Teenager seeks to overturn GMC judgment
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《英国医生杂志》
A teenager with chronic fatigue syndrome this week challenged the decision of the General Medical Council to clear a paediatrician who interfered in her case without her parents?consent.
At the High Court in London, lawyers for Miss A, aged 18, whose identity is protected by court order, accused the GMC of reaching a legally flawed decision in acquitting Christopher Cheetham of serious professional misconduct.
Her counsel, David Wolfe, told Mr Justice Charles that Dr Cheetham, then a consultant paediatrician at Wycombe General Hospital, High Wycombe, Buckinghamshire, had continued to intervene after her parents opted for treatment by a different paediatrician.
If the GMC decision were allowed to stand, said Mr Wolfe, it would "fundamentally undermine the right of parents to choose between different medical treatment regimes for their sick child."
He told the judge that the case had led to a considerable debate in the medical community. He cited a comment from paediatrician Harvey Marcovitch, in a BMJ news article on the GMC抯 decision: "A lot of paediatricians have been contacting the college , saying they have a terrible dilemma when families won抰 cooperate with them in knowing how far they抮e allowed to go in spreading information" (BMJ 2002;325:673).
Miss A, aged 12 at the time, was seen in 1997 by Dr Cheetham, now retired, who advocated an inpatient programme of psychotherapy and physiotherapy. Her parents disagreed, believing the condition was organic and that she should be treated at home.
They formally withdrew consent for his involvement in her treatment and consulted Nigel Speight, a consultant paediatrician from Durham with a special interest in chronic fatigue syndrome. He agreed that she should be treated at home under the care of her GP. A local child protection conference approved the treatment and decided Miss A抯 name should not be put on the "at risk" register. Mr Wolfe told the judge that Miss A had now substantially recovered.
But Dr Cheetham had disagreed with the treatment and continued to try to influence it for a further two years, writing letters to doctors involved in Miss A抯 care criticising their assessments and treatment. He also tried to access her medical records without consent and asked for test results.
The GMC ruled in September 2003 that Dr Cheetham was entitled to act as he did because the Children Act 1989 allows doctors to interfere if they have a reasonable suspicion that a child is suffering, or likely to suffer, significant harm.
Mr Wolfe said there had been no suggestion that Miss A was in danger of being harmed. He asked the judge to declare that the law did not give a doctor a general right to seek to influence a child抯 clinical management simply because he disagreed with the treatment regimen, if that regimen was a recognised course of treatment by a doctor of unquestioned competence, and in circumstances where there was a range of different legitimate responses to the condition. .(BMJ Clare Dyer legal corr)
At the High Court in London, lawyers for Miss A, aged 18, whose identity is protected by court order, accused the GMC of reaching a legally flawed decision in acquitting Christopher Cheetham of serious professional misconduct.
Her counsel, David Wolfe, told Mr Justice Charles that Dr Cheetham, then a consultant paediatrician at Wycombe General Hospital, High Wycombe, Buckinghamshire, had continued to intervene after her parents opted for treatment by a different paediatrician.
If the GMC decision were allowed to stand, said Mr Wolfe, it would "fundamentally undermine the right of parents to choose between different medical treatment regimes for their sick child."
He told the judge that the case had led to a considerable debate in the medical community. He cited a comment from paediatrician Harvey Marcovitch, in a BMJ news article on the GMC抯 decision: "A lot of paediatricians have been contacting the college , saying they have a terrible dilemma when families won抰 cooperate with them in knowing how far they抮e allowed to go in spreading information" (BMJ 2002;325:673).
Miss A, aged 12 at the time, was seen in 1997 by Dr Cheetham, now retired, who advocated an inpatient programme of psychotherapy and physiotherapy. Her parents disagreed, believing the condition was organic and that she should be treated at home.
They formally withdrew consent for his involvement in her treatment and consulted Nigel Speight, a consultant paediatrician from Durham with a special interest in chronic fatigue syndrome. He agreed that she should be treated at home under the care of her GP. A local child protection conference approved the treatment and decided Miss A抯 name should not be put on the "at risk" register. Mr Wolfe told the judge that Miss A had now substantially recovered.
But Dr Cheetham had disagreed with the treatment and continued to try to influence it for a further two years, writing letters to doctors involved in Miss A抯 care criticising their assessments and treatment. He also tried to access her medical records without consent and asked for test results.
The GMC ruled in September 2003 that Dr Cheetham was entitled to act as he did because the Children Act 1989 allows doctors to interfere if they have a reasonable suspicion that a child is suffering, or likely to suffer, significant harm.
Mr Wolfe said there had been no suggestion that Miss A was in danger of being harmed. He asked the judge to declare that the law did not give a doctor a general right to seek to influence a child抯 clinical management simply because he disagreed with the treatment regimen, if that regimen was a recognised course of treatment by a doctor of unquestioned competence, and in circumstances where there was a range of different legitimate responses to the condition. .(BMJ Clare Dyer legal corr)