Updated - The BMA - Do no harm?

I have a real issue with some sections of the medical profession and their attitudes to vaping/ecigarettes. In particular +The BMA .

Why? Well, let's set a baseline;
http://bma.org.uk/about-the-bma "The British Medical Association (BMA) is the trade union and professional body for doctors in the UK."
They are a trade union, not a medical advisory body. Theirs is to look after their members and help them stay up to date, not to advise others on what they should do or not do in their personal or business lives.

The responsibility for general health and health policy in the UK falls to the Department of Health, who earlier this year said they were not planning an indoor vaping/e-cigarette ban. They are assisted by Public Health England who, in their 2014 report, did not make a judgement on vaping/ecigarettes.

The responsibility for protecting patients, ensuring doctors are competent and up to date falls to the General Medical Council. They should also discipline doctors who behave unprofessionally, illegally or against the health of patients.

Advice to employers on health matters is the responsibility primarily of the Health and Safety Executive. The HSE offered this advice earlier in the year;

"HSE’s advice is that an employer needs to consider e-cigarettes in the wider context of risk in the workplace. We are aware that some organisations have banned their use but this is not something HSE has advised on. Employers may want to ask for advice on this from Public Health England...........If an employer decides to 'prohibit' the use of e-cigarettes in the workplace but allow for ‘vaping’ breaks or provide areas where employees can use e-cigarettes, the employer needs to ensure that those who use e-cigarettes are not put at risk of harm from second-hand tobacco smoke."

So, the BMA is not responsible for public health, policy, education or workplace safety. But that hasn't stopped them from tacitly and inaccurately encouraging doctors to advise against vaping, calling for stronger regulations, lobbying football clubs to ban vaping from grounds or offering guidance to employers and businesses on the "dangers" of vaping in workplaces.

(Update) A clear example of the BMA exerting undue and inappropriate influence was seem in http://www.theconstructionindex.co.uk/news/view/construction-companies-clamp-down-on-vaping-policies;

"A spokesperson for Skansa told The Construction Index: “The BMA has provided guidance on the use of e-cigarettes at work, and Skanska’s policy follows that expert guidance. While e-cigarettes may help existing smokers to give up, there is still the potential for health risks to the individual using them and to those in close proximity. Therefore, all restrictions and conditions that apply to smoking tobacco products also apply to the use of e-cigarettes.”

One of the cornerstones of medicine is the "Hippocratic Oath". There are numerous variations on it, including the Declaration of Geneva. These are in this case best summed up in the GMCs "Duties of a Doctor" as they are legally responsible for the quality and behaviour of UK doctors. From this I will take the following core principles;

  • Make the care of your patient your first concern.
  • Provide a good standard of practice and care. 
    • Keep your professional knowledge and skills up to date.
    • Recognise and work within the limits of your competence. 
  • Be honest and open and act with integrity.
  • Never abuse your patients' trust in you or the public's trust in the profession.
But the BMA and many doctors are using old, often already discredited, research to explain and justify their position. Just before their ARM a "spokesperson" for the BMA, Dr George Rae, spoke on BBC radio quoting just that sort of evidence;

Rae: But you’ve got to realise that there are chemicals within e-cigarettes, particularly a group of chemicals called nitrosamines, and nitrosamines actually can cause cancer. They can be even more cancer forming than what you’re getting within cigarettes themselves.

Strike 1,2 and 3. Acting in the concern of established policy and stance, out of date knowledge, not competent in the field concerned (although Dr Rae does like the limelight). That nitrosamine research was debunked in 2012!

And when the BMA were called out on this they ignored the evidence they were presented with (see here for examples) and refused to engage with us, the patients.

And when calls were made for this behaviour to be punished, for those responsible to be castigated both the BMA and GMC refused to deal with the issue.

Strikes 4 and 5. Definitely OUT!

But still the GMC and Department of Health let the BMA and others act against the health concerns of their patients, with outdated knowledge and skills, abusing the integrity of their profession and public trust. Why do the BMA behave in this way? There are many theories from political/financial coercion through puritanism and health snobbery.

Do No Harm, BMA, Do No Harm... If you push people away from the "Harm Reduction" of vaping you are doing harm. Not too difficult to quit is it? After all, you're just a union, stick to that eh?

Thanks to +The Construction Index  +ECigaretteDirect  +The Guardian+Clive Bates, Dick Puddlecote, +The BMA, The GMC, HSE and DoH for links/quotes.

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