Dear Sirs,

I am due to attend the orthopaedics department at [hospital name] on [date], for a pre-operative assessment for an upcoming hip operation. As I am sure you appreciate, I am extremely keen to ensure this experience is as straightforward and stress-free as possible - as I am sure you are - particularly at the current time, when the global coronavirus situation is causing so much enduring stress for us all.

The nature of the procedure I am shortly to undergo is to remove a hip replacement that was installed [number of] years ago, as this device was composed of cobalt and chromium metals, and, resultantly, has been slowly poisoning me ever since. Recent tests have confirmed my body's toxic loads of these metals are now at extremely dangerous levels and posing a threat to many of my major organs. Clearly, not only is this situation a cause of ongoing stress and distress to me, but it is also not optional or 'elective' - I must have this device removed from my body, if I am to recover optimal health and longevity. 

I, of course, accept this device was installed in error, and at a time where science had not fully revealed the dangers of cobalt and chromium hip replacements, and this highlights an important point - medical errors can happen, and dangers and long-term health effects of medical products may not always be apparent until many years into the future. 

I am, therefore, always cautious and circumspect before consenting to receive any medical product or procedure - all of which always come with a degree of risk, some known, some unknown - and only when I have thoroughly researched the issue to my own satisfaction do I offer my consent - and the thoroughness I apply is in line with the guidelines of informed consent, as per the Montgomery ruling (1), which informs the General Medical Council and NHS' code of best medical practice. 

The Montgomery ruling makes it clear that patients must be informed of all known material risks of any medical procedure, including risks that may be considered more uncommon, before their consent can be considered fully informed and therefore legally and ethically valid.

On this basis, I have made the considered decision not to receive any Covid-19 vaccinations, nor to consent to lateral flow or PCR testing for Covid-19. There are many reasons for my decision, which I am happy to elaborate on in future correspondence, but for the sake of brevity and expedience as my appointment date rapidly approaches, I will be succinct: I would like to make emphatically clear to the hospital that international human rights' law fully protects my rights to decline any preventive or diagnostic offered to me, for any or no reason, and not to suffer any penalty or disadvantage - such as withheld surgery - as a result. 

This right is enshrined in UNESCO's Universal Declaration on Bioethics and Human Rights, which states at Article 6, Section 1:

"Any preventive, diagnostic and therapeutic medical intervention is only to be carried out with the prior, free and informed consent of the person concerned, based on adequate information. The consent should, where appropriate, be express and may be withdrawn by the person concerned at any time and for any reason without disadvantage or prejudice." [2]

Although no mention of any testing or vaccination requirement has been made in any written correspondence I have received from the hospital, you can imagine my shock and dismay when I was informed verbally by a member of [the consultant's] team that I would be denied my urgent surgical treatment unless I submitted to both Covid testing and Covid vaccination.

This is a shocking violation of both medical ethics and human rights' law, and by using tactics of coercion and intimidation to attempt to force compliance, entirely flouts the clear guidelines of informed consent as laid out by the GMC. It is also important to note that, as Covid-19 vaccinations are still in clinical trials, which will not be complete until 2023 (3), these constitute experimental medicine, and, as the Nuremberg Code makes abundantly clear, medical experimentation must have the fully informed and voluntary consent of the human subject (4).

However, as the hospital's ostensible testing and vaccination 'requirement' has only been communicated to me verbally, and not in writing, I have reached the inevitable conclusion this is not actually formal policy of the hospital - since, as I am sure the hospital's lawyers have advised, this would be illegal to enforce - but an 'optional extra' that is being misrepresented by staff as essential in order to coerce patient compliance.

I sincerely hope this is nothing more than a policy misunderstanding by junior staff resulting from unclear communication from senior management, since any other conclusion would be deeply troubling indeed. 

I look forward to receiving your prompt written acknowledgement, ahead of my appointment on [date], that there will be no further expectation of, or pressure upon, me to receive either Covid testing, or Covid vaccination, in order to progress with my essential surgical procedure. Please further note that my GP, who has been overseeing my case for the last [number of] years, has also advised me not to receive a Covid-19 vaccination, as his view is that with my existing medical complexities, it would be unwise to submit to medical experimentation until there is more data available on long-term safety.

After the deep distress I have endured from a medical procedure – my hip replacement - that initially appeared safe, but in the long-term, proved anything but, this is an issue I am far more acutely attuned to than most.

I look forward to hearing from you.

Yours sincerely,

[Name]

References:

1) https://www.themdu.com/guidance-and-advice/guides/montgomery-and-informed-consent

2) http://portal.unesco.org/en/ev.php-URL_ID=31058&URL_DO=DO_TOPIC&URL_SECTION=201.html

3) https://clinicaltrials.gov/ct2/show/NCT04368728

4) https://www.bmj.com/content/313/7070/1448.1