Beyond Factional Politics: Constitutional Renewal and Impartial Healthcare

A clinician's conscience and a citizen's responsibility

I support Crown Prince Reza Pahlavi and the Lion and Sun movement because I believe Iran needs a free, secular democratic future, governed by law and connected peacefully with the outside world. My support is directed towards a constitutional transition in which Iranians can determine their own political future. It is a commitment to human dignity, national reconciliation and the rebuilding of a country whose people deserve security and opportunity.

As a trauma and orthopaedic surgeon living and working in Britain, I also owe an unconditional professional duty to my patients. A person's religion, nationality or political opinion must never determine the respect, attention or treatment they receive from me. These two responsibilities can coexist. Their compatibility depends on the way I exercise them.

The argument I wish to make is that support for a national transition should not automatically be reduced to allegiance to one faction in ordinary party competition. Supporting a figure who can convene a constitutional process is a different commitment from insisting that one party must govern, one economic doctrine must prevail or one group must be excluded. That distinction deserves serious consideration by healthcare employers, professional bodies and the wider public.

This article develops the professional distinction examined in my earlier booklet, A Doctor's Conscience, A Patient's Trust. ¹¹ It also requires precise language. Cross-party advocacy for constitutional change remains political in the broad sense. Its humanitarian purpose does not make it politically uncommitted. My case is that such advocacy can reach beyond factional interests and remain compatible with impartial healthcare.

When a constitutional question becomes a national question

Ordinary political disagreement takes place within a constitutional framework that participants accept sufficiently to contest elections, criticise governments and transfer power. A crisis of constitutional legitimacy concerns the framework itself: whether the institutions claiming authority still offer people a credible means of consent, accountability and change.

I regard Iran's predicament as a crisis of this deeper kind. In my interpretation, the question extends beyond which officeholder or faction should administer the existing order. It concerns the relationship between citizens and the institutions that govern them, including the place of religious authority, equality before the law and the right to organise an alternative.

Long historical developments can accumulate into a chain reaction. Political exclusion, repression, economic insecurity and repeated disappointment may reinforce one another until incremental adjustment becomes increasingly difficult. This is an analytical description of pressure, rather than a calculation of a predetermined outcome. The course of events still depends on choices, institutions, organisation and international circumstances.

War, revolutionary upheaval and prolonged instability are grave dangers. Concern about them should strengthen the case for civilian protection and preparation for an accountable transition. It should not make destruction appear desirable or inevitable. A new constitution is a possible response to a legitimacy crisis; the crisis itself guarantees neither constitutional renewal nor democracy.

For a clinician, the practical importance of this distinction is immediate. Political breakdown threatens hospitals, medicines, rehabilitation and ordinary family life. An alternative must explain how public services will continue and how people will be protected while authority is being reorganised.

The people must remain the authors of the constitution

The International Covenant on Civil and Political Rights recognises peoples' right to self-determination. Its Article 25 concerns citizens' participation in public affairs and elections. The UN Human Rights Committee's General Comment No. 25 explains the connection between these rights and the choice or change of a constitution through democratic processes. These principles support a people-centred constitutional argument; they do not confer a mandate on a particular leader or prescribe monarchy or republic. ^{1, 2}

I favour constitutional monarchy. That preference must remain subject to a genuinely free decision by the Iranian people. A referendum whose acceptable result has already been dictated would fail the principle it claims to serve.

A credible process would require open debate, representative participation, reliable voting arrangements and protection for people who choose differently. Women, minorities, religious citizens, secular citizens and people with disabilities must be able to participate as equal members of the political community. Majority consent must operate alongside safeguards against domination and discrimination.

My support for transitional leadership therefore rests on a constitutional promise: help the country reach a process in which the people can decide. Leadership should protect that promise, accept scrutiny and remain accountable to it.

Why I support Crown Prince Reza Pahlavi as a central convener

Crown Prince Reza Pahlavi's public account of his role provides a basis for this argument. In his speech to the Foreign Affairs Committee of the Dutch House of Representatives on 6 July 2026, he described a coalition spanning left and right, republicans and monarchists. He set out territorial integrity, equal rights and individual liberties, separation of religion and state, and the people's choice of their future system as guiding principles. This is evidence of his stated position, rather than independent proof that every constituency supports him. ³

I support that conception of his role. In my judgement, he can serve as a central pillar of coordination during a constitutional transition: a recognisable figure around whom different democratic forces can discuss the process, seek international understanding and prepare for institutional reconstruction.

