A possible offender part 2
and a difficult decision
Part #2
Professor B was accused of sleeping with youths and men in a country where homosexuality is illegal. Some were his patients and with some he paid for their education. Some were under the UK age of sexual consent.
I worked for the UK hospital which was his main employer. We suspended him, for actions not in our service, to investigate. His suspension soon posed considerable difficulty delivering some parts of the cardiac service, and of teaching his extremely important new treatment to other hospitals across the world. His work meant some children could have a procedure done by catheter, not by cutting open the chest.
Photo from Mohamad Azaam at Unsplash. (This is a stock photo and no-one in it is implicated!)
Our working theory was that our hospital wasn’t a great place to attempt anything untoward. He didn’t have much contact with patients during their stay. There wasn’t much privacy, there were too many nurses with child protection training around, and a British children’s hospital usually has parents around, even overnight. Making relationships to exploit later was far more worrying.
The tough choice was this. Already other clinicians could do many cases with his method, but at the cutting edge, there were patients who needed his pioneering skill for the best outcome. One case was considered inoperable without him and several would be riskier. We needed him to train new staff, even faster than planned, so the department and the world could do without him if the charges were proved.
The department organised a plan that would allow him to work, under severe restrictions.
The CEO looked at me and said, ‘So can we defend this in the media if we let him work?’
‘Yes,’ I said. ‘Giving our patients the best chance is what we’re here for. We just need the plan to be credible.’ I knew who would be doing the defending.
Fierce rules were put in place. The Professor was not allowed in a room with a patient without an additional senior member of staff, solely to watch him. This even applied in clinical procedures, where there were several other staff anyway and the procedure was routinely filmed. Watching him in the procedure room was to manage understandable parental anxieties, rather than to believe there was a serious risk. He was a smart man and he wasn’t going to do anything while he was watched.
When the news did break, we immediately activated a patient and family helpline. People affected needed to talk this through with someone. The public and media response was as good as could be expected. The media’s “serious questions” got serious answers – the bald truth. It had been the right call.
Misplaced loyalty
The degree of staff denial was extraordinary. The admirable senior staff – who felt personally betrayed – accepted there was an issue and friendship couldn’t get in the way. The evidence was strong. Even if all sexual accusations were lies, the Professor’s actions - inviting underage patients to sleep and shower in his rooms - were scandalous and indefensible. The leadership had to manage staff who just didn’t want to believe it, including those who thought the management had made it up. In a field which lives and dies by evidence-based medicine, some believe to this day that this able man was brought down by a conspiracy.
Even now, the Professor is invited to the odd prestigious conference.
Some staff said we shouldn’t collude with ‘wicked African homophobia’. This ignored the realities that he abused his power. There was no homophobia. The disciplinary investigation came across a couple of consenting relationships with adults who weren’t patients or relatives. Those posed no professional concerns, so they were dismissed as irrelevant.
This curious self-deception occurs elsewhere. Daniel Carleton Gajdusek, a Nobel Laureate with a distinguished career, brought 56 boys from Micronesia to the United States and paid for their education. Some of them later accused him of sexual misconduct, and there’s a heart rending documentary. Gajdusek also wrote in diaries and clinical journals about sex with boys, and incest, which he defended. When the accusations broke, eminent figures were quick to accuse the boys of lying, then to shift to the wholly different claim that sex happened but that they consented, and that these relationships were culturally acceptable. Gajdusek served one year of jail in a plea bargain. As an SFF fan, it pains me to mention Arthur C Clarke and his life surrounded by boys in Sri Lanka, although the allegations were never upheld in a court.
Interesting that the documentary about Gajdusek, The Genius and the Boys, was directed by Swedish investigative journalist Bosse Lingquist. He also first exposed Paolo Macchiarini, (who I spotted was a grandstanding narcissist, if not a cruel and dangerous crook.) Macchiarini was defended by Sweden’s most prestigious medical organisation despite enough alarm bells to wake a city.
A verdict
In Greek tragedy, the hero has many good qualities but is brought low by their flaws.
Most of the accusations were confirmed and after a very deliberate and careful investigation, the hospital dismissed him. In due course even younger victims were identified from his time abroad, including horrifically the family of a French boy aged ten he touched inappropriately. The family decided to give him a second chance, and so they hadn’t reported his behaviour several years before.
The UK regulator, the GMC, brought the Professor before a professional tribunal to permanently deprive him of the right to practice as a doctor. He simply refused to engage with the process. The case turned out to have wider implications.
Rogues deserve rights
The Professor was found unfit to practice – in layman’s term, banned from being a doctor - and his team appealed. The GMC as prosecutor had assumed that none of the boys, youths and men could possibly be brought to the UK to face cross examination because of the stigma and legal threats they faced in their society.
The defence argued that the principle of testing prosecution evidence is important for fairness. The court agreed. It ruled that the GMC should have thoroughly considered every possible option, including new-fangled videoconferencing, before they relied on evidence which could not be directly challenged. The system needs to be fair, even if the person probably did it. I agree with the court but I recognise the GMC had a difficult job to do.
The GMC had to re-prosecute the tribunal which still reached the same damning conclusion.
This test case, named after the Professor, now binds all such bodies. This shows why rights cannot be kept only for ‘good people.’ Sometimes, throughout history, it has been the defence of absolute rogues which lead to legal protections for everyone. Disappearing MP John Stonehouse who staged his death to defraud his insurers, ended up in a test case, defending the right of the jury to decide on facts.
The African authorities did not prosecute the European philanthropist. I recognise the enormous risk the victims might have been under if they testified. UK authorities investigated – the law had been changed to allow overseas offences to be prosecuted here - but nothing came to court. Maybe the victims would have welcomed their day in court.
The balance of probability
Criminal courts work to ‘beyond reasonable doubt’, or as juries are now instructed, ‘you must be sure’. Employers and professional tribunals (and civil courts) work to ‘the balance of probability,’ which is ‘more likely than not’.
That’s why a hospital can fire someone and the professional tribunal remove them from the register, and yet the same case might lose in court.
For a doctor, our law says that a hospital must be allowed to fire them if there is a reasonable chance but not absolutely certainty that they pose a danger.
In addition, if a doctor repeatedly refuses to follow good safe practice, the employer need not wait until someone is actually harmed before they are disciplined.
This is a sad tale. I suppose I take comfort in the fact that no matter how well respected and important the man was, he was not considered more important than the safety of children and young people in his care. Survivors were believed and hopefully protected, and the important clinical work will continue. At a personal level, I’m pleased that the difficult decisions we made balancing safety and delivering care were accepted.