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Guest khuram

GMC vs COURTS

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Prof Row Meadow won his appeal against being struck of the medical register.

Today,a historical deciscion was given when Prof Roy Meadow was cleared from the charges of giving misleading evidence in the cases for sudden infant deaths.It was acknowledged that he acted within the proffessional boundaries and gave an honest proffessional opinion which resulted the courts wrongly sentencing the women with charges of murder.

GMC should think about protecting their doctors at the first place rather than acting solely on societal wishes which is heavily influenced by the culture of blame.

What a relief for us now knowing that we can confidently use our expertise while acting in the best interest for all concerns.

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I agree up to a point.

When acting as an expert witness one must be certain of his/her opinions as the consequences may involve (as they did in Prof Meadow's case) imprisonment and family break-downs for the accused.

It's unusual that the current proposal is to protect expert witnesses from 'consequences' of their evidence, such as litigation.Surely they ought to be accountable if their evidence are misleading.

Having given evidence on one occasion I am not for a moment suggesting that the pressure being taken off is a bad thing but I am somewhat concerned about the removal of accountability for the consequences of expert witness recommendations

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Recently I attended the Annual Forensic Faculty meet of the college in Newcastle Gateshead. This topic about whether the GMC was right to strike Prof .Sir Roy Meadows off the register was debated.2 experts for the motion saying yes! the GMC was right & 2 experts saying No! the GMC was wrong.They took a poll before the speeches(5 minutes each)! & one after the debate.

Ofcourse, an overwhelming majority voted for the NO. There were over 500 Forensic Psychiatrists from UK, Europe & the US.

But I voted for the YES.

these are my reasons:-

1) This is a Paediatric professor Giving evidence about Manchuhausen by Proxy syndrome,essentially a psychiatric condition.he wanders OFF from his area of expertise.

2) He quoted evidence from an unpublished paper meaning any other expert cannot give his opinion on it as it is UNPUBLISHED evidence.

3)He then gets his Statistics wrong.

4)He then REPEATEDLY gives evidence in various cases(Sally Clarke,Trupthi Patel etc..) & also in the hearings of the GMC & does not correct himself.

5)I am concerned of our views as a profesion(Medicine) as a whole to Media(TV &Tabloids & Broadsheets) & Politicians. Yeah, there are knee jerk reactions, political show boating etc......... but that is the age we live in. everything is modelled on public opinion & focus groups.My guess is we as a profession are realising this late.

whether we like it or not we have  to learn to live with it, if possible engage it and dare I say influence it if we can.But Ignoring it is not an option.

Bristol Scandal,Harold Shipman & Roy Meadows case have caused our profession some damage.

By this I am not saying what the GMC did was right nor am I implying that there are no systemic implications.

Solicitors could have used independent experts,cross questioned him,judges could have clarified things, none of this happened.The less said about the GMC the better.

But All of us have had some(atleast) experiences of INDEPENDENT EXPERTS with questionable morals & ethics in the tribunals,judicial reviews etc......

In the end, I conclude by stating Prof Sir Roy Meadows did irrepairable damage to child protection issues, a cause he championed all his distinguished career.I was speaking to my neighbour over this(a teacher) & she said if this what a Professor is like, then think of the ordinary ones!!!! This is what we have to deal with.

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There's a must-read article on this whole sorry affair in Hospital Doctor magazine today - click here.

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thanks for posting the above link. hospital dr delivery has been patchy recently.

it sent shivers down my spine.

absolutely fascinating how penny mellors true personality hasn't been portrayed in the press. a truly dangerous woman ....for drs but ...more importantly kids who are subject to parental abuse .

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Dear Maram,

A small correction, Munchausen by proxy is not classified in mental disorders like factitious disorders, but along with child abuse which is not an 'F ' code but 'T' if my memory is correct.

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maran posted his views sometime back , only read the thread today

Just to make him aware that sir roy meadows is actually the person who gave the very concept of this syndrome , the so called MSBP

he first invented it when he burst to prominence in 1977 with a paper in the Lancet entitled 'Munchausen Syndrome By Proxy: The Hinterlands of Child Abuse',

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I acknowledge the corrections. However you would have to agree with me that there is considerable overlap between social paediatrics and child psychiatry. Paediatricians(at least when taught at medical college) examine the child and look for physical signs of sexual abuse. Yes, over the years of doing child protection work will also see the psychological damage of abuse.However that does not make them experts on psychological damage(although their opinion may be valid).

This is where i feel Prof.Sir Roy Meadows made the mistake. Did he ask for a Psychiatric opinion?Did he acknowledge he was not an expert in psychological issues?

For example, as Psychiatrists we see a lot of poor physical health in our patients.We might know management protocols for some of the conditions.but that does not make us experts in internal medicine.get my drift?

My contention was Prof Sir Roy Meadows used his considerable reputation and authority to use unpublished eidence,got the statistic wrong & espoused a syndrome( yes! he was its creator/describer) with no great theoritical underpinnings( epidemiology, its presence in various races etc....) & still continued to espouse his views after his evidence was overturned in the courts of law(in many cases).

Does it warrant GMC actions? We are entitled to our opinions.

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The diagnosis of Manchuhausen by Proxy Syndrome also raises many questions for Psychiatry itself.

Yes, Prof Meadows described it, but is it really there? what is the epidemiological base? what is its validity across races? has this been replicated else where?

Quite often I hear senior psychiatrists say the same about Schizoaffective disorder? some vouch by it, some say it doesnt exist.

for example if i say TB, we see lymphadenopathy,evening rise of temparature,cough with expectoration and haemoptysis & culture positivity & X-Ray findings of Ghon foci.But unfortunately We dont have signs & investigations.

when senior and experienced psychiatrists often have very strong views on PTSD & Schizoaffective disorder, is it right for paediatricians to make a psychiatric diagnosis?

Looking forward for an informed debate.

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