Dear Royal College,

I am writing to you as a lifelong sufferer of hereditary progressive arthro-ophthalmopathy, a condition that has been passed down in my family for the last four generations, meaning I have had close contact with ophthalmologists all my life.

As you will know, this condition carries with it a high likelihood of retinal detachment which can lead to blindness. My great-grandmother was blinded by the condition in her early twenties, and my grandfather, by the age of 12. I also nearly lost my sight when my retinas detached at the age of nine, but fortunately, fast-acting surgeons were able to repair them with cryosurgery. I then had to have surgery again in my early thirties for cataracts, the early-onset of which are another known complication of the condition.

I give you this background to underline how closely I and my family have been involved with ophthalmologists for all of my lifetime, an involvement I am very pleased to report I have always found nontraumatic, professional, and appropriate - especially when I was a child. Clearly, the prospect of losing your sight followed by serious emergency surgery at the age of nine could prove deeply distressing and even engender lasting trauma, but the experience did not, given I was treated with such care and consideration by all medical staff, from the surgeons to the ward nurses. In fact, I recall the entirety of my hospital stay rather fondly, and can still remember the name of my personal nurse (Darren) and how kind he was to me, and the brilliance and compassion of the surgeon. Mr. [name], whom I contacted again recently to thank him again for the gift of my sight. 

It would be my sincere hope and expectation that all child eye patients are treated with the same care and compassion that I was, and that they do not come to associate fear and trauma with procedures to do with their eyes, a part of the anatomy that even many adults are particularly squeamish about (I know many who will not even wear contact lenses as they "can't bear the thought of sticking something in their eye"). 

By profession, I am a copywriter who also does some legal consultancy work, and one of the services I offer is professional letter-writing, for people who are being discriminated against or disadvantaged by the coronavirus restrictions, a legal position that I specialise in and understand particularly well (with these restrictions being so new, most of the legal world does not). 

You can imagine, then, that I have been left deeply shocked and dismayed to be contacted by a number of individuals who have informed me their children's urgent eye surgeries are being cancelled if they do not submit their children to the procedures known as COVID-19 testing. 

Many families do not wish to consent to this testing, which is not only invasive and distressing, especially for a child, but also completely unfit for purpose. There are myriad flaws and inadequacies with both the PCR and lateral flow tests (1, 2, 3), neither of which are reliable indicators of the presence of viral disease, and the PCR test in particular is ultimately clinically meaningless, having past form for falsely diagnosing "epidemics" because of its over-sensitive nature (4). 

However, even if these tests were reliable (which they are not), coercive testing - predicating a child's urgent medical procedure on whether they have a test that has no relationship to the condition they are receiving surgery for - is both unethical and illegal, under multiple medical ethics and human rights laws - including, but not limited to, the Montgomery ruling (5) and UNESCO's Universal Declaration on Bioethics and Human Rights, Article 6, Section 1 (6). 

When individuals contact me regarding these coercive testing policies, it appears clear these diktats are not originating from the surgical staff conducting the operations, but from the administration departments of the hospitals and local NHS Trusts. 

I therefore suspect that surgical staff, in the main, have no idea patients, including child patients, are being subject to this extraordinary manipulation and duress, so I felt it was my duty - as someone who supports these families and as someone who has gone through childhood eye surgeries myself - to bring this to your attention.

I have been able to successfully overturn these hospital policies when families contact me about them because they are not lawful, but not all families are aware of their legal rights and so will submit to hospital pressure - especially when hospitals go so far as to threaten to contact children's services if the family does not comply, as one London hospital did.  

Successful medical care is based on mutual trust and respect between the medical staff, the patient, and their families, and this is, of course, especially so when the patients are children. Coercion, duress, penalty, and discrimination are not words that should have any place in medicine, a statement with which I am sure you will agree.

Coercive testing (and vaccination) is happening throughout the NHS at the current time and I and many others are working hard to challenge this and to ensure the imperative nature of informed patient consent is upheld at all times. I am deeply concerned about the implications of coercive medical processes in all settings, and for obvious reasons, but it feels particularly personal and resonant when the individuals being coerced are children awaiting eye surgeries.

As I indicated earlier, I do not believe this coercion originates from ophthalmologists themselves, so I bring this situation to your attention in the hope that you will take steps to address it, and ensure that all patients ophthalmologists operate on - especially children - are not being pressured or blackmailed into receiving any diagnostics or preventatives that their families do not wish them to receive. Otherwise, that essential trust between doctor and patient will be severed for good and the implications of that are deeply undesirable for all concerned - especially given this kind of coercion is illegal and will eventually reach court.

Thank you for your time, and for everything the profession did when I was a child to ensure I am able to write this letter to you today.

Yours sincerely,

Miri Finch

References:

1) https://blogs.bmj.com/bmj/2021/01/12/covid-19-government-must-urgently-rethink-lateral-flow-test-roll-out/

2)https://www.newscientist.com/article/2263746-test-caught-just-3-per-cent-of-students-with-covid-19-at-uk-university/#ixzz6n6hD5CP0

3) https://www.theguardian.com/world/2021/jan/12/experts-call-for-rethink-lateral-flow-mass-testing-covid-uk

4) https://www.nytimes.com/2007/01/22/health/22whoop.html

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

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