In my opinion, this is ridiculous. A U.K. private clinic surgeon is being criminally investigated for performing a mastectomy to remove breast cancer from an elderly woman. He is already in prison, but spoke at an inquest hearing through video conference. The woman ended up dying a month later, and while that could be a coincidence, they are blaming the surgery for hastening the woman's death - that the stresses of the surgery accelerated her demise. But that sort of reasoning is absurd, in my opinion. The woman was already in very poor health and had cancer that had spread to her lungs and bones. Other doctors are claiming this woman should not have been a candidate for surgery, because she was terminally ill and her body was too weak to handle a surgery. She also suffered from renal failure. This definitely was not an obvious and clear case of wrongdoing on the part of this surgeon. It seems like government health system (NHS) doctors are questioning the decision of this private clinic doctor. (The patient and her family consented to the surgery, so that is not the issue) This doctor would have never been subject to a criminal inquiry about this if it had happened in the U.S. I think there may be a different attitude in the U.K. Making matters more difficult is the fact this surgeon did not keep the most accurate notes or records. According to his memory, he is sure the patient must have been referred to him by government doctors at the NHS, which would imply that they approved of and recommended the surgery. (She would have been transferred to the private clinic surgeon because of the long waiting list time to be able to get surgery through the NHS ) But the government doctors are saying they have no evidence of that. The government doctors are saying the procedure was not the right decision. But this woman had a huge 7cm tumour in her breast. The surgeon explained that removal of a large aggressive primary tumour allows the secondary deposits of cancer that remain to be better controlled. There are some medical studies that give evidence to support this idea, and it is probably true. The woman's official cause of death was a perforated duodenal ulcer (in the intestine), which doesn't really seem to have so much directly or clearly to do with the breast surgery procedure. However, this doctor is being investigated for several other past surgeries that were deemed "inappropriate". This surgeon specialised in doing "cleavage-sparing mastectomies", which aimed to only take out the tumour area and leave as much surrounding breast tissue as possible, so the women would not completely lose their breast. But this was not standard or recommended practice, and leaving surrounding breast tissue means a much higher chance of the cancer returning. The cases of 62 patients who later died after surgery are being probed. The surgeon had previously been sentenced to 20 years for other surgeries. He was jailed in 2017, convicted of 17 counts of "wounding with intent" and three of "unlawful wounding", which was related to 10 patients. I cannot provide any perspective of those other cases, but this particular case seems absurd and ridiculous. It is possible they are only scrutinising this case because of his malpractice in other cases. Which I suppose may be understandable. But I am thinking it is also possible those other previous cases might be very much like this case. If that were the case, then in my opinion this whole thing is insane and this surgeon should not have been sentenced to prison. This could be an example of how "expert testimony" can result in people being wrongfully convicted. Because the judge, the prosecutor, and any jury are not really capable of understanding what the facts mean on their own, and are relying entirely on the testimony of expert witnesses to tell them what to think about the facts. surgeon Ian Paterson patient Gladys Currall, from Solihull, died in 1998 at the age of 82 Mastectomy on elderly mum inappropriate , inquest story by Oprah Flash, BBC News, November 12, 2024 It seems in the U.K. they're less willing to extend independent discretion and independent decision-making to individual doctors, allowing those doctors to pursue courses of treatment that they think are best. And if a doctor makes a decision which other doctors disagree with and do not consider to be "standard practice", then that doctor can be sent to prison for a long time.
With respect, I'm not sure your lay opinion, based as it is on a singular news report from an ongoing inquest and full of speculation, misunderstanding and misrepresentation, is especially relevant. Yes, that is why an inquest is being held to determine the full circumstances of the patients death. No, the British legal system is questioning the decisions of everyone involved in the treatment of the patient. She was an NHS patient and the NHS doctors referred her to the private clinic specifically contracted to take on some NHS patients. There is a question of whether that was fully informed consent if Paterson didn't inform them of other options while stating his preferred recommendation. This isn't a criminal inquiry, it's a coroners inquest. Such inquests exist in the US too, though I don't pretend to know whether one would be called in the same circumstances in the US. If not, that doesn't automatically mean it shouldn't have though. It is possible for American way to be the wrong one you know. That is hardly a defence. He doesn't get to not keep (or remove?) records and then simply declare what happened after the fact. Well you're free to submit your expert diagnosis to the inquest, but I suspect they already have several people who might be slightly better qualified and informed on the matter. So because you've personally decided that he wasn't necessarily wrong in this case, he could have been innocent in all of the other cases he was convicted of. You are putting your random opinions on a par with multiple inquests and criminal cases that you know literally nothing about? No, expert testimony is required specifically because judges and juries aren't able to understand all of the technical details. Coroner's inquests will typically use independent experts to provide that necessary information, though interested parties will often be able to present relevant expert testimony as part of their evidence too. In actual criminal cases, both prosecution and defence are able to present expert testimony to support their cases, who can be cross-examined and, if necessary, questioned by the judge for clarification. I don't see what a better alternative to these long-established procedures could be. No. All doctors (NHS, private or in the fuzzy area in between) are free to apply their professional discretion but they are also subject to the rules of their employers and the regulations and laws of the jurisdiction in which they're working. Not following standard practice alone is never going to be cause for regulatory challenge, let alone legal ones. Not following standard practice in a manner that could cause patient harm can be cause for regulatory challenge and not following standard procedures in a manner that does cause patient harm can be cause for legal challenge. Who in their right mind would object to that principle to protect the wellbeing of patients and the broader medical profession?