His historical identity is significant to many Iranians, including me. Others approach the Pahlavi name with reservations or different memories. An inclusive alternative must be able to hear those differences. Recognition, inherited symbolism and public visibility cannot substitute for democratic consent.

A central pillar should help a political community build institutions capable of standing beyond any individual. Its value would be measured by whether it widens participation, protects disagreement and helps transfer authority into a legitimate constitutional settlement. Support should therefore involve reasoned commitment and accountability.

A common constitutional foundation across left, centre and right

The distinction between constitutional purpose and party competition can be expressed simply:

Democratic leftists, liberals, conservatives, centrists, constitutional monarchists and republicans can cooperate around the first principles while retaining their own programmes. Women's-rights campaigners, environmental activists, labour representatives, professionals and unaffiliated citizens should have meaningful roles in that cooperation.

Women and environmental campaigners should participate in shaping institutions and priorities. A movement cannot claim breadth while treating their concerns as decoration. Inclusion means an opportunity to influence decisions, criticise leaders and organise independently.

Above-party or supra-factional leadership is therefore an aspiration that must be demonstrated. It is not a status acquired by declaration. A person who rejects monarchy must remain a legitimate participant in the constitutional debate. No one should have to prove democratic sincerity through a compulsory expression of personal loyalty.

For the Lion and Sun movement as I support it, the shared purpose is a country in which disagreement can be expressed safely and power can be contested lawfully. Such a movement creates the space for future party politics; it need not settle every future party argument today.

Humanitarian purpose and impartial care

My humanitarian concern begins with the person exposed to injury, imprisonment, displacement or fear. Support for constitutional renewal follows from the belief that accountable institutions can better protect that person's life and freedom. Yet immediate assistance must remain available even where political agreement is absent.

The World Medical Association's Declaration of Geneva puts patient welfare, dignity and autonomy at the centre of the physician's commitment and excludes political affiliation and other personal characteristics from interfering with the duty to the patient. This ethical principle supports consistent care across political divisions. ⁴

In my consulting room, that means the same care for a supporter of the Islamic Republic, a republican, a monarchist, a Muslim patient and a person who wants no political discussion at all. Treating a person does not endorse their political position. It fulfils the professional relationship.

Secular government must also protect freedom of religion. Opposition to religious domination of the state must be expressed without hostility towards Muslims as people. The constitutional principle I defend protects believers, minorities and those without religious belief alike.

There is a further distinction between a political movement motivated by human rights and a humanitarian organisation operating under a mandate of neutrality. Supporting a preferred transitional leader does not automatically confer that organisational status. Healthcare professionals can state their civic preference honestly while continuing to provide impartial medical assistance.

What the GMC guidance establishes

The GMC's July 2024 statement on protests and activism recognises doctors' entitlement to political opinions and campaigning. It explains that concerns are assessed individually and proportionately, with attention to conduct and public protection. It also rejects inappropriate use of referrals to discourage comment or unfairly target individuals. This supports a distinction between disagreement with a doctor's cause and a substantiated professional concern. ⁵

The guidance on personal beliefs requires fair treatment and bars personal views from influencing the care provided. Discussions of a clinician's beliefs during a consultation must respect professional boundaries and remain relevant to the patient's care. ⁶

Good medical practice, paragraph 87, prohibits expressions of personal belief to patients that exploit vulnerability or could reasonably cause distress. Paragraphs 89–90 address accuracy and public professional communication; paragraphs 94–95 address interests affecting, or appearing to affect, clinical decisions and their management. ⁷

The social-media guidance requires professional conduct online, protection of confidentiality and compliance with relevant employment policies. It prohibits abuse, discrimination, bullying, harassment and deliberate targeting. Public communication and private messaging can both raise professional questions. ⁸

Read together, these sources do not impose political silence. Nor do they approve the Lion and Sun movement, endorse Crown Prince Reza Pahlavi or exempt supporters from scrutiny. My conclusion is an interpretation of the published framework: lawful civic advocacy can coexist with professional impartiality when its conduct meets the applicable standards.

