Why the shaken baby syndrome tribunal led to Dr Waney Squier being struck off
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Version 0 of 1. Michael Mansfield, Clive Stafford Smith and others argue that the General Medical Council is behaving like a “21st-century inquisition” (Letters, 22 March) in the case of Dr Waney Squier (Shaken baby syndrome doctor struck off, 22 March). This is untrue and based on a fundamental misunderstanding of the role of the GMC in law and the particular circumstances of this case. First, the GMC is not and has no intention of being the arbiter of scientific opinion – the allegations we brought against Dr Squier did not rest on the validity of her scientific theory but upon her competence and conduct in presenting her evidence to the courts. It is strange that eminent lawyers, in setting out their argument, choose to ignore the fact that no fewer than four senior judges had expressed strong criticisms of the way Dr Squier had presented her evidence in court. These were in cases of the most serious kind in which the welfare and lives of children were at stake, as well as the liberty of individuals. This hearing was brought following that criticism. In law we have a duty to investigate serious allegations of this nature and, if there is sufficient evidence to substantiate them, to present them before the autonomous Medical Practitioner Tribunal Service, the agency responsible for making decisions in these matters, independent of the GMC. The tribunal in this case found proved more than 130 allegations about Dr Squier’s conduct, determining that she misled courts and acted dishonestly and irresponsibly by cherrypicking research and evidence. A doctor giving evidence in court is bound by the same standards as those in medical practice, and they are also bound by additional rules set by the court. They must maintain patient and public trust by acting with honesty and integrity at all times, and their work should be rigorous and their opinion presented objectively and fairly. If it becomes clear that a doctor has lost their objectivity as an expert witness – by cherrypicking facts or research to suit their views, or by working outside their area of expertise – that is a matter we must investigate. Far from wishing to suppress different views, we recognise that scientific advance is achieved by challenging as well as developing existing theories, and importantly in this context we are absolutely clear that neither the GMC nor the courts are the place where such scientific disputes can be resolved. To be clear, it is possible that a doctor who ultimately was proved to have the correct theory could present their evidence in such a way as to mislead, just as it is possible for a doctor advocating a theory ultimately proved to be flawed to present their case in context and with integrity.Niall DicksonChief executive, General Medical Council • The decision to erase Dr Waney Squier from the medical register will have a serious adverse effect on the administration of justice and lead to an increase in wrongful convictions of baby carers. The understanding of the syndrome comprising the triad of bilateral thin-layer subdural haematomata, retinal haemorrhages and encephalopathy – once pathognomonic of baby-shaking – is changing. Even the diehard protagonists of “shaken baby syndrome” have had to recognise that there is no science to support the hypothesis that shaking babies produces the pathological picture. The clue is not in the name, but the use of SBS as a diagnosis at one and the same time provides a convenient explanation for the presentation and an easy conviction of the parent holding the baby. Dr Squier, who once followed the mainstream opinion, came to realise that the imputed causal link between alleged shaking and the pathology had no basis in science, and she dared to say so. The work of this internationally acclaimed neuroscientist has been recognised by the Innocence Network granting to her the prestigious “Champion of Justice Award. The real danger created by this unjust regulatory decision is that few medical doctors now will dare to challenge mainstream opinion. Simply reminding a court that in the absence of scientific evidence, one hypothesis is no better than another will be sufficient to put at risk an expert’s medical career. It is for the court to determine which experts give evidence in these complex cases. It is not the place of a lay tribunal to usurp that function.Dr Michael J Powers QCFellow of the Faculty of Forensic and Legal Medicine • What has happened to Dr Waney Squier is appalling, and fits with a well-established theme here in the US of attempting to silence critics of shaken baby syndrome through prosecutions, censures, professional ridicule and threats. I am a career investigative reporter with a documentary film (to be released 15 April) all about this. It is called The Syndrome and it is the culmination of eight years of my research. I also happen to be a career reporter who has gotten laws passed in the US to help abused and neglected children (see my bio on website). The attempt to eliminate the opposition in shaken baby syndrome cases is sickening and undemocratic. Dr Squier is a world-renowned neuropathologist whose work and courage should be celebrated. In fact, she is being celebrated, at the very same time that she is being stripped of her medical licence. In early April, Dr Squier will receive a Champion of Justice Award at the National Innocence Network conference in Texas. What the GMC has done is clear. It has sent a message to all who dare question this dogma: speak up and we will ruin your career. The world is watching.Susan GoldsmithWriter/producer, The Syndrome • In the weeks since the various decisions have been handed down in the hearing of Dr Waney Squier (Doctor guilty of misleading courts over shaken babies, 12 March), a series of criticisms has been levelled against the tribunal that heard the case (Letters, 22 March; This shaken baby syndrome case is a dark day for science – and for justice, 14 March). As national chair of the Medical Practitioners Tribunal Service (MPTS), it would not be appropriate for me to comment on the tribunal’s decision, but I will address the points made about the tribunal. Such tribunals are not set up or designed to make decisions on the science or on clinical matters – this is perfectly clear – but they are judging whether an individual doctor’s actions fell short of the professional standards that would be expected of any competent doctor. The presence of medical members on a tribunal is to make sure that a medical perspective is reflected, not to mirror the particular specialism of the doctor appearing before it. The tribunal does not and should not bring specialist clinical expertise; in the same way as the judiciary operates, its role is to make judgments based on evidence, including evidence from experts. The law requires that all cases are heard by a mix of lay and medical tribunal members, which I believe is right to retain the confidence of both the medical profession and the public. During the course of a hearing both the GMC and the doctor can call evidence from expert medical witnesses to assist the tribunal in understanding issues relevant to a case. All such evidence is taken into account and thoroughly considered by tribunals when making a decision. It is crucial that decisions made by MPTS tribunals are independent. Our tribunal members go through a rigorous appointment process and are selected for their ability to consider evidence and make fair, consistent and robust decisions which stand up to scrutiny. What is more, those decisions can be subject to appeal before the high court, by either the doctor, if he or she feels it is unfair, or by the GMC if it considers the decision to be insufficient to protect the public or to retain public confidence in the medical profession. The Professional Standards Authority can also refer a decision to the high court.David PearlNational chair, Medical Practitioners Tribunal Service • Join the debate – email guardian.letters@theguardian.com |