GMC must consider case against paediatricians who suspected parents of fabricating child’s illness

A couple suspected of fabricating their daughter’s illness and threatened with having her taken into care have won a High Court ruling that the General Medical Council must reconsider their complaint against the two paediatricians who raised the concerns.

The girl, now 15 years old, was eventually diagnosed with chronic fatigue syndrome. The local council agreed to withdraw the care proceedings and was ordered to pay the family’s costs after an independent expert appointed by the court and the doctor treating the girl made the diagnosis.

Her father, named only as Mr F to protect his daughter’s identity, lodged a complaint with the GMC against the paediatricians, who were named in the High Court judgment as Dr A and Dr B.

Mr F’s complaint included an allegation that the doctors had changed their minds and accepted that chronic fatigue syndrome was the correct diagnosis but had not immediately informed the local authority or the court hearing the case.

The charges were drawn up and the case went to the GMC’s preliminary proceedings committee (PPC), but, in July 2004, that committee decided not to refer the case to the professional conduct committee and threw it out.

Mr F sought a judicial review, arguing that the allegations were sufficient, if proved, to support a finding of serious professional misconduct. The GMC was willing to send the case back to the PPC, but the two doctors intervened as interested parties to oppose the application.

Mr Justice Sullivan ruled that the committee had failed to deal with the allegations and should have made further inquiries. He said that the charges as formulated had raised a specific allegation that the doctors had engaged in deceitful conduct, which had to be dealt with in the committee’s reasoning, and sent the case back to the committee.

A spokesman for the GMC said, “We note the decision handed down by Mr Justice Sullivan. The case will be referred back to the PPC for consideration.”

You can read the rest of this article herehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459583/

Source: Dyer C. GMC must consider case against paediatricians who suspected parents of fabricating child’s illness. BMJ. 2006 May 13;332(7550):1110. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459583/ (Full article)

Paediatrician cleared of serious professional misconduct

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.

You can read the rest of this article herehttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC403879/

 

Source: Dyer C. Paediatrician cleared of serious professional misconduct.  BMJ. 2004 May 1;328(7447):1035. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC403879/ (Full article)

 

Chronic fatigue syndrome comes out of the closet

An Alberta court ruling and new guidelines for physicians issued by the Quebec medical college are giving chronic fatigue syndrome a legitimacy it never before enjoyed. What will this mean for physicians?

Chronic fatigue syndrome (CFS) is gaining unprecedented legitimacy in Canada because of a recent Alberta count ruling, new guidelines from the Quebec medical college and recent research suggesting that the syndrome may have a biological basis. There is little doubt these developments will affect physicians across Canada.

Although viewed as a modern phenomenon, CFS was first reported by Hippocrates and has been known this century under various names: myalgic encephalomyelitis, Iceland disease, Epstein-Barr virus and yuppie flu. It has been labelled as CFS since 1988, and is currently estimated to affect 20 000 to 30 000 Canadian adults. According to the Centers for Disease Control and Prevention, CFS involves chronic fatigue for at least 6 months and a minimum of 4 other symptoms (p. 519). Scientists and doctors have been debating its existence and symptoms for years, but the debate may be winding down because of an Alberta court case (p. 533).

In March an Alberta woman finally won her case against Crown Life when the court ruled that she qualified for long-term disability benefits because of CFS. The well-publicized case emphasized the difficulty physicians have in diagnosing the illness, and the Alberta College of Physicians and Surgeons hopes to respond with CFS guidelines within a year. Dr. Brian Ward, the assistant registrar in charge of standards, says the college’s interest “began long before the case.” He says it has received frequent complaints from patients with CFS who can’t find physicians willing to treat them or follow their conditions. “They’ve asked us to increase the level of awareness among physicians and to provide education,” says Ward.

You can read the rest of this article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1229658/pdf/cmaj_159_5_537.pdf

Comment in:

What causes chronic fatigue? [CMAJ. 1999]

What causes chronic fatigue? [CMAJ. 1999]

 

Source: Sibbald B. Chronic fatigue syndrome comes out of the closet. CMAJ. 1998 Sep 8;159(5):537-41. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1229658/

 

Chronic fatigue syndrome gets court’s nod of approval as legitimate disorder

Lawyer Karen Capen looks at the implications of a recent Alberta court case involving chronic fatigue syndrome. She thinks Canada’s physicians should pay close attention to this precedent-setting case.

 

Few medical diagnoses are more hotly debated than chronic fatigue syndrome (CFS). Now, an Alberta court has added to the controversy. In Baillie v. Crown Life, a judge ruled that a women with CFS qualifies for long-term disability benefits.1 Crown Life was ordered to pay benefits to plaintiff Sharon Baillie, a former senior computer systems analyst with the insurance company.

Part of the case dealt with the insurance policy and the time requirements for filing a claim. For physicians, however, the ruling’s importance centres on how difficult it is to diagnose the condition.

This legal recognition of CFS, which the Alberta court handed down in March, should alert doctors of the need to understand the range of symptoms that fall within the condition’s diagnostic profile. The symptoms assigned to CFS generally include at least 6 months of extreme fatigue that reduces a person’s activity by 50% or more. This is accompanied by at least 4 other problems such as aching muscles and joints, headache, sleep disturbances, memory and concentration problems, and sore throat. Although the cause has yet to be determined conclusively, it is thought to involve a virus and/or a weakened immune system.

In recognizing CFS, the Alberta court recognized that a number of medical bodies have done the same thing, including the World Health Organization and the Centers for Disease Control and Prevention in Atlanta.

You can read the rest of this article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1229657/pdf/cmaj_159_5_533.pdf

Comment in:

What causes chronic fatigue? [CMAJ. 1999]

What causes chronic fatigue? [CMAJ. 1999]

 

Source: Capen K. Chronic fatigue syndrome get court’s nod of approval as legitimate disorder. CMAJ. 1998 Sep 8;159(5):533-4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1229657/pdf/cmaj_159_5_533.pdf