Dear [consultant and hospital director],
I am writing to you ahead of my scheduled procedure, [name of procedure], at [hospital name] on [date].
As you can imagine, I am very keen to ensure this procedure, and all attendant appointments, progress as smoothly as possible, causing a minimum of anxiety and distress to myself. That is why I have elected to invest in private care, rather than seeking my treatment with the NHS, as I felt that private care would afford me the best possible conditions for making my own decisions and tailoring the experience to suit my specific needs. Where it comes to such critical and personal issues as my health and medical care, it is incredibly important to me to feel that I am in control of a situation, that my needs and preferences are being respected, and that I am not being coerced into any experience I do not wish to have.
Therefore, I was deeply alarmed and distressed to be verbally informed by the hospital that I must receive a PCR test as a precondition of my surgery. I do not wish to receive this test, a highly invasive diagnostic which involves inserting a medical device deeply into my bodily cavities. The prospect of this causes me profound anxiety, and it is not an experience I am prepared to undergo, in what are already very distressing circumstances.
As you are aware, medicine in the UK is governed by strict guidelines of informed consent, and the General Medical Council is bound by the Montgomery ruling, which states all medical processes must have the free and express consent of the patient (1). Predicating my urgent surgery on a test which has no relationship to the medical issue I am experiencing is patently coercive, and, therefore, does not fulfil the stipulations set out by Montgomery.
International human rights law also protects my rights to decline any diagnostic offered to me without suffering penalty or disadvantage (such as delayed or withheld surgery). Please see UNESCO's Universal Declaration of Bioethics and Human Rights, Article 6, section 1, which states:
"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 The consent should, where appropriate, be express and may be withdrawn by the person concerned at any time and for any reason without disadvantage or prejudice."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)
My unwillingness to undergo the PCR test is further exacerbated by the profound limitations of this test, as it is an extremely unreliable indicator of the presence of active viral infection. The PCR test was never intended to be used to detect viral disease, and, in fact, its inventor specifically stipulated it should never be used for these purposes, since the test is only able to detect genetic sequences of viruses, and not viruses themselves. As the human body is full of viral genetic sequences, then, to quote the inventor of the PCR test, Nobel-prize winning scientist, Kary Mullis, "anybody can test positive for anything with the PCR. It doesn't tell you that you're sick" (3).
The PCR test works by amplifying results many times. If they are amplified less than about 30 times, nobody will test positive. If they are amplified more than 60, everyone will. Therefore, a positive PCR test result is ultimately clinically meaningless.
It is important to note that using PCR test technology to falsely diagnose viral illness is not a new phenomenon. In the USA in 2007, a pertussis epidemic was falsely declared on the basis of PCR testing. Nearly a year later, the entire episode was declared a false alarm, since not a single case of pertussis was confirmed with the definitive test, growing the bacterium, Bordetella pertussis, in the laboratory. Instead, it appears the individuals who tested positive on the PCR were probably afflicted with ordinary respiratory diseases like the common cold. According to epidemiologists and infectious disease specialists, this episode occurred because too much faith was placed in a quick and highly sensitive molecular test - the PCR test - that led them astray.
Reflecting on the situation, Dr. Cathy A. Petti, an infectious disease specialist at the University of Utah, said the story had one clear lesson.
"The big message is that every lab is vulnerable to having false positives," Dr. Petti said. "No single test result is absolute and that is even more important with a test result based on PCR." (4)
Please note also that I am not unwell and have no symptoms of any infectious illness, so even in the unlikely event that I am an ‘asymptomatic carrier’ of a coronavirus, the chances of me transmitting this to anyone else are vanishingly small, as qualified by the World Health Organisation, who have stated that asymptomatic transmission is “very rare” and that disease control should focus on testing and isolating those who have symptoms of disease only (5). If I do develop symptoms of an infectious illness, I will be happy to reschedule my surgery until such a time when I have regained full health, but presuming I do not develop such symptoms, then I will expect my surgery to proceed as planned on [date].
Thank you for your time, and I look forward to your prompt written acknowledgement that there will be no further expectation placed upon me to receive a PCR test as a precondition of my urgent surgery.