276
BRITISH MEDICAL JOURNAL
Chlamydia SIR,-The leading article (16 June, p 1588) gives the plural of chlamydia as chlamydiae. My classical brother assures me that chlamydia is already the plural of chlamydion, a diminutive form of chlamys (genitive chlamydos): a woollen cloak fastened by a brooch on the right shoulder, worn especially by horsemen. Therefore it would be correct to refer to organisms of the genus Chlamydia rather than to treat the word as a feminine singular. FREDERICK J WRIGHT Edinburgh EH10 6PU
***Dr Wright is correct, of course, and we will be more wary with our Greek in future.-ED, BM3.
Abortion (Amendment) Bill SIR,-Permit me to draw the attention of all doctors of good will and sincere concern to the latest doctrinaire attack upon the smooth and sensible working of the 1967 Abortion Act: that of Mr John Corrie, MP. His Bill was given its second reading on 13 July 1979. The 28-week rule is a medical and scientific, as well as legal, concept that allows the practising doctor to work to about 20 weeks' gestation with comfortable leeway. To make a 20-week limit would be to reduce the effective maximum for abortion to 16 weeks. The proposed restrictions in abortion counselling to exclude doctors who are not five years qualified and yet who deal with life, death, and sanity in all other respects, would be merely insulting in a way that only a layman, excused by his ignorance, would dare. This Bill is one more transparent effort of a small but vocal minority to enforce their doctrinaire ideas upon the will of the public and the profession which serves it. It can best be resisted by an immediate letter of protest to your MP or to the DHSS. NORMAN CHISHOLM London NW3 2XD
SIR,-Although we do not support the principle underlying the Abortion Bill of 1967, we most warmly welcome any mitigation of its misuses, including the currently proposed modification of the social clauses. Thus we would in this sense support the proposals contained in Mr Corrie's amending Bill. The conscience clause applies, in our opinion, to all doctors, not only to those engaged in obstetrics and gynaecology. Equally it applies to all nurses, both in operating theatres and wards, where many abortions may now be accomplished effectively. The patient's conscience too should be respected by ensuring full information prior to consent for prenatal screening. Underlying the above points is the importance Mr Corrie has laid upon proper counselling. This we welcome. You demonstrated' that those advised to have an abortion often complied, but those unduly so influenced are prone to continuing feelings of regret and to depression subsequently, and you further pointed out that it is the care with which the decision is reached and the degree of support afterwards which influence the likely psycho-
28 JULY 1979
logical outcome. Thus we strongly support the example to the nation even if it means some amendments promoting better counselling. sacrifice in our standard of life in order to preserve our standards and therefore our K P ROCHE status. Master of the Guild If the junior hospital doctors wish to of Catholic Doctors prolong their apprenticeship before assuming JONATHAN GOULD full professional responsibilities that is their Chairman of the Standing Parliamentary Committee option; but consultants and principals in of the Guild of practice should give them a lead, not follow Catholic Doctors theirs, and in the opposite direction to the London WlN 1PD one that they have taken us. As Byron said, 1 British Medical_Journal, 1976, 1, 1239. "In all the catalogue of human woe, the worst is that sad phrase I told you so." JOHN DAVIS SIR,-I am profoundly disturbed to see St Mary's Hospital, statements attributed to the BMA based on Manchester M13 OJH decisions made by the Representative Body two years ago and applied to conditions as they are at the moment in respect of the Corrie New consultant contract Abortion (Amendment) Bill. There is no doubt that abortion is for many SIR,-Although clearly the overwhelming of us fundamentally a moral issue, and I would body of opinion is expressly against the new have thought that the BMA had more wisdom contract that negotiations over two years have than to allow any of its committees to make led to, I feel I am obliged to add to that weight decisions which offend the moral principles the adverse opinions of the physicians in this of some of its members. It should stick to district. They have asked me to write expressfacts. I would have no objection, for example, ing our deep dissatisfaction with the outcome, to the publication of an analysis of members' and the disappointment of hopes raised. The views on moral issues such as abortion, but I deficiencies of this contract as stated are would not feel happy at continuing to be a quite obvious and we are glad to express our member of such an organisation if decisions satisfaction that the recommendations have on a moral issue became declared policy based been rejected. on the majority vote. The matter of emergency recall fees, PHILIP R NORRIS however, may still remain and here we feel we must register a further objection. While London Wl clearly the costing arrangements for these fees are entirely unsatisfactory, we also dislike the Pay and contracts principle involved in paying emergency recall fees, feeling that as true professional people, SIR,-Some weeks ago, before the rejection in the original meaning of that word, this by the negotiators of the terms of the new responsibility to our patients already exists contract, an unpublished letter signed by a and should be recognised in our total rehigh proportion of the consultant staff of muneration and should not require additional what used to be the United Manchester recompense. Further, we feel that the proHospitals was sent