Doctors reject the reinstatement of anti-vaccine colleagues. The president: "It is not up to politicians to decide"

“A situation like this is tantamount to telling a court that the state does not accept a judgement and is therefore rewriting it,” says Filippo Anelli, president of the National Federation of the Order of Doctors, getting straight to the heart of the matter: the political message conveyed by the FdI amendment approved a few days ago by the Chamber of Deputies’ Social Affairs Committee is that what constituted a breach of the Order’s ethical principles during the pandemic is no longer considered as such now that the emergency has passed.

However, we need to rewind a little. Two days ago, during the debate on the enabling act for the reform of the healthcare professions, the Montecitorio committee approved the controversial amendment, first tabled by FdI MP Alice Buonguerrieri. In practice, the provision provides for the reinstatement – or at least the initiation of assessment procedures to that end – of healthcare professionals struck off the Medical Register during the pandemic. And this is where political interference begins: “In this way,” continues Anelli, “the autonomy of the professional bodies is not treated as a matter provided for by the regulations. In accordance with the principle of subsidiarity, the power to take disciplinary action and impose sanctions against members of the professional body rests with us.” The reform is expected to reach the Chamber of Deputies in the near future; the majority hopes this will happen before the summer recess.

The president then explains to "Il Foglio" that only four or five doctors have been struck off the register. “It is not a question of numbers,” he explains, “but of competence.” The key message is that “the state is trying to wipe the slate clean for those who, during the Covid pandemic, drew on all their personal experience and made personal sacrifices, whilst other colleagues breached the established rules of adherence to scientific evidence”.

Striking off the professional register was, and still is, reserved solely for serious breaches of the code of ethics. Expressing doubts or alternative theories without scientific evidence regarding the efficacy of vaccines approved by the scientific community, and promoting and extolling alternative (or harmful) treatment methods, are prime examples of ‘serious breaches’. The association’s rules already provide for the possibility of reinstatement, subject to a review of individual cases. “Resolving issues in this way,” Anelli emphasises, “which do not merely concern a personal opinion but which violate the principles of the code, leaves us perplexed. The assessment that was carried out led to a decision to strike these doctors off the register – a decision with which one may or may not agree, but which must be respected.”

Strictly speaking, therefore, this constitutes a genuine encroachment on our powers: “It troubles us that the state wishes to intervene in a matter which politics itself has delegated to us”. In effect, the Association is thus sidelined in this procedure: it allows for an application for re-registration to be submitted within a 60-day period from the law’s entry into force, in cases where an appeal is still pending before the Central Commission for Healthcare Professionals.

It is important to emphasise that those who were struck off the professional register were not removed for their political views but for breaches of the code of ethics. Merely initiating reinstatement procedures highlights ‘how adherence to science is not an absolute principle’, says Anelli, before adding: ‘We always act in the interests of the community and in accordance with Article 32 of the Constitution. When standards of care and the scientific perspective cease to be points of reference, the protection of citizens is put at risk. All legislation and case law agree that the decision and responsibility regarding cases involving professionals should rest with doctors.”

In 2022, a similar issue arose between professionals and politicians, but in that case it concerned the suspension of healthcare workers from the professional body. A year earlier, in April 2021, with the arrival of the first vaccines, Parliament had passed a decree-law imposing a compulsory vaccination requirement on all healthcare workers, under penalty of suspension from the professional body and therefore a ban on practising their profession. The requirement was subsequently lifted just over a year later, and Parliament itself decided to reinstate those who had been suspended, including those who had not previously complied with the requirement. “We’re talking about around 2,000 colleagues,” concludes Anelli, “we endorsed the measure, but it was not a decision we took on our own initiative.”