An apolitical organisation in a very political world

What can the Association say? What can the Association do? These are two questions often put to the Board when some disaster strikes (natural or human-induced), or when some event or catastrophe occurs. The list from the last year or two, which I could give by way of example, is long and there is a risk of leaving something out (and, so, cause offence – more on this later). Should we always say (or do) ‘something’? As a recent President reminded me, don’t forget the power of a statement of support. How do we square this with being an apolitical organisation? And, what does that mean?

One definition of ‘apolitical’ may be: having no interest or involvement in political affairs , another might be: having an aversion to politics or political affairs . These are certainly not true; we are very interested in political events which impact on healthcare and on our members. Indeed, our Advocacy and Campaigns team prepare a Political Monitoring Update for the Board every week. Of note, we are not a trade union. We are a company limited by guarantee, and we are also a charity; in fact, we are two organisations – one a company and one a charity. We choose to be apolitical in a party-political sense, and so don’t align ourselves with any political organisation. It is certainly true that whatever stance we took politically we would upset some part of our membership. We are a members’ organisation; we try to help our members and their patients for example, with educational events, guidelines, wellbeing and much other work, and represent their views via our campaigns and advocacy work. We link informally with other ‘like-minded’ organisations such as specialist societies, surgical societies, Royal Colleges and Colleges, and with partners such as industry and other charities.

Should we always say (or do) ‘something’?

So, back to what we can say and do to help in times of crisis. Firstly, we wish we could do more! A pertinent example is the current war in Ukraine. We wish we could help – directly by providing care to the casualties of this conflict, or by supporting our colleagues in Ukraine and surrounding countries. But we have no infrastructure to deliver aid and ensure it goes to the areas we would wish for, and – at the time of writing – we have had no requests for help to find or fund specific items (and, yes, we have asked, via those who have links to Ukraine). So, instead we have suggested that members who wish to help do so via the established international humanitarian aid charities such as the Disasters Emergency Committee. We did make a statement shortly after the war started, but if we are honest, we doubt it reached many of our colleagues in Ukraine. There have already been, sadly, some unedifying messages apportioning blame directed at individual anaesthetists who work in countries involved in the current conflict. It is very difficult for us to know who is doing what, or supporting what, in a country that is relatively ‘closed’ and the inhabitants under careful observation.

The other issue, which may seem callous but is a real practical problem, is how do we decide which disaster or crisis needs, or is helped, by a statement or action by us. There comes a point where someone needs to make a subjective decision. The same applies to noting deaths or writing obituaries. How can we decide which death is in some way more notable or momentous than another? A suicide? The death of a young colleague? The truth is every death is a huge loss to someone. There are some deaths we do mark, and they are usually those with a very notable career in anaesthesia that has led to national or international changes that bettered patient care. The Ukraine war was an obvious event on which a statement seemed right. But, again, natural or human-induced disasters are too frequent, and how do we decide which flood, tsunami, volcanic eruption, earthquake, fire, building collapse, epidemic, war, conflict, terrorist act, train or airplane crash to respond to? Are we at risk of belittling some by not responding to them?

One useful way to think about this may be to ask what difference a statement or particular action will make. Is there a risk of tokenism, or can we add our voice to those seeking change? This involves an assessment of a topic, a proposal of something we can say or do that we believe can make a change, and a further assessment of who will listen or take note. We do need to be careful that we don’t ‘cry wolf’, and we should only use our voice or actions when we think they will be effective. I don’t believe we get these decisions right every time. There are times when a simple statement of support is clearly the right thing to do. Examples include the conflict in Ukraine, and from home in a very different context, our statements about the extraordinary pressures some of our trainee members faced during the pandemic. In that sense we accept that in some circumstances a statement of support can help.

This article itself will generate opinions, and not all of them will be favourable. This is your Association, so – as ever – do let us know your views. Remember, I haven’t even started on the role of social media, the risk of fake news, and whether we should respond to every comment, opinion or item posted online.

Mike Nathanson
President, Association of Anaesthetists