to your offices supporting fession is only to be degraded with the the one that you published from the staff of additional requirement to have our visits Northwick Park Hospital (17 March, p 755), authenticated and recorded before any such which had urged its rejection as a matter of fees are paid. principle. It was T S Eliot who said that the M O'CONNOR ultimate treason was to do the right thing for Division of Medicine, the wrong reason and this is how the profession North District, Manchester has now been betrayed by its representatives. Those of us who teach medical students do not wish to pass on merely the body of Community medicine-a change in knowledge that our profession has accumulated direction but also those Hippocratic principles governing our practice which makes us a profession SIR,-The recent leading article (7 July, p 3) rather than a trade. People do not consult on community medicine reiterated a point physicians (I count surgeons as operating of view that is in danger of being accepted by physicians) for items of service but because virtue of ceaseless repetition: namely, that they are anxious about their health and wish there is low morale in the speciality, uncerto put their problems to an adviser with the tainty about its future direction, and anxiety professional attributes of disinterested concern, about its role. I have not yet read the paper, referred to in the possession of proved knowledge and skills, and adherence to accepted standards of the leading article, by the Unit for the Study conduct including the assumption of res- of Health Policy, although I hope to do so. ponsibility that continues beyond the period It is undoubtedly a perfectly reasonable point of consultation of therapeutic intervention. of view to argue that community medicine We are paid for being, not doing, though should be reflecting the general concern of doing is part of being; and we can no more society with environmental issues and probe paid for items of service than the mother viding more forceful leadership. It is quite wrong, however, to link this of a baby cares for it solely in terms of feeding, debate to the alleged low morale in the changing, and periods of stimulation. The rejection of the terms of the new specialty. At a recent seminar in Harrogate contract and all that goes with it gives us attended by 36 district community physicians another chance to reject on principle, which from all over the country this prevailing we should thankfully take. As Dr Ritchie impression was clearly shown to be wrong. Russell says in his helpful letter (7 July, p 53), There is, among many district community we are privileged people; and at this point physicians at least, a noticeable esprit de corps. in our history we should acknowledge the There is clearly the feeling that the central principle of noblesse oblige to set a good content of the district community physician's
BRITISH MEDICAL JOURNAL
Chlamydia SIR,-The leading article (16 June, p 1588) gives the plural of chlamydia as chlamydiae. My classical brother assures me that chlamydia is already the plural of chlamydion, a diminutive form of chlamys (genitive chlamydos): a woollen cloak fastened by a brooch on the right shoulder, worn especially by horsemen. Therefore it would be correct to refer to organisms of the genus Chlamydia rather than to treat the word as a feminine singular. FREDERICK J WRIGHT Edinburgh EH10 6PU
***Dr Wright is correct, of course, and we will be more wary with our Greek in future.-ED, BM3.
Abortion (Amendment) Bill SIR,-Permit me to draw the attention of all doctors of good will and sincere concern to the latest doctrinaire attack upon the smooth and sensible working of the 1967 Abortion Act: that of Mr John Corrie, MP. His Bill was given its second reading on 13 July 1979. The 28-week rule is a medical and scientific, as well as legal, concept that allows the practising doctor to work to about 20 weeks' gestation with comfortable leeway. To make a 20-week limit would be to reduce the effective maximum for abortion to 16 weeks. The proposed restrictions in abortion counselling to exclude doctors who are not five years qualified and yet who deal with life, death, and sanity in all other respects, would be merely insulting in a way that only a layman, excused by his ignorance, would dare. This Bill is one more transparent effort of a small but vocal minority to enforce their doctrinaire ideas upon the will of the public and the profession which serves it. It can best be resisted by an immediate letter of protest to your MP or to the DHSS. NORMAN CHISHOLM London NW3 2XD
SIR,-Although we do not support the principle underlying the Abortion Bill of 1967, we most warmly welcome any mitigation of its misuses, including the currently proposed modification of the social clauses. Thus we would in this sense support the proposals contained in Mr Corrie's amending Bill. The conscience clause applies, in our opinion, to all doctors, not only to those engaged in obstetrics and gynaecology. Equally it applies to all nurses, both in operating theatres and wards, where many abortions may now be accomplished effectively. The patient's conscience too should be respected by ensuring full information prior to consent for prenatal screening. Underlying the above points is the importance Mr Corrie has laid upon proper counselling. This we welcome. You demonstrated' that those advised to have an abortion often complied, but those unduly so influenced are prone to continuing feelings of regret and to depression subsequently, and you further pointed out that it is the care with which the decision is reached and the degree of support afterwards which influence the likely psycho-
28 JULY 1979
