The Irresistible Force Paradox of Criminal medical negligence.
The immovable object (B) and the unstoppable force (A) are both implicitly assumed to be indestructible (C), or else the question would have a trivial (D) resolution.(E)
The Law (A) The Medicine (B) The Media (C)
Let the science speak to help the grief #dropitandwait(D).
Put the egos away and learn from the mistakes #beforeitstoolate(E).
The ‘paradox’ is flawed (D) because if there exists an unstoppable force (A), it follows logically that there cannot be any such thing as an immovable object (B) and vice versa. (E)
Dr Letlape said the Beale case had criminalised the medical profession and many doctors feared working under such conditions.
“I am a practising doctor and I cannot practise under this climate where I may be killed for helping society. That is not the environment we want to practise in, where ... I can be treated as if I am a criminal when there is a provision in the law in terms of how these matters should be handled.
“We are in danger. We cannot practise in this climate, the laws of the country are not being followed. Why are you not dealing with this the way it should be, why are you criminalising medicine?”
A):The law: The unstoppable force.
ANALYSIS | Cyril should ignore HPCSA letter - law experts
Law experts have questioned the wisdom behind a letter by the Health Professions Council of South Africa (HPCSA) to President Cyril Ramaphosa about the prosecution of Johannesburg paediatric surgeon Professor Peter Beale.
Law expert Dr James Grant said the constitutional independence of the National Prosecuting Authority (NPA) ensured no one, including the president, could influence a prosecutorial decision.
“Yes, representations can be made to the NPA before prosecutions begin about whether a certain matter should be prosecuted or not, but ONCE THE PROSECUTION is under way there is NOTHING that can be done.
“What can certainly not be done is to write to the president, once the NPA has decided to prosecute, and request his intervention in the matter.”
He said because of the separation of powers, the president would not legally be able to intervene, “as he does not have the authority to do so”.
Grant said the HPCSA writing to the prosecutors in the case or the presidency could not be considered as interfering in the duties of the NPA.
“I would expect the presidency’s office to completely ignore the HPCSA.”
He said what would be considered to be interference in the NPA’s duties was if the HPCSA instructed doctors, who may be called as witnesses in the case, to refuse to give evidence.
“That would amount to obstruction of justice.”
Constitutional law expert Pierre de Vos said if the HPCSA was asking the president to intervene in the matter, then the council would be asking him to breach his constitutional obligations.
“The NPA’s independence is enshrined and protected by the constitution. I cannot imagine that the HPCSA was acting on any legal advice. If they were, then it was very bad advice.”
He said while a party to a court case could make representations to the court, there was no obligation for the court to consider such.
De Vos said a party that was not involved in a court case did not have a right to make representations to the court.
B): The medicine: The immovable/essential object
“We can’t practise in this climate': doctors write to Cyril Ramaphosa”
The Health Professions Council of SA (HPCSA) has written to President Cyril Ramaphosa about the criminal case against Dr Peter Beale and Dr Abdulhay Munshi, who was shot dead last week.
The pair were charged with culpable homicide after the death of a prominent businessman's 10-year-old son following a laparoscopic operation to stop reflux last year.
Munshi was shot five times after an apparent bumper-bashing incident in Johannesburg last Wednesday. Munshi had got out of his car to investigate when he was killed. The criminal case and shooting have unsettled the medical community and speculation abounds about the motives for the murder.
The HPCSA said on Monday that it had written to Ramaphosa about the matter after a “lack of action” by the National Prosecuting Authority (NPA) and the minister of justice.
“This has implications for the medical profession. We are just acting responsibly, just like when we notified the minister of justice and minister of police, we feel he needs to be aware of what is happening,” said spokesperson Kgosi Letlape.
Letlape said the case had criminalised the medicine profession and many doctors feared working in such conditions.
“I am a practising doctor and I cannot practise under this climate where I may be killed for helping society. That is not the environment we want to practise in, where [by] my professional action, I can be treated as if I am a criminal when there is provision in the law in terms of how these matters should be handled.
“We are in danger. We can’t practise in this climate, the laws of the county are not being followed. Why are you not dealing with this the way it should be, why are you criminalising medicine?” asked Letlape.
