After Bawa-Garba: the principle of shared responsibility

  The case had been rekindled in the minds of many this week for two reasons. Firstly, Hadiza Bawa-Garba has been allowed back to work, and secondly, court transcripts have become available. Excerpts from these have been Tweeted to counter several ‘myths’ or received facts such as ‘it was her first day back from maternity... Continue Reading →

Fear and medicine – friend, foe, natural bedfellow?

Juliet entered the ward expecting a normal, busy day. But the face of her colleague Nethmi who met her by the nurses’ station told her that something was up. “What?” asked Juliet, responding to Nethmi's wordless warning. “Mr Peterson. Bed 19. They took his vascath out last night.” “So?” “Did you tell the nurse to... 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 →

Not in my name

  A recent coroner’s report caught my attention (highlighted by HSJ's Shaun Lintern via Twitter). A patient died from a ruptured aortic aneurysm, and during the investigation it was discovered that it had been seen on a CT scan four years earlier. However, the patient never came to hear of it, the GP was not informed, and... Continue Reading →

Interactive Ward Ethics 2: Dangerous

This is the second interactive post, and the scenario places our long suffering but excellent medical registrar, Nina Charan, in a no-win situation. She observes a colleague, another registrar, making a complete mess of a delicate medical procedure, and has to decide how to deal with it. Should she ignore it, manage it herself, give him... Continue Reading →

Patterns and pride: diary of a medical anecdote

...There is, it seems to us, At best, only a limited value In the knowledge derived from experience. The knowledge imposes a pattern, and falsifies, For the pattern is new in every moment And every moment is a new and shocking Valuation of all we have been. T.S. Eliot, East Coker (Four Quartets) Day 1... Continue Reading →

Intersection

This is a brief tale of two patients who never met, but whose lives became briefly entwined with huge consequences.  Until the day that saw both became ill their life lines had not intersected before. Suddenly those lines veered from their usual course and dived across the city towards a bland, anonymous nexus...the hospital. They arrived... Continue Reading →

The eyes and the ears: why Adam blew the whistle

Previously I wrote a dialogue between two junior doctors. They discussed why Michael would not report, to some higher authority, the dangerous incompetence of a consultant. In this second dialogue, Adam explains to his friend why he phoned the GMC to report dangerous staffing levels. This dialogue seeks to illustrate why a doctor might feel... Continue Reading →

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