Professor Kieran Murphy:

Senator Labhrás Ó Murchú asked about the background to the plain English issue in the context of the ethics guide. Following a period of extensive consultation with all stakeholders, the council produced its draft guidance. This was submitted to the National Adult Literacy Agency, not in order that that body might change its substance but rather to ensure the principles underlying the guidance were sufficiently clear to a lay audience. We had considerable interaction with NALA in this regard which resulted in a further refining of the language used in the guide. The final version was published only after the language was agreed to with the agency. The guide members have before them is the final version which was published in 2009. As I mentioned, it is, by necessity, a dynamic document which must reflect the fact that medicine changes. Last year, for example, we published supplementary guidance for the profession on the relationship between doctors and industry. The next council will, in turn, publish a revision of the current ethical guide.

Senator Paul Bradford asked whether there had been complaints regarding the existing guidelines on abortion. The council receives complaints where a doctor is deemed to be in breach of the guide. As I mentioned in my opening statement, to the best of my knowledge, we have not received any complaint that a doctor was in breach of the current council guidelines on abortion.

Regarding the evidence base for suicide, the principles underlying the council's guidance are that doctors need to be most informed when they are making clinical decisions. These decisions must be guided by the available evidence. Consequently, it is imperative from the council's point of view, in order to fulfil its mandate to protect the public, that all doctors are guided by the best available evidence internationally to take appropriate clinical decisions that will ensure patients are protected.

I have already covered that last point in the context of referring to the research and evidence for any intervention.

As I stated, the council's very strong view is that any clinical decision that is taken needs to be guided by the best available evidence. It is probably worthwhile reiterating that doctors have guidance from lots of different sources. The Medical Council's guidelines form one set of guidance available to doctors. For example, within psychiatry and the new clinical care programmes in the HSE, specific guidelines are being developed by those programmes in order to manage a range of clinical scenarios such as self-harm. The doctor is expected to adhere to all the guidance, including that issued by the Medical Council, the practice guidelines published by the employer, namely, the HSE, through the clinical care programmes and the guidelines produced by each training college or royal college for each specialty. It is important for members to understand the Medical Council's guidelines are not the only point of reference through which doctors work. Doctors are guided by a range of different practice guidelines and protocols of which the Medical Council's guidelines are just one component.