FROM MEDIC-LAW CASE FILES –
Medical Practitioners Tribunal accepts expert psychologist evidence and clears doctor of dishonesty
A doctor facing allegations of misconduct and dishonesty in a fitness to practice hearing convened by the GMC has been cleared of this; the key to his acquittal was the evidence from an expert in cognitive neuroscience who gave evidence that the doctor’s inaccurate account was due to ‘false memory’ and ‘reconstruction’ rather than dishonesty.
The Allegations
The GMC had alleged that the doctor had failed to attend to a patient when called (resulting in the death of the patient of a curable condition) and then provided an explanation that was dishonest.
The trust that had referred the doctor to the GMC had conducted an investigation itself and dismissed him. It had found that the doctor had been called to see the patient on two occasions but on both occasions, instead of going to see, he had given incorrect advice on the phone and this had resulted in the patient’s death. When asked to provide a statement, the doctor had provided a completely false account and implicated a consultant by saying that he had received advice from the consultant regarding the patient’s management when that consultant had not even been on call. The investigation findings of the trust formed the basis of GMC’s allegations.
After his dismissal the doctor had continued to maintain that he had spoken to the said consultant; based on this he had commenced a case in the Employment Tribunal, claiming that the trust had suppressed documents which would confirm that the said consultant had indeed been on call. However, the trust then produced evidence that the consultant concerned had not only not been on call, the doctor had known this because he had named someone else in a consent form he had completed in relation to another patient that night.
Expert evidence: Cognitive Neuroscience
Medic-Law represented the doctor. Having analysed the GMC case we identified two key areas in the case, the calls made to the doctor from the ITU and the specific circumstances in which the doctor was asked to give the statement accounting for his actions. In relation to the latter, while it was clear to us that the doctor had provided an account which he firmly believed to be true, it was also clear that the account was grossly inaccurate.
But was this account dishonest? Given the degree of inaccuracy in the doctor’s statement, we felt that there was a real possibility that the tribunal may find him dishonest.
After careful analysis, we decided to commission a report from an expert in cognitive neuroscience (psychologists with expertise in ‘memory’) in relation to the doctor’s statement. The expert reported that the inaccuracy in the doctor’s account had a scientific explanation; the doctor’s poor initial recollection of events coupled with pressure over him from trust authorities to recall the events to be able to clear himself had led to unwitting creation of ‘false memory’ and ‘reconstruction’.
This was a breakthrough. Until then, despite not doubting that the doctor was being truthful, we were unable to offer an explanation for what had happened.
When we sent a copy of the expert report to the GMC, they were not pleased; they threatened to commence another investigation into the doctor’s fitness to practise. The GMC then vigorously opposed the presenting of the expert evidence to the Medical Practitioners Tribunal, citing the case of R v Turner, which says that evidence cannot be allowed in deciding how a person reacts to stress and strains of life.
However after concerted arguments on behalf of the doctor, the Tribunal accepted that the issue in this case was complex enough to allow the evidence from the expert.
Account was NOT dishonest!
Based on the expert’s evidence, the tribunal were persuaded to find that while being inaccurate and misleading, the doctor’s account was NOT dishonest. Further, with careful forensic analysis, we were also able to establish that the incorrect advice that had resulted in the patient’s death had not come from the doctor but had come from someone else. Based on these theMedical Practitioners Tribunal has completely cleared the doctor.
Comments
The use of expert psychology evidence in Fitness to Practice hearings is probably unprecedented. However, this proved vital in this case and without this, it would have been extremely difficult to defend the allegation of dishonest.
While the doctor has had to learn many lessons, the doctor is glad that the ordeal has come to an end.