He said it was important for the council to alert the president of what had been happening so it did not come as a shock when doctors refused to do their jobs.
“It can’t be that when people refuse to practise or leave the profession, the president wonders why or why he wasn’t alerted to the issues,” he said.
Paediatric surgeon Prof Peter Beale has gone into hiding after the death of fellow-accused Munshi.
The child's father Mo Sayed has denied any involvement in the shooting.
“Naturally there is a lot of speculation about the motive for the murder and status of the case against the doctors. It seems some are now trying to use this unfortunate and tragic incident to delegitimise the ongoing court process,” he was quoted as saying by the Sunday Times.
“We would never do something like this. I have spent a substantial amount of funds and resources to bring this case to where it is, which is to the court to get justice.”
TimesLIVE
C): The media: (questions?) Assumes both forces are indestructible.
Q&A with HPCSA president Dr Kgosi Letlape
(04/10/2020)
Are you concerned about vigilantism against doctors?
Yes, we are.
Why is it happening?
We don’t know. But we’re concerned that colleagues will become scared to practise.
Was Dr Munshi’s death a result of a failure of the system?
I don’t want to speculate on cause and effect, but where you have a trial — the criminalisation of a profession that is in the public space — and one of the accused gets gunned down, you have to be concerned.
Are you concerned about the functioning of the legal system in cases involving doctors?
We have expressed our dissatisfaction to the National Prosecuting Authority (NPA).
What are you dissatisfied about?
A professional act being dealt with as a criminal act because of an unfavourable outcome.
Do you have a problem with criminal charges against doctors?
If doctors face the prospect of being criminally charged despite acting professionally, because a life has been lost, that is a concern. Because it means that every day we are practising at our own risk even if we act with the utmost integrity and professionalism.
If a doctor messes up and someone dies, should he not be criminally charged?
If you’re saying, “If there’s an unfavourable outcome and the doctor has acted properly and professionally” …
That’s what a court needs to determine, surely?
There are provisions in the law dealing with that. The Inquest Act of 1959. We would expect that if there is a procedural death there would be an inquest.
Why was the inquest route not followed?
Do you act quickly and effectively enough when you receive complaints about doctors?
That is subject to outsiders. There are processes that have to be followed. In the last few years we’ve seen continuous legalisation of the process and it is taking longer to resolve matters. But our duty is not to protect doctors, it’s to protect the public.
Did you do so in the case of [paediatric surgeon] Peter Beale?
We acted in accordance with what is expected of us.
Is it true that two other children died after he operated on them?
Not that I’m aware of.
The families were not happy with the response of the council.
All I can inform you of is that my duty is to ensure that complaints are dealt with urgently.
Should doctors with that kind of track record still be operating?
There’s a defined process of getting practitioners to account for such matters. It depends on the facts.
Can you see why families might feel their only option is to lay a criminal charge?
We’re not saying they have no right to lay criminal complaints. We’re saying there is prescription in law in terms of how such matters, where there is a procedural death, should be handled. We’re asking the NPA why those provisions in our law were not used. We are baffled that a matter that was screaming “inquest, inquest” was not handled in that manner.
(D) #dropitandwait The Trivia or science
Review of the latest NPA statements surrounding Prof Beale’s medically related murder case.
01/02/2022
#itistoolate #timeforevidence #sciencewilljudge
Case is postponed to January 2023.
Originally charged in November 2019.
The State is expected to call 49 witnesses, including clinicians and people who worked at the two hospitals where the children died.
The new further charge of Culpable Homicide?
The surgeon operated on a patient, the patient passed away from a myocarditis found in Post Mortem?
Statement:
"The primary MEDICAL cause of the death of the deceased was noted as myocarditis [which is inflammation of the heart] in a person undergoing SURGERY," the indictment read.
Review:
(The science)
The incidence of myocarditis in children is uncertain but it is estimated that 1 per 100,000 children per year are affected. It has been reported that 0.05% of all pediatric hospitalizations are for myocarditis. Understanding the incidence of myocarditis is problematic because the disease is difficult to diagnose.
