Further Confessions of a GP

I knew that Raymond had sexually abused young children in the past. He had served his time and I had no reason to believe he was re-offending or even considering it. Perhaps he was completely rehabilitated and was in a healthy loving relationship with a consenting adult. The problem was I couldn’t help but worry that my prescribing him Viagra could potentially lead to further abuse of children. I wasn’t sure if Mr Raymond knew that I had a record of his previous offences, although my apparent awkwardness may well have made it fairly obvious.

‘Do you have a regular partner?’ I asked, attempting to enquire as if making light conversation.

‘Er, no, not exactly. I just, you know, like to still be able to have erections by myself, if you catch my drift.’

After a few moments of an uncomfortable silence, I broke it with some honesty.

‘Look, Mr Raymond, I know that you have a criminal record for sex offences in the past and I need to just make sure where I stand legally before I consider prescribing you Viagra.’

‘That’s all behind me, Doctor. I did a whole programme when I was inside. With this bad back of mine I barely even leave my flat, let alone get myself into any trouble.’

‘Look, I’ll find out the rules about this sort of thing and then I can decide. Come back and see me next week.’

I was relieved when Mr Raymond left, but I still couldn’t work out what to do. Mr Raymond had once abused children. The legal system had deemed him safe for release from prison and were it not for his medical condition he might well be able to have completely normal erections. I had no evidence to suggest that by me prescribing Viagra, children would be put at risk. What if he wasn’t abusing children, but was looking at child pornography? Would that make a difference? Perhaps he still fantasised about children but just used his own imagination to get aroused? When do I start having to be concerned about the ethics of this as his doctor? At what stage should I be allowed to pass judgment on when a man should or shouldn’t be permitted to have erections?

I decided to do some research on the matter, which is a posh way of saying that I Googled ‘prescribing Viagra to paedophiles’. The first pages that cropped up were about a French man who raped a young boy after being prescribed Viagra by his doctor in 2007. This served to prove that my greatest fear could potentially become a reality and it successfully increased my paranoia. Doctors belong to a defence union which can give advice at times like this. I called them up and the medico-legal expert told me that unless I had reasonable cause to fear that Mr Raymond was an active risk to children, I couldn’t justify refusing the prescription. She also told me that if I did refuse to prescribe him Viagra, Mr Raymond would be within his rights to make a complaint and take legal action against me. I documented this very carefully and was relieved that the law was so clear. I’m sure that many would be disgusted at the idea of a convicted paedophile receiving Viagra on the NHS, but the decision was out of my hands. To my relief, Mr Raymond never turned up for his follow-up appointment. Perhaps he was too embarrassed, or possibly, most likely, he bought some cheap Viagra online instead.

Hannah

The overwhelming desire to become a mother was so strong in Hannah it was almost palpable. It seemed to ooze from every pore of her skin. Ever since she had been my patient it was pretty much the only thing that she ever came in to talk to me about. All other physical ailments were put aside in order to concentrate on that most basic of human desires: to have a baby.

Hannah was now 42, and as each month passed her dream of motherhood slipped further and further from her grasp. There is plenty of talk in the media about career women putting their jobs first only to find that they have left it too late to have a baby. This wasn’t the case with Hannah. She would have happily started a family in her 20s, but she had quite simply never met the right guy. When she reached 37, Hannah decided against risking her chance of motherhood by waiting for Mr Right, and chose instead to embark on fertility treatments as a single woman. Our initial consultations were about the pros and cons of using an anonymous donor versus using the sperm of a generous gay friend. At first she battled to get funding for IVF on the NHS but failed, and so instead used all her savings to have cycles of fertility treatment privately. With each cycle came the drugs and the injections, followed by the hope and then, finally, in Hannah’s case, the overwhelming disappointment.