Over the past few weeks my social media replies have been full of people asking me to write about the case of an Irish GP, Dr. Marcus DeBrun, who is currently in the middle of a disciplinary dispute with the Irish medical council arising from a number of complaints made against him. These complaints appear to relate to his social media activity. In recent weeks Dr. DeBrun has been highlighting a communication from the Medical Council which purports to offer him a way out of the dispute, conditional on his undertaking not to make comments publicly which “undermine public health guidelines or public health authorities”; “undermine the medical profession”; “contradict the medical council’s code of ethics”; or “are factually inaccurate”. Dr. DeBrun has published those communications here:
In that tweet, Dr. DeBrun says he has been offered a “full pardon” in return for his silence. That is not accurate – in fact, the offer is conditional on his acceptance of a formal censure by the medical council, which is very far from a pardon and would constitute a permanent negative mark on his record.
Now, to date, I have not written about this case because it is generally this publication’s policy not to comment one way or the other on unresolved legal matters, and this very much remains an unresolved legal matter. Dr. De Brun has publicly refused the medical council’s offer, and has committed to attending a disciplinary hearing at which he will mount what amounts to a “not guilty, your honour” case to the medical council.
However, given the amount of material in the public domain, and the degree to which Dr. DeBrun is effectively fighting the Medical Council in the court of public opinion, he has in essence invited us all to become jurors in his case, albeit jurors without any power to convict or acquit. If readers ask for my opinion, in these circumstances, I figure they are entitled to it, with the caveat that I can only comment on the material that Dr. DeBrun has made public, namely the medical council letter.
There are I think a few issues with it that should concern every citizen.
The first is section b(i) which appears to injunct the doctor – and by implication all other members of the medical council – against “undermining public health guidelines and public health authorities”. We can fairly assume that if this is a requirement being made of Dr. DeBrun to continue practicing, then it must also be a requirement for every other medic. If so, it is a tyrannical and dangerous requirement, especially as it relates to public health authorities. Even the Pope, despite official Catholic dogma, is not actually infallible. Human beings make mistakes, and in the case of the public health authorities, who is better placed to point out those mistakes than…. Doctors? This is a condition that Dr. DeBrun is correct to reject, and correct to fight against. He is doing us all a service in this regard.
The second is section b(iv) which injuncts Dr. DeBrun against making “statements that are not factual and/or are not evidence based and/or are misleading”.
Dr. De Brun would, I am sure, assert that he has never made any statements that were not – at minimum – “evidence based”. Almost everybody who asserts an opinion in public believes that they have some evidence to support it, since opinions tend to be formed from observations of the world around us. In Dr. De Brun’s case, my observations of his output over the post-covid years is that while the quality of the evidence may be debatable, he appears to genuinely believe that everything he has said about Covid 19 vaccines and Covid 19 public health policies is true or at least that there is enough evidence to ask questions about both. And we should remember, in his defence, that Dr. DeBrun was one of the very first medics to raise serious questions about the state’s policy in relation to nursing homes early on in the pandemic, when the only real “evidence” available was his own professional opinion.
All of that is to say: The judgment of a professional medic on public health policies may be wrong, but it is usually worth hearing. When you start injuncting doctors against making public commentary that later proves to be false, you are creating a rod for the public’s back: By the time facts have been proven beyond a reasonable doubt, it may be too late to act upon them.
Sections b(ii) and b(iii) are I think much less concerning, and should be the minimum expected of medics in their public conduct. Those two sections demand that Dr. DeBrun undertake “not to undermine the medical profession or bring it into disrepute” and that he does not say things in public that “are contrary to the applicable edition of the medical council’s guide to ethics and professional conduct”.
These are objectively reasonable demands: Doctors who undermine the medical profession would tend, by their actions, to make people trust their doctors less. This in some cases may lead to people making ill-advised treatment decisions and imperiling their health. To be a doctor is to have some collective responsibility for public faith in the medical profession. As for abiding by the code of conduct and ethics for medical practitioners, well: If Dr. DeBrun cannot agree to that easily, he should not be in medical practice.
We then get to the crux of the matter: Why is Doctor DeBrun being called before a medical council hearing at all?
Well, this is where it becomes much harder to comment: Dr. DeBrun has released the text of what amounts to an offer to censure him for misconduct, but there is no publicly released detail of the specifics of the complaints against him or who the individual complainants are. We can deduce from the reference numbers that the complaints relate to the year 2020, and therefore most likely relate to public comments he made about Covid 19 policy in that year.
We can further deduce, given that a censure has been proposed, that the medical council does not see the matter as being of sufficient gravity for a career-ending punishment. We can further deduce, from the offer made to him, that the complaints likely relate to either section b(i) or b(iv) – that is to say that the council believes he has a case to answer in relation to either undermining public health advice, or making false or misleading statements about covid policies in 2020.
This is why, at Gript Media – and indeed most other media outlets – we tend to await the outcome of legal matters before engaging in commentary on them. There are certainly elements of the DeBrun case which, on their face, are very concerning as they relate to the freedom of doctors to become, in effect, whistleblowers.
But it is also true that while Dr. DeBrun certainly appears to believe the things that he says are true, he continues to say things in public that are not entirely based on the complete evidence. We have an example of that from just this morning:
Here, for example, Dr. DeBrun appears to suggest that covid vaccines should not be considered “safe and effective” because there are fractionally higher instances of “adverse effects” in the vaccinated versus the unvaccinated. But this ignores a whole bunch of relevant facts – like for example that unvaccinated people are vastly younger and healthier as a population group, while the priority for vaccination was always the older and the unhealthier. Or, as the study he was sharing mentioned, that there is a known effect in medicine called the “healthy vaccinee effect” which means that people who take all their vaccines are generally much more health-conscious and are likely to seek medical diagnoses far more often than their vaccine-skeptical opposite numbers. This is merely one example where the information he chooses to share and the manner in which he shares it is very clearly likely to advance a particular case without giving the public all of the facts. In this respect, one can understand the medical council’s concern. Medical advice, in my view, is generally too complicated to share in pithy tweets and doctors would be well advised to refrain from it.
We will continue to follow the case as it progresses, but for now, those are my thoughts on the matter.