The signs and symptoms of myocarditis can be quite variable. Infants may show signs of listlessness, labored breathing and pallor. Frequently, they become disinterested in feeding or very fussy and difficult to console. Most older children will complain of abdominal or chest discomfort, fatigue or weakness. Respiratory symptoms such as increased work of breathing and wheezing may lead physicians to incorrectly diagnose children with asthma or pneumonia. It is not unusual for some patients to have experienced flu-like symptoms a few days or weeks before seeing a physician. Sometimes, sudden death is the FIRST sign that something is wrong.
Charge of 1st Degree Murder?
The surgeon operated on a patient, the patient passed away.
Statement:
"Having intentionally misled the complainants (parents), into believing that the surgical intervention was necessary when in truth and in fact it was not, the accused knew that he was placing the life of the deceased at risk when it was not necessary to do so. Notwithstanding the fact that the accused was aware that there is an inherent risk with any surgical intervention undertaken, the accused recklessly continued," the indictment read.”
The fraud charge relates to the results of a distal oesophagal biopsy.
Review:
(The science)
EGD (esophago-gastroduodenoscopy) AND BIOPSY IN GERD:
EGD allows direct visual examination of the esophageal mucosa and mucosal biopsies enable evaluation of the microscopic anatomy[19]. Endoscopic findings in patients with GERD include esophagitis, erosions, exudates, ulcers, strictures, hiatus hernia, and areas of possible esophageal metaplasia. A continuously patent gastroesophageal junction (GEJ) seems to be helpful to predict esophagitis in biopsies[20].
Recent global consensus guidelines define reflux esophagitis as the presence of endoscopically visible breaks in the esophageal mucosa at or immediately above the GEJ[12,13,21]. The identification of esophagitis with EGD has specificity 90%-95% for GERD[22], but has a poor sensitivity of around 50%[23]. About 50% of adult patients with GERD symptoms (i.e., heartburn and/or regurgitation) showed normal endoscopy in referral centers[24], but studies from community practice demonstrated that 53% to 70% of the patients had non erosive reflux disease (NERD)[25-29]. Erosive esophagitis (EE) does not seem to be as common as previously suggested in adults[30].
In regard of the pediatric population, a recent multicenter survey in 7188 children aged 0-17 years that underwent EGD showed 12.4% prevalence of EE[31] whereas a previous single center had showed 34.6% prevalence in 402 children[32]. The criticism for the studies in children is that patients who had EGD were not patients with GERD symptoms only, therefore the prevalence of EE in pediatric patients might be underestimated.
Acid suppression before EGD may significantly limit the sensitivity of endoscopy as a diagnostic tool. A recent study has shown that PPI use contributes significantly to the classification of GERD patients into the NERD-phenotype. NERD adults on PPI therapy demonstrate some features that are significantly different from PPI-naïve patients, but similar to EE patients. This observation supports the notion that some PPI-NERD patients are actually healed EE patients, and that an overlap does exist between the GERD phenotypes[33].
Evidence from adult studies indicates that visible breaks in the esophageal mucosa are the endoscopic signs of greatest interobserver reliability[34,35].
OPERATOR EXPERIENCE is an important component of interobserver reliability[36,37].
There is insufficient evidence to support the use of histology to diagnose or exclude GERD[11].
Several variables have an impact on the validity of histology as a diagnostic tool for reflux esophagitis[54,58].
These include sampling error because of the patchy distribution of inflammatory changes and a lack in standardization of biopsy location, tissue processing, and interpretation of morphometric parameters. Histologic findings of elongation of papillae and basal hyperplasia are nonspecific reactive changes that may be found in esophagitis of other causes or in healthy volunteers[53,54,58-60].
The PRIMARY role for esophageal histology is to rule out other conditions in the differential diagnosis, such as eosinophilic esophagitis (EoE), Crohn disease, BE, and infection[12,53]. EoE may have typical endoscopic features such as speckled exudates, trachealization of the esophagus, or linear furrowing; HOWEVER in up to 30% of cases the esophageal mucosal appearance may be NORMAL[51]. Two to 4 mucosal biopsy specimens of the proximal and distal esophagus should be obtained aiming diagnosis of EoE[52]. The number of eosinophils more than 15/phf is the major histological criterion of EoE[51,52]; however eosinophils have been found in a lower number in the esophageal mucosa of asymptomatic infants younger than 1 year of age[61], and in symptomatic infants with cow’s milk-protein allergy[62].
