Paediatrician cleared of serious professional misconduct
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《英国医生杂志》
A teenager who had been bedridden with chronic fatigue syndrome (CFS) for two years this week lost her High Court challenge to a decision by the General Medical Council to clear a paediatrician who tried to influence her treatment against her parents' wishes.
Lawyers for the 18 year old, named only as Miss A, argued that the decision to find Christopher Cheetham not guilty of serious professional misconduct was legally flawed because the GMC had not considered whether he had been acting in breach of confidence.
But the judge, Mr Justice Charles, said the GMC had been concerned with a charge of serious professional misconduct, not an action for breach of confidence. The breach of confidence argument had not been advanced before the GMC, and it was under no duty to consider whether the charge of serious professional misconduct could have been established in an alternative way.
Dr Cheetham, then consultant paediatrician at Wycombe General Hospital, High Wycombe, saw Miss A at the age of 12 in 1997. She was bedridden with the illness from June 1997 to mid-1999 but has now substantially recovered.
The paediatrician, now retired, advocated an inpatient programme of psychotherapy and physiotherapy. Her parents disagreed, believing the illness was organic and she should be treated at home.
They withdrew consent for Dr Cheetham's involvement in her treatment and consulted another paediatrician, who agreed that she should be treated at home under the care of her GP.
But Dr Cheetham disagreed with the treatment and continued to try to influence it for a further two years, writing letters to doctors involved in Miss A's care. He also tried to access her medical records without consent and asked for test results.
The GMC ruled that Dr Cheetham was entitled to act as he did because the Children Act allows doctors to take action if they reasonably suspect a child is suffering, or likely to suffer, significant harm.
Mr Justice Charles said the paediatrician's actions were "on the information before me within the range of proportionate steps open to Dr Cheetham that were justified in the overall public interest." His interference was "a proportionate response," given that the causes of chronic fatigue syndrome were not known and serious welfare issues were involved.
Miss A and her parents did not have the autonomy that an adult of sound mind would have to take treatment decisions and there was a need to monitor her progress "in the light of competing professional views on treatment."
The judge refused permission to appeal, but the family's solicitor, Frances Swaine, said they would ask the Court of Appeal for permission.
She added: "The High Court's judgment not only unfairly shifts the balance of decision making in medical treatment away from parents and in favour of the medical profession, it undermines the right of parents to have virtually any say at all in the appropriate treatment of their children."(BMJ Clare Dyer, legal cor)
Lawyers for the 18 year old, named only as Miss A, argued that the decision to find Christopher Cheetham not guilty of serious professional misconduct was legally flawed because the GMC had not considered whether he had been acting in breach of confidence.
But the judge, Mr Justice Charles, said the GMC had been concerned with a charge of serious professional misconduct, not an action for breach of confidence. The breach of confidence argument had not been advanced before the GMC, and it was under no duty to consider whether the charge of serious professional misconduct could have been established in an alternative way.
Dr Cheetham, then consultant paediatrician at Wycombe General Hospital, High Wycombe, saw Miss A at the age of 12 in 1997. She was bedridden with the illness from June 1997 to mid-1999 but has now substantially recovered.
The paediatrician, now retired, advocated an inpatient programme of psychotherapy and physiotherapy. Her parents disagreed, believing the illness was organic and she should be treated at home.
They withdrew consent for Dr Cheetham's involvement in her treatment and consulted another paediatrician, who agreed that she should be treated at home under the care of her GP.
But Dr Cheetham disagreed with the treatment and continued to try to influence it for a further two years, writing letters to doctors involved in Miss A's care. He also tried to access her medical records without consent and asked for test results.
The GMC ruled that Dr Cheetham was entitled to act as he did because the Children Act allows doctors to take action if they reasonably suspect a child is suffering, or likely to suffer, significant harm.
Mr Justice Charles said the paediatrician's actions were "on the information before me within the range of proportionate steps open to Dr Cheetham that were justified in the overall public interest." His interference was "a proportionate response," given that the causes of chronic fatigue syndrome were not known and serious welfare issues were involved.
Miss A and her parents did not have the autonomy that an adult of sound mind would have to take treatment decisions and there was a need to monitor her progress "in the light of competing professional views on treatment."
The judge refused permission to appeal, but the family's solicitor, Frances Swaine, said they would ask the Court of Appeal for permission.
She added: "The High Court's judgment not only unfairly shifts the balance of decision making in medical treatment away from parents and in favour of the medical profession, it undermines the right of parents to have virtually any say at all in the appropriate treatment of their children."(BMJ Clare Dyer, legal cor)