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Australians who rely on their family doctor to provide individualised health advice may be unaware that doctors have now been muzzled when it comes to discussions regarding Covid.

A Discernable interview currently circulating on social media features Dr Carolyne Bosak, a GP, and the Victorian MP, David Limberick, discussing their concern for the growing mental health crisis caused by lockdowns. In a striking moment toward the end, the presenter, Matt Wong, asks Bosak if she agrees with Limberick’s call for lockdowns to be lifted. Bosak demurs, saying only “I have an opinion but I actually can’t really express it freely”.

Dr Bosak explains that her reticence is prompted by the Australian Health Practitioner Regulation Agency’s (AHRPA) official position statement entitled “Registered health practitioners and students and COVID-19 vaccination” that threatens doctors with regulatory action if they depart from the pro-vaccination script provided by the government. The position statement limits what doctors can say either in public, on social media and – perhaps most significantly – within the context of therapeutic relationships with their patients:

National Boards expect all health practitioners to use their professional judgement and the best available evidence in practice. This includes when providing information to the public about public health issues such as COVID-19 and vaccination. When advocating for community and population health, health practitioners must also use their expertise and influence to protect and advance the health and wellbeing of individuals as well as communities and broader populations.

Any promotion of anti-vaccination statements or health advice which contradicts the best available scientific evidence or seeks to actively undermine the national immunisation campaign (including via social media) is not supported by National Boards and may be in breach of the codes of conduct and subject to investigation and possible regulatory action.

Several things ought to concern us about AHPRA’s Position Statement.

Government censorship of doctors is invisible to patients.

The first is that patients are very likely unaware of the extent to which government has intruded into the intimacy of the doctor-patient relationship to constrain any conversations that touch upon Covid-19. It is one thing to be given partial information when there is full disclosure of that fact.

But unless all doctors are as frank with their patients as Dr Bosak, it is likely that most Australians are proceeding in the false belief that their doctor’s advice about Covid-19 is free and frank.

Where doctors agree with AHPRA’s position statement, there will be no conflict. But some conscientious doctors don’t agree. Patients should know that AHPRA has ensured only one opinion is available; contrary opinions have been silenced.

Patient health is no longer the only consideration for doctors.

A second concern is that, in matters related to Covid-19, it instructs doctors to consider not just the welfare of their individual patient but also, “the health and wellbeing of … communities and broader populations”. To maximise vaccine take-up AHPRA is encouraging doctors to consider factors apart from the individual health needs of their patient.

Doesn’t this violate the first principle in AHPRA’s own Code of Conduct: “[i]n clinical practice, the care of your patient is your primary concern”?

Government overreach negatively impacts patient health.

Under normal circumstances it is recognised that overly-prescriptive direction from centralised health bureaucracies produces a “one-size-fits-all” approach that will fail to deliver the best results for some patients.

Even before the pandemic, doctors objected to AHPRA’s encroachment into matters beyond their purview.

In 2018, for example, when APHRA revealed proposed updates for its Code of Conduct, several doctors complained that requirements for them to be “respectful of the beliefs and cultures of others” would make it impossible for doctors to challenge cultural beliefs and practices. Similarly, AHPRA’s stipulation that doctors are not to discriminate on “medically irrelevant” grounds such as “race, religion, sex, gender identity, sexual orientation, disability or other grounds” failed to recognise that these were not always “medically irrelevant”.

AHPRA errs about ‘settled science’

AHPRA’s 2018 revisions to the Code of Conduct also limited what doctors can say publicly and in social media:

While you may hold personal beliefs about the efficacy or safety of some public health initiatives, you must make sure that any comments you make on social media are consistent with the codes, standards and guidelines of your profession and do not contradict or counter public health campaigns or messaging.

A registered health practitioner who makes comments, endorses or shares information which contradicts the best available scientific evidence may give legitimacy to false health-related information and breach their professional responsibilities. Practitioners need to take care when commenting, sharing or ‘liking’ such content if not supported by best available scientific evidence.

What constitutes “the best available scientific evidence?” Apparently, doctors are not trusted to evaluate evidence for themselves and are expected to rely unquestioningly on the health bureaucracy. But science is a voyage of discovery which depends for its progress on challenging settled conclusions. Today’s “best available scientific evidence” may be rejected as incorrect tomorrow in light of new information.

Guidelines constrain peer-to-peer information sharing on social media

Given that medical history is peppered with abhorrent practices, quashing medical and scientific debate is problematic and counter to patient welfare. This is never truer than in a pandemic. The suppression of open debate increases the likelihood of committing to harmful policy and decreases our ability to change trajectory should new information come to light. Groupthink is far more dangerous than a virus.

AHPRA’s gag order extends to their social media messages, and thus impinges on conversations between doctors in social media groups. Such groups are regularly used by doctors to share professional observations and consult with their peers. But now, anyone who appears to impugn the wisdom of the national immunisation program risks being reported.