Finally, endoscopically visible breaks in the distal esophageal mucosa are the most reliable evidence of reflux esophagitis. Mucosal erythema, pallor, and increased or decreased vascular pattern are highly subjective and nonspecific findings that are variations of normal. Histologic findings of eosinophilia, elongated papillae, basilar hyperplasia, and dilated intercellular spaces, alone or in combination, are INSUFFICIENTLY sensitive or specific to diagnose reflux esophagitis.
CONVERSELY, absence of these histologic changes does not rule out GERD.
Endoscopic biopsy is important to identify or rule out other causes of esophagitis, and to diagnose and monitor BE and its complications.
Goldani HA, Nunes DL, Ferreira CT. Managing gastroesophageal reflux disease in children: The role of endoscopy. World J Gastrointest Endosc 2012; 4(8): 339-346 [PMID: 22912907 DOI: 10.4253/wjge.v4.i8.339]
https://www.wjgnet.com/1948-5190/full/v4/i8/339.htm
The law:
First, the court has to find that there was an intention to kill. Then the court must look at the evidence to determine (based on the surrounding circumstances) whether there is premeditation or planning.
What is clear from all the definitions of ‘plan’ and ‘premeditated’ above is that there is a thought process involved with both concepts. Both require a person to have thought about the act to be done. The act done is then not by accident or mistake but deliberate.
Finding that the murder was planned requires that there must have been a plan, design, or scheme in place. The accused must have thought about the murder days in advance, the planning must have been done in order to ensure that the act of murder is successful.
https://www.derebus.org.za/murder-intention-premeditation-pre-planned-what-does-it-all-mean/
Statement sources:
01/02/2022
Murder-accused paediatric surgeon Peter Beale charged in connection with another child's death (1)
https://www.news24.com/amp/news24/southafrica/news/murder-accused-paediatric-surgeon-peter-beale-charged-in-connection-with-another-childs-death-20220201
Charge for toddler's death added to surgeon Peter Beale's murder and fraud case. (2)
E): #Beforeitstoolate The resolution
News 24:
Interview request 09/03/2020
Here were my questions (asked 10/03/2020)
and my responses (given 10/03/2020)
1).What made you start this petition?
The aftermath of watching a video of two experienced colleagues of mine (with about a combined 7O years of expert medical experience behind them) being handcuffed together and marched out in front a police station made me ask myself:
Why have I never seen any other professional i.e judge, journalist, lawyer or politician (let alone a criminal) being put into the back of police van, in full view of the public, like this, before? So, there must be something more to this story than meets the eye or has been reported.
The effect was profound, I was confused, angry and for the first time in my career I was uncertain of my medical instinct. I closed my busy practise and decided to investigate and obtain as much information with regards to this story as I can find. I used the my Facebook group “SA Doctors United” to post my findings.
All doctors where initially not to concerned with the early media reports, we are very used to it, it has become a normal occurrence and well documented internationally that reporters and media outlets always seem to “love the drama and negativity” when it is related to doctors. In the case of Prof Beale and Dr Munshi is was a classical example of the above.
Many of us knew or felt that the prescribed medico-legal processes will eventually follow through and a more accurate account would be made available to the public and doctors to consider.
It was only after the actual arrest warrants where granted prior to the formal inquest/medical review and with the now infamous video of both doctors being handcuffed and escorted into a police van to attend their court hearing was posted, did it all become apparent that this was a serious issue and we needed to speak out.
The petition was started to create global awareness and inform the international public about the dangerous precedent that has been set by our national prosecution agency by prematurely criminalising a medical related death that has not followed the standard investigate and prescribed processes.
2). What has been the reaction to the petition?
The feedback has been united and uniform, across the board. It is evident in every media statement released by our union SAMA, our governing body HPCSA and every medical fraternity operating within South Africa.
