UK doctors’ strikes 2023–2024: still justified in the interests of public health, even in time-critical outpatient contexts

Abstract

We respond to David Wilkinson’s arguments against our view of the ethicality of doctors’ strikes and our claim that the 2023–2024 UK doctors’ strikes are morally permissible and arguably supererogatory.Wilkinson proposes that in specialist outpatient settings, striking doctors should help arrange their own cover to prevent disproportionate harm to patients and to abide by the principles of non-maleficence and fiduciary duty. This hasn’t happened during the 2023–2024 UK doctors’ strikes; therefore, in his view, these strikes are morally impermissible. We reject Wilkinson’s proposal on the grounds that the risk of disproportionate harm is adequately mitigated by existing arrangements and his interpretations of non-maleficence and fiduciary duty are overly demanding.We agree with Wilkinson that strikes put particularly high pressure on covering doctors in chronically under resourced specialisms. But this doesn’t justify calling off or depowering doctors’ strikes because, without effective strikes, under-resourcing is likely to continue and, ultimately, cause even more harm.Wilkinson argues that doctors cannot justifiably strike in the interests of public health because they don’t have a broad duty to public health. We think they do have such a duty; however, we argue that doctors can justifiably strike in the interest of public health whether they have such a duty or not.Finally, we defend our claim that doctors’ strikes can be supererogatory from Wilkinson’s objections that there may be no such thing as supererogatory action and that our view absurdly entails that strikes can be supererogatory despite placing unfair demands on others.