For instance, Dr Paul Oosterhuis was called to appear before the Medical Board today after two anonymous critics had complained about his Covid-19 related social media posts. Dr Oosterhius is an anaesthetist with over 30 years experience, including in critical care and resuscitation. His posts related to early treatment and prophylaxis, PCR tests, and risk-benefit calculations regarding COVID-19 vaccination and lockdowns.

AHPRA demands that doctors support vaccination regardless of evidence.

While the Code of Conduct requires doctors to follow “the best available scientific evidence”, the 2021 Covid Position Statement goes much further. It threatens any doctor who contradicts “the best available scientific evidence or seeks to actively undermine the national immunisation campaign (including via social media)” (emphasis added).

Clearly it would be nonsensical for AHPRA to recommend that doctors continue to encourage vaccination, even if this ran counter to “the best available scientific evidence” — but this is what the Position Statement tells them to do.

AHPRA’s failure to allow for the possibility of adverse reaction to vaccines is incomprehensible. The so-called Covid-19 “vaccines” are a novel mRNA technology; they are still in the clinical trial phase of testing. The clinical trials will not be completed until 2023; they are only provisionally approved for emergency use by the TGA by reason of the Covid-19 emergency; and they are being rolled out to high-risk population groups, such as pregnant women, which were excluded from the clinical trials.

AHPRA’s Position Statement is dated March 9. Australia’s vaccination program had begun a scant two weeks earlier. There is simply no justification for the extraordinary confidence in a problem-free roll-out.

What about informed consent?

News of adverse reactions — including anaphylaxis, thrombosis and coagulation disorders, heart problems such as myocarditis and pericarditis, neurological damage, strokes, paralysis, convulsions and death — is now emerging piecemeal in various countries. It goes largely unreported in the mainstream media.

Unless health authorities are providing fuller and better information to doctors, they will be ill-equipped to offer balanced information about the risks and benefits of the vaccine to their patients. Even if doctors researched the scientific literature for themselves, AHPRA’s injunction to say nothing that might “undermine the national immunisation campaign” appears to ban doctors from sharing information that might discourage a patient’s vaccination decision.

Without fully informed consent of the patient and freedom from coercion, Australia’s national Covid-19 vaccination program violates the Nuremberg Code.

The pressure on doctors is all in one direction

Doctors risk “investigation and possible regulatory action” if they give individualised advice. The federal government’s decision to indemnify doctors from legal liability for vaccine injury removes the threat of personal financial loss for poor advice, further eroding the basis on which doctors might defend a decision to advise caution.

Patients rely on their doctor’s professional ethics when they take his advice. They may be unaware that even these professional ethics are subject to the downward pressure created by AHPRA’s Position Statement because doctors are being encouraged to vaccinate anyone over the age of 16 with a pulse.  

Intimidation of medical staff

Dr Bosak is not alone in feeling the intimidatory effects of Covid-19-related injunctions from AHPRA and other regulatory authorities. Information provided anonymously to me in August from medical staff in Australian hospitals speaks of rising levels of harassment and intimidation in workplace. One person told me:

Hospitals have been for weeks sending senior staff members around with clipboards … asking staff if they have had their COVID Vaccine in front of other staff, in contravention of the Patient Right to Privacy (Staff shouldn’t be asked about private medical procedures nor should they be asked in front of other staff members it is a breach of privacy) and recording the responses. This has been going on repeatedly harassing staff who have already indicated that they will not be getting the vaccine for various reasons.

Further to this … hospitals are sending emails pressuring staff to get the vaccine. They have not stated in writing that it is mandatory nor have they threatened work loss or any reprisals in writing. However, two days ago at a morning staff meeting all staff where advised that in line with the organisation in NSW they were making the vaccine mandatory and any staff member that doesn’t get the vaccine would no longer get work.

On the same day doughnuts, treats & shopping vouchers were handed out in the tearoom at morning tea to all staff who have had their vaccine, which is a form of exclusion and bullying as the staff who were not vaccinated become highlighted and targeted.

Like everyone else, healthcare workers have a right to decline a medical procedure. In response to workplace vaccination pressure, some have felt the need to decline in writing and to ask for written acknowledgement of their decision.

In national emergencies, transparency is absolutely necessary to secure the co-operation of the public. Suppression of free and open debate confirms the suspicions of the vaccine-hesitant that there is something to hide.

The result is a loss of public trust in the health authorities. AHPRA’s gag order runs counter to its own aims of encouraging vaccination. It should be removed immediately.

Elisabeth Taylor

Dr Elisabeth Taylor is a graduate from the University of Sydney and Commonwealth scholar with a PhD in Medieval Women’s History from Cambridge University. She now works as a researcher, writer and speaker,...