The GMC's statement concerning the Middle East reinforces the same approach. It recognises campaigning rights while insisting on respect for patients and colleagues, accuracy and the rejection of antisemitism and Islamophobia. These obligations apply consistently across causes. ¹⁰

NHS values and institutional boundaries

The NHS Constitution for England places access according to clinical need, respect, dignity, compassion and non-discrimination at the centre of the service. It also describes responsibilities towards patients and colleagues. These are standards for the operation of healthcare, rather than an endorsement of any overseas political programme. ⁹

In my view, the relevant professional test is whether advocacy compromises those standards. A clinician's lawful personal support for democratic change abroad should not automatically be treated as evidence of biased clinical judgement. Equally, an employer can have legitimate concerns about specific behaviour, workplace disruption, misuse of resources or misleading claims of institutional representation.

A clinical website requires particular care because a visitor may be seeking treatment. This article is personal civic writing. It does not represent an NHS, university or regulatory position, and reading it or agreeing with it is never a condition of receiving care.

Professional titles describe my experience and explain why civilian injury and human dignity matter to me. They do not grant specialist authority over every political prediction or imply that my employer endorses my constitutional preference.

Institutional boundaries should therefore be visible in both words and practice: clinical services must remain accessible, consultations must focus on care, and political activity must comply with the applicable workplace rules. A disclaimer helps clarify authorship; professional conduct supplies the more important assurance.

A practical commitment for healthcare professionals

For Iranian healthcare professionals who share this outlook, I propose the following commitments. They are a civic and professional proposal, rather than an approved GMC or NHS code:

1. Provide care according to clinical need and professional judgement, regardless of political allegiance, religion or origin.
2. Keep consultations and clinical communications focused on the patient's needs, without recruiting patients into political activity.
3. Respect colleagues who disagree and reject harassment, discrimination and collective blame.
4. Protect patient confidentiality and keep clinical records and contact lists out of campaigning.
5. State civic views in a personal capacity and avoid implying institutional sponsorship.
6. Check factual claims, distinguish interpretation from evidence and acknowledge uncertainty.
7. Disclose and manage relevant organisational, financial or other interests when they intersect with professional decisions.
8. Support civilian protection consistently, including for people who oppose our preferred leadership.

These commitments make the claim of impartiality assessable. They also protect the credibility of advocacy. A movement centred on human dignity must show that dignity in the way its supporters speak, organise and practise.

Doctors are regulated by the GMC; nurses and other healthcare professionals have their own regulators and professional standards. This article's GMC analysis should not be treated as a determination of every healthcare worker's obligations.

Peace, prosperity and the responsibilities of an alternative

My support for the Lion and Sun movement is directed towards a modern, prosperous Iran able to cooperate with its neighbours and the wider world. That includes an economy in which ordinary people can work, build businesses, receive education and obtain reliable healthcare. Cooperation across borders should expand opportunities for Iranians while preserving their right to govern themselves.

A common commitment to prosperity does not erase legitimate disagreement about economic policy. Democratic parties will differ over taxation, welfare, public ownership, markets and environmental regulation. A constitutional alternative should preserve the institutions through which these differences can be debated and tested.

Preparation for transition should address continuity of hospitals and essential services, civilian oversight, transparent administration and protection of vulnerable people. National reconciliation should include accountability through fair procedures, support for victims and rejection of collective retaliation. I developed these concerns in Humanity Before Geopolitics and Revenge, Social Justice and the Highest Degree of Intelligence. ^{12, 13}

A constitutional alternative becomes credible when it can describe the society it intends to make possible and the limits it accepts on its own power. The ability to oppose an existing order must be accompanied by the capacity to preserve life, protect dissent and govern accountably.

The statement I would place before authorities and patients

I support Crown Prince Reza Pahlavi's role in convening an inclusive transition towards a secular democratic Iran, with the final constitution determined freely by the Iranian people. I favour constitutional monarchy and respect the right of others to advocate a republic. My civic support is grounded in human rights, national reconciliation, peaceful international cooperation and the protection of civilians.

In my professional work, every patient is entitled to the same respect and clinically appropriate care, irrespective of political opinion, religion or nationality. I do not speak on behalf of the NHS, my university or a professional regulator. My advocacy must remain consistent with lawful conduct, accurate communication, patient confidentiality and respect for colleagues.

This is the explanation I believe Iranian healthcare professionals should be able to offer without surrendering either their conscience or their professional responsibility. Support for constitutional renewal can have a purpose that reaches across party boundaries. Its compatibility with healthcare impartiality is demonstrated through equal care and accountable conduct.

I support the Crown Prince because I believe he can help Iranians reach a future in which their constitution belongs to them. The strength of that position lies in defending their freedom to decide, including the freedom to disagree with me.