logical outcome. Thus we strongly support the example to the nation even if it means some amendments promoting better counselling. sacrifice in our standard of life in order to preserve our standards and therefore our K P ROCHE status. Master of the Guild If the junior hospital doctors wish to of Catholic Doctors prolong their apprenticeship before assuming JONATHAN GOULD full professional responsibilities that is their Chairman of the Standing Parliamentary Committee option; but consultants and principals in of the Guild of practice should give them a lead, not follow Catholic Doctors theirs, and in the opposite direction to the London WlN 1PD one that they have taken us. As Byron said, 1 British Medical_Journal, 1976, 1, 1239. "In all the catalogue of human woe, the worst is that sad phrase I told you so." JOHN DAVIS SIR,-I am profoundly disturbed to see St Mary's Hospital, statements attributed to the BMA based on Manchester M13 OJH decisions made by the Representative Body two years ago and applied to conditions as they are at the moment in respect of the Corrie New consultant contract Abortion (Amendment) Bill. There is no doubt that abortion is for many SIR,-Although clearly the overwhelming of us fundamentally a moral issue, and I would body of opinion is expressly against the new have thought that the BMA had more wisdom contract that negotiations over two years have than to allow any of its committees to make led to, I feel I am obliged to add to that weight decisions which offend the moral principles the adverse opinions of the physicians in this of some of its members. It should stick to district. They have asked me to write expressfacts. I would have no objection, for example, ing our deep dissatisfaction with the outcome, to the publication of an analysis of members' and the disappointment of hopes raised. The views on moral issues such as abortion, but I deficiencies of this contract as stated are would not feel happy at continuing to be a quite obvious and we are glad to express our member of such an organisation if decisions satisfaction that the recommendations have on a moral issue became declared policy based been rejected. on the majority vote. The matter of emergency recall fees, PHILIP R NORRIS however, may still remain and here we feel we must register a further objection. While London Wl clearly the costing arrangements for these fees are entirely unsatisfactory, we also dislike the Pay and contracts principle involved in paying emergency recall fees, feeling that as true professional people, SIR,-Some weeks ago, before the rejection in the original meaning of that word, this by the negotiators of the terms of the new responsibility to our patients already exists contract, an unpublished letter signed by a and should be recognised in our total rehigh proportion of the consultant staff of muneration and should not require additional what used to be the United Manchester recompense. Further, we feel that the proHospitals was sent to your offices supporting fession is only to be degraded with the the one that you published from the staff of additional requirement to have our visits Northwick Park Hospital (17 March, p 755), authenticated and recorded before any such which had urged its rejection as a matter of fees are paid. principle. It was T S Eliot who said that the M O'CONNOR ultimate treason was to do the right thing for Division of Medicine, the wrong reason and this is how the profession North District, Manchester has now been betrayed by its representatives. Those of us who teach medical students do not wish to pass on merely the body of Community medicine-a change in knowledge that our profession has accumulated direction but also those Hippocratic principles governing our practice which makes us a profession SIR,-The recent leading article (7 July, p 3) rather than a trade. People do not consult on community medicine reiterated a point physicians (I count surgeons as operating of view that is in danger of being accepted by physicians) for items of service but because virtue of ceaseless repetition: namely, that they are anxious about their health and wish there is low morale in the speciality, uncerto put their problems to an adviser with the tainty about its future direction, and anxiety professional attributes of disinterested concern, about its role. I have not yet read the paper, referred to in the possession of proved knowledge and skills, and adherence to accepted standards of the leading article, by the Unit for the Study conduct including the assumption of res- of Health Policy, although I hope to do so. ponsibility that continues beyond the period It is undoubtedly a perfectly reasonable point of consultation of therapeutic intervention. of view to argue that community medicine We are paid for being, not doing, though should be reflecting the general concern of doing is part of being; and we can no more society with environmental issues and probe paid for items of service than the mother viding more forceful leadership. It is quite wrong, however, to link this of a baby cares for it solely in terms of feeding, debate to the alleged low morale in the changing, and periods of stimulation. The rejection of the terms of the new specialty. At a recent seminar in Harrogate contract and all that goes with it gives us attended by 36 district community physicians another chance to reject on principle, which from all over the country this prevailing we should thankfully take. As Dr Ritchie impression was clearly shown to be wrong. Russell says in his helpful letter (7 July, p 53), There is, among many district community we are privileged people; and at this point physicians at least, a noticeable esprit de corps. in our history we should acknowledge the There is clearly the feeling that the central principle of noblesse oblige to set a good content of the district community physician's
