One word ended Dr David Mackereth's 26-year career. Now he wants to have his say.

Is a doctor’s contrary belief system grounds to have him fired?

That’s the question many are considering today, amidst reports of Dr David Mackereth, a physician from the United Kingdom, having his employment terminated because of his refusal to refer to transgender people by their preferred gender pronoun.

Dr Mackereth, a 55-year-old who has worked as a doctor for more than two decades, says his contract as a medical assessor for the Department of Work and Pensions (DWP) in Dudley was terminated late last month after he refused to comply with the 2010 Equality Act.

A staunch Christian, Dr Mackereth argues his stance on matters of transgenderism should be irrelevant in considerations of his ability as a doctor.

“I am clear in my own mind what the Bible teaches on gender,” he told the Daily Mail on the weekend. “In the beginning, God made them male and female.”

It is an expectation of those working within the NHS in Britain that patients are referred to by whatever pronoun they choose, and that the term “pregnant people” is used in place of “pregnant women” to be inclusive of transgender individuals.

When Dr Mackereth voiced his discomfort with the protocol, and his refusal to abide by it, he was called into a meeting with his manager and his contract was placed under review.

“[My manager] asked, “If a man asked him to call you Mrs, would you do it?” I said I couldn’t. If somebody has male XY chromosomes and male genitalia I cannot in good conscience call them a woman.”

While discrimination – fuelled by religious values or otherwise – is still discrimination, Dr Mackereth argues society is entering a state of disrepair, whereby speech and expression is policed so strictly it constitutes despotism.

He disagrees with the boundaries dictating what language is and isn’t acceptable, he says, and should be able to express that disagreement without losing his job.

“Are they going to take all these doctors and nurses to one side and sack them? There’d be no NHS left,” Dr Mackereth told the publication, pointing to the considerable number of Christian and Muslim doctors who he says agree with him, but don’t speak up out of fear for their jobs.

“People could say ‘He’s not treating people with respect’ — as if respect means you agree with everything somebody says to you. It doesn’t. It means I will disagree but will still give the same standard of care.

“I’m not out to upset anyone. I care deeply about transgender people. But we must be able to say what we think, and defend what we believe in a non-combative way. Otherwise we will turn into a dictatorial state in which we are all enslaved.”

So long as he refuses to comply with the edict, it’s believed the doctor will be unable to gain employment in a government job or under the NHS again.

Ultimately, Dr Mackereth points to the balancing act the UK and much of the developed world now grapples with; does a patient’s right to be referred to by their preferred pronoun outweigh the right of a doctor to live by his conservative religious beliefs?

If we look to Australia, where article 2.1.1 of the Australian Medical Association Code of Ethics stipulates “consider first the well-being of the patient”, it could be strongly argued Dr Mackereth has no grounds to dispute his termination, and that his manager made a difficult – but correct – call.

Still, he argues the patrolling of language and expression in our modern world is toxic.

“Some of my colleagues — senior doctors — are fired up by what happened to me, but what am I supposed to say to them?

“After all, if they say the same thing as me, will the country start losing much-needed, remarkable surgeons who are no longer considered fit to work because they used the wrong pronoun?”

Where do you stand? Should doctors lose their jobs if they refuse to use the patient’s preferred pronoun?