Same-sex marriage and the role of the GP College

During my medical training in Amsterdam I witnessed many of the effects of the Dutch liberal policies such as the legalised practice of euthanasia and their model on cannabis. The Netherlands was also the first country in the world to legalise same-sex marriage over 15 years ago.

When it comes to same-sex marriage I support this. Not so much because of health reasons but simply because I believe it is fair.

I acknowledge that LGBTIQ communities (Lesbian, Gay, Bisexual, Transgender, Intersex and Questioning) have had a lot to endure. I also respect that there will be people who disagree with me here and may have other opinions.

In Australia we now have the odd situation of the voluntary Australian Marriage Law Postal Vote, where we are asked to vote on the question: Should the law be changed to allow same-sex couples to marry? 

The RACGP position

The postal vote has created healthy debate but also vigorous campaigns by the ‘yes’ and ‘no’ camps. Organisations and businesses are being asked by their members and customers to take side and the health sector is no exception.

Unfortunately there have been inappropriate and hurtful comments on social media and elsewhere. It seems to me that these unintended consequences of the postal vote are doing more harm than good.

The Royal Australian College of General Practitioners (RACGP) has a diverse membership of more than 35,000 GPs with a range of views. The RACGP Council believes that members should make their own, personal decision about marriage equality.

This position does not imply that the RACGP is against same-sex marriage, or for, and it does not mean that the College or general practitioners do not acknowledge the many challenges facing the LGBTIQ community.

It also does not mean that the RACGP president is personally neutral on this topic – I know that he supports same-sex marriage.

The background

To better understand the position of the RACGP Council it is good to look at the history and the role of the College. For many years the organisation has mainly focused on training, education and quality standards. In recent years the RACGP has moved into advocacy to improve support of and recognition for the provision of quality general practice care.

The RACGP has invested heavily in a large database of guidelines, standards, policies and position statements driving general practice care. However, there has not been a demand from members to advocate on public policy issues such as climate change, sugar tax, alcohol sale, refugees or marriage equality – as a result the College has not developed a position on many of these topics.

The RACGP recently sent out a poll asking members if they would like the RACGP to advocate on a wider range of public policy issues, and one of the examples given was marriage equality. The response: One hundred members participated and one third stated that they did not think this was a role for the College.

This is only a very small sample and clearly more debate is required. The direction of the College will ultimately depend on what the membership wants. Traditionally the Australian Medical Association (AMA) has been doing this kind of advocacy very well, but perhaps there is a role for the Colleges?

Social responsibility 

An important argument for change is that it would increase the College’s social responsibility. As family doctors we come in contact with all of life’s challenges so we may as well participate in the various debates.

On the other hand, it will be difficult for the College to be everything to everyone. It may create more disputes.

Lastly, various RACGP sources including the Standards for General Practices affirm and underline respectful and culturally appropriate patient care and, in accordance with the law, strongly condemn discriminatory treatment of people based on their personal characteristics.

I’d urge everyone to be kind and considerate and show respect for others in this important debate.

Addendum 02/10/2017: RACGP Council has issued a statement in support of marriage equality.

At the time of writing Edwin Kruys was vice-president of the Royal Australian College of General Practitioners (RACGP).

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