy and social justice. By striking and demanding better working conditions or higher salaries they are working in the best interests of other doctors and therefore they are working towards social justice. They are recognising that doctors deserve and have the same rights as every citizen and entering this field does not rid them of these rights. As they have made the decision to strike they are also working in an autonomous fashion as they have made the choice to demand better conditions and while autonomy in medicine is often related to the patient in this case it is important as it shows initiative. Without this initiative many more patients would die as doctors would not know how to act in the unique situations they face every day. Not everything in medicine can be carried out by the book.

As strong as this argument is it is impossible to get away from the fact that every doctor has a duty of care to their patients and while they are championing social justice by striking they are jeopardising both patient care and belief in the medical system. These two factors are what should be considered most when tackling this argument as it is the public who require the service of the medical profession. And while some will argue that social disruption is the only way of bringing about change, this is not the case. For example when the NHS was brought about in 1948, Aneurin Bevan had to ‘stuff the doctors mouths with gold’ (the gold equating to promises of continued private practice among other things) to convince them that the NHS was a good idea that should be pursued. He did this as doctors carried on with their normal lives and jobs, no strike was required. Therefore it can be concluded that doctors should not be allowed to strike because of a duty to the public and patients.