Understanding Gosport

  Many doctors and nurses must be trying to understand what went on at War Memorial Hospital, Gosport, especially those who regularly look after patients who are approaching the end of life. Yet, reading the independent report, its magnitude, complexity and ugliness forced me to look away. With its chronological sweep (27 years), terrifying number... Continue Reading →

Accountability, blame and medical error after Bawa-Garba

  The reaction to the Dr Bawa-Garba case has shown that the medical community finds it hard to accept that individuals can be held personally accountable for underperformance (once we exclude malice, drunkenness or other gross examples). Rather, deficiencies in the healthcare system surrounding the individual should be identified and corrected. Don Berwick was very... Continue Reading →

Justice and safety: a dialogue on the case of Dr Bawa-Garba

  Everyone must have a view. Thousands have expressed theirs. Many have committed to funding an independent legal review. None were there. None heard what the jury heard. Most have read the essentials of the case, and we are worried that if we commit a serious clinical error, we may be ‘hounded’, ‘scapegoated’ or ‘persecuted’, first by the criminal... Continue Reading →

3AM, eternal

A NHS Trust was found to have transgressed a patient's human rights this week. A young man with severe learning disabilities, Carl Winspear, was made ‘Not For Resuscitation’ at 3 o'clock in the morning without a discussion taking place with his mother. He did not have mental capacity to be involved in the decision, and it was... Continue Reading →

Decisions, decisions – informed consent in the 21st century

  Obtaining consent for medical procedures has become more nuanced, and potentially more demanding for doctors. The Supreme Court has decided that information given during the consent process should include any ‘material risk’ that a ‘reasonable person’ in that patient’s situation would want to know about. Quoting from the Nadine Montgomery judgement, “The test of... Continue Reading →

You choose: the case of the absent surgeon

The judgement against Royal Devon & Exeter Foundation Trust in the case of Kathleen Jones appears to have created a precedent that gives patients the right to choose who performs their surgery. KJ needed a spinal operation, and a certain surgeon, Mr C, was recommended to her by the GP. She was referred and assessed,... Continue Reading →

Notes on a judgment

  The judgment given in the case of Janet Tracey’s estate vs Cambridge University Hospital NHS Foundation Trust* contains lessons and warnings for doctors and nurses. There are fundamental implications, and there are subtle insights into how we go about discussing DNACPR decisions. The judge wrote, in conclusion: I would, therefore, grant a declaration against... Continue Reading →

Hurricane Katrina and the DNR fallacy

It happened nearly a decade ago, and although the details were there to be read in articles and commentaries, the publication of Sheri Fink's book 'Five Days At Memorial' has provided an opportunity to explore the tragedy. However, for all the comprehensive detail, the author has been accused by the protagonist with the highest profile,... Continue Reading →

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