now we do have real death panels in the USA "Arizona Transplant Patients Die on 'Death Panel'" https://archive.findlaw.com/blog/arizona-transplant-patients-die-on-death-panel/ "A second Arizona transplant patient has died. Gov. Jan Brewer's passed extreme budget cuts that stop paying for seven types of transplants, ABC News reports. The Arizona Health Care Cost Containment System, the state's Medicaid agency, offers healthcare programs such as transplants for state residents."
The information concerns how that patient came about going to this surgeon's clinic, which doctor recommended her to that practice. That's normally not the type of information doctors keep or save. It would normally not be considered medically relevant. But in this case it is, when they are questioning whether the procedure should have been performed. If this surgeon can prove that the patient was referred to him by the NHS, then it would tend to show that there was more than one doctor at the time who agreed with the procedure being done, and that would help vindicate this surgeon. This could also be a case where a doctor was sentenced to 20 years based on what amounts to a matter of medical opinion. This concerns a matter of more than one patient, to be sure. And they suspect this doctor's questionable decisions of possibly causing patients to end up dying, but they can't be sure, and do not have absolute proof of that. I concede it is a stretch, but I'm just saying if all those other cases that the doctor was criminally convicted of resemble this case, then that doctor was wrongfully convicted, in my view. (Assuming of course that the news article is portraying an accurate picture of this case) I concede that full informed consent, informing the patients of the pros and cons of the procedure, and how the recommended decision could deviate from standard medical practice, is an important point. In this particular case, it sounds like to me, removal of most of the tumour was better than not removing anything. It sounds like the patient probably didn't have too long to live, regardless.
This comes from another news article: "For several years before the trial, concerns were raised about his practice of carrying out 'cleavage-saving mastectomies', a controversial operation that left breast tissue behind after the removal of cancerous cells. This method meant that the chances of a relapse within five years doubled. Speaking on the steps of the court, Diane Green, who was not a named victim in the trial but underwent such a procedure at Paterson's hands, said others who worked with the surgeon now needed to be investigated. 'He has been stopped, but we need to look to those who were co-conspirators, who let this go on, who saw this happening and said nothing,' she said." So it does seem like the NHS doctors who may have referred patients to this surgeon may be lying to try to protect their own hides (or perhaps to protect the NHS from financial liability). He was accused of performing breast removal surgeries of 10 patients for non-medically justifiable reasons, which is what the criminal charges related to. Breast surgeon Ian Paterson jailed for 15 years for carrying out needless operations, Alexandra Topping, The Guardian, 31 May 2017
Which only serves to show that you have no idea what you're talking about. When a patient is transferred from one team to another (NHS or private), the sending team will obviously provide reasons for the transfer and may even suggest or recommend the next steps for them. Regardless of whether they do or not though, the receiving team still retains complete responsibility for what they choose to do, be it in line with the send teams recommendations or not. It is not clear that surgery, let alone any specific type of surgery was even recommended in this case, and even if it was, it would be entirely on Dr Paterson to determine whether surgery was the best course of action or if any other treatment should be considered. That wasn't the case though, and even if it had been, that would have zero impact on the demonstrated facts in this case. So you object to cases being decided based on expert medical opinion but you're fine with deciding this one on the basis of your entirely amateur opinion? The NHS has already paid out compensation to many of his patients. The outstanding ones are mostly private patients and it is the private providers who are covering their hides. I'm sorry, but this case doesn't fit your pre-determined anti-NHS position. There were certainly failures and flaws in procedures and actions of some NHS organisations (hence the compensation) but it's the private element of the system that led to this being allowed to go on so long and take so much effort to stop.
