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120 GENERAL MEDICAL COUNCIL THE council held an extra session on July 17 and 18 to deal with penal cases remaining unheard at the end of their regular summer session in May. Sir HERBERT EASON, the president, took the chair, and Dr. W. W. D. THOMSON joined the council as representative of the Queen’s University of Belfast for five years from June 15. Penal Cases INADEQUATE TREATMENT OF INSURED PATIENTS Two cases referred by the Minister of Health as com- plainant constituted an innovation in procedure, for the charges both involved failure of clinical duty towards patients, an issue never previously before the council. In neither case had the Minister removed the practi- tioner’s name from the panel. Gerald Donagh Flatley, registered as of 4, Stepney, Drive, Scarborough, Yorks, MB BELF. (1932), appeared before the council on the charge that he failed, despite repeated requests, to visit or treat various persons for ’ whose treatment he was res’ponsible under the National Health Insurance Acts, and that he thereby committed breaches of the terms of service. Mr. S. Winterbotham, the council’s solicitor, examined witnesses who said that they had repeatedly called at the doctor’s surgery to request his attendance on relatives whom they considered seriously ill. On a few occasions they had seen him and he had promised to attend but had never done so. On most of the occasions he had been absent, and they had left messages which had pro- duced no result. The patients had either been sent to hospital or seen by other doctors. Dr. Flatley, whom was not legally represented, said that he had only one kidney and was suffering from bad oedema of the legs and from general ill health the result of malaria contracted on active service ; consequently he had not been able to work as well as he would have wished. He was unable to obtain a deputy from among his colleagues. He had about 1100 panel patients. He had appeared before the local insurance committee and been fined :fJI0, but had heard nothing about a " part VI " inquiry. He lived about 250 yards from his surgery. He was an Admiralty surgeon and also had a fair amount of private work. His caretaker was old and unreliable ; at the material time he had discharged her, and had also had his telephone disconnected because he disputed the account. There was a notice in the window of the siir- gery beside the door telling patients his private address. The council found the allegations proved and that these amounted to infamous conduct in a professional respect, and directed the Registrar to erase Dr. Flatley’s name from the Register. Leon Morven Shirlalw, registered as of 36, Collier Row Lane, Romford, Essex, LRCPE (1936), appeared on the following charge : ’ That being a registered medical practitioner, on March 21, 1944, you failed to exercise reasonable skill and care in the treatment of Charles William Pearsqn, a person for whose treatment you were responsible under the National Health Insurance Acts, and who had to your knowledge on that day, before you visited him, drunk in error part of the contents of a bottle of a liniment commonly known as Lin. ABC, being- a’ preparation containing substances included in the First Schedule to the Poisons Rules, 1935, as substances falling- within the Poisons List to which special restrictions apply, which you had prescribed for him on March 13 and 17, 1944 ; and in parti- cular (1) you failed to make an adequate examination of the said Charles William Pearson when you visited him ; (2) you failed to take steps to ensure that his stomach was completely emptied of its contents with the least possible delay : and (3) you failed to inform the authorities of a hospital, to which you had arranged for him to be removed, with reasonable promptitude of the composition of the liniment which he had drunk. Dr. Shirlaw was accompanied by Mr. Oswald Hempson, solicitor, instructed by the Medical Defence Union, members of which withdxew. Mr. Winterbotham read (by consent) the statement by the appeal tribunal of the Ministry of Health of the facts found by them when they heard Dr. Shirlaw’s appeal from the adverse decision of the Essex insurance com- mittee. It was common ground that on March 13, 1944, Dr. Shirlaw attended the patient at his surgery and prescribed an expectorant and also a liniment com- pounded of aconite, belladonna, and chloroform. The prescription was repeated on March 17. At about mid- day of March 21 the patient drank by misadventure some of the liniment. His relatives gave him an emetic and summoned the doctor, who attended promptly, was ,informed of what had occurred, and prescribed repeated doses of sugar and water and the application of hot-water bottles. At 8.30 PM, on a report that the patient’s condition was worse, the doctor had him removed to the local hospital, where he died the following day. Before the tribunal Dr. Shirlaw had said that on entering the sickroom he had seen about a cupful of brown vomit, and had concluded that the patient had himself got rid of all the poison. He had found the pulse regular, steady, and of good volume, and no symptoms of toxicity. The relatives, however, denied that the patient had vomited, or that Dr. Shirlaw had examined his heart or lungs. The tribunal had concluded from Dr. Shirlaw’s own evidence that his examination had been cursory and inadequate and that he had failed to exercise reasonable skill and care or to fulfil the conditions of his’ contract of service. , ’ Mr. Hempson admitted that the doctor had been guilty of an error of judgment, and even of lack of due skill, but that, he suggested, was by no means the same thing as infamous conduct in a professional respect as defined by the Court of Appeal in Allinson v. GMC (1894) 1 QB 750 : " Something with regard to [his profession] which will be reasonably regarded as disgraceful or dishonourable by his professional brethren of good repute and compe- tency." Where, he asked, was this thing to stop ? Any one of the members of the council might make a mistake -miss a swab, remove the wrong eye, operate on the wrong side-and anyone could be wise after the event. Mr. Shirlaw had in no respect neglected the interests of his patient. The Ministry had its own powers to remove doctors from the list of insurance practitioners ; appar- ently his conduct had not been so culpable as to warrant this ; yet it asked the council to say that he should not remain on the register. The fatal result of the doctor’s error had nothing to do with its culpability. No-one could say that, if he had done all he should have done, the patient would have recovered. The council, found the facts proved to their satis- faction, but that the doctor had not been guilty in rela- tion to -them of infamous conduct in a professional respect. . ABETTING ABORTION James Alexander Henry Van Derwert, registered as of 8, Regent’s Square, London, WC1, LRCPE (1898), appeared on the following charge (and two others on which no evidence was offered) : In or about July, 1944, you referred Miss Aileen Sheila Watson to ... Pius Louis Beausoleil for attendance in order that’ he might procure her abortion. In or about July, 1944, you referred Miss Aileen Sheila Watson to the said Pius Louis Beausoleil for attendance and/or treatment and/or the performance of an operation in a matter which to your knowledge required professional discretion or skill. By your presence, countenance, advice, assistance, and cooperation you knowingly enabled the said Pius Louis Beausoleil to engage in professional practice as if he were duly qualified and registered. , Dr. Van Derwert was accompanied by Mr. G. F. Rut- ledge, solicitor, of Messrs. Smithdale, Rutledge & Co. Mr. Gerald Howard, of counsel, instructed by Messrs. Waterhouse, said that Miss Watson had become pregnant and had sought the advice of a Mrs. " C. D. " with a view to an abortion. By telephone and visit they had made various attempts to see Dr. Van Derwert, and at length they had met him at the door of his surgery as he was returning. According to the statement he originally made to the police, he had said that he could not help Miss Watson but that if he met anyone who could, he would put her in touch with him. Three or four days later he met Beausoleil, a panel patient of his, in the street, and gave him Miss Watson’s address and added that he believed she was pregnant. Before the council Dr. Van Derwert said he had written to the police desiring to vary this statement ; what had really happened was that he had been pestered by the women, who had finally managed to obtain a meeting with him ; he had not been interested in them but had merely told them to go somewhere else, that there were plenty of herbalists about. On a later occasion Mrs. C. D. had said that Miss Watson had gone to Eastbourne ; he had afterwards said to Beausoleil that a woman was worrying him and asked him to go and find out the reason. , A police officér gave evidence that the police had actually entered the house when Beausoleil was perform-
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