We have major concerns and we need help to stop a disaster.
The petition has reached close to 67 000 signatures and comments. I have personally received numerous messages and official statements of support from the global and national medical societies, including the World health organization.
The internationally based medical protection society and numerous legal associations have also officially endorsed the petition through official statements.
What is noticeable is that members of the local public and around the world have decided to look closer into this story after reading the petition and the reviewing numerous updates.
The public have read the numerous comments from doctors and medical societies after this majority of them have signed the petition after recognised the problem and consequences of this premature criminal legal action. They want answers and are now asking questions rather than just believing “the prima facie” reporting.
3). What is are your general thoughts on criminal charges against the two doctors?
I am very concerned about the thought process used to lay the charges prior to following the formal prescribed protocol, it has effected all healthcare professional overnight.
The medical community is broken and paralysed by the calculated attack from certain media outlets. The combination of poorly informed and misunderstood national reporting on this matter can not be understated. Despite numerous attempts to inform, educate and warn the relevant new agencies, their impatience at “getting an up and down story out there” started the vicious cycle of events that has created a fracture in the country’s doctor patient relationship.
Watching two experienced colleagues handcuffed and escorted to court in a police van in full view of the public, for what looks like as per the reports, a medical complication related to medical intervention, has had an unprecedented effect on the medical communities psyche and decision making process with regards to patient care.
We feel betrayed, Broken and bullied by the people we have dedicated our lives to taking care of.
4). Many families have come forward to tell their stories of what they feel was negligence on behalf of Dr Beale towards their children. What are your thoughts on this general and also in relation Mo Sayed’s case – who laid the criminal charges against Beale and Munshi?
These poor families that have suffered loses are my main and primary concern. The bizarre process that has taken place that has lead to the premature criminalisation of the case against both the doctors concerned is or has created a defensive stance that their medico-legal lawyers will take up.
The answers and information that these grieving and angry families require to allow them to gain closure, curtail their anger and treat their grief will now be even harder to obtain purely because this is now a criminal matter rather than an inquest or medical legal mediation.
This type of situation required early communication of answers rather than prolonged suppression of questions.
The unprecedented move to prematurely arrest the two doctors concerned and to feed into the anger and grief relating to the families of the patients concerned has now tasked the national prosecuting agency with an extremely complex and sensitive criminal case that has gained world wide attention.
The NPA has chosen to take up the challenge to provide the answers and evidence required for that these numerous families. There is a thin line between medical negligence and culpable homicide and the line between medical negligence and unavoidable medical complications is even thinner.
This line is often deliberated and highlighted by the same medical fraternity that has been paralysed and angered by the lack of the prescribed process that should have been followed prior to the arrest.
It is imperative that should the NPA continue criminal legal proceedings against these two doctors, they will have confirmed that they have accepted the responsibility help all the families get the answers that they need, to move on in their grief. Should they fail to do so or not following through with their promise, it will be a gross injustice on their side to have accepted the task in the first place, before allowing the prescribed medico-legal processes to be followed.
They have accepted the task and everyone is now watching and waiting for the follow-up.
All grieving families have wounds that require answers and information to allow healing. Theses answers require time and patience to achieve. Some families have had their old scars re-opened and new doubt placed in their mind due to the extensive media campaign against these doctors.
In medicine it is the oldest scars that take the longest to heal from new inflicted wounds.
5). Do you think criminal charges set a bad precedent for medical professionals to do their jobs?
Without a doubt, it would be ignorant and naive to think that these criminal legal actions would not have a negative effect on the entire profession.
The medical profession has been shaken by the actions of the NPA and Views of the South Africa public in general.
Doctors have a Full right to be emotional.
Patients should be as well.
It is dangerous to have an emotional doctor treating patients in this country right now.
Fear and anger can cause problems.... as the HPCSA have warned....
“If the legal approach used in the case of Professor Beale and Dr Munshi is perpetuated, the board is concerned that medical doctors will in future allow patients to die naturally without their intervention for fear of being criminally prosecuted,” it said in a statement.
With regards to doctors and prosecution, there might a misinterpretation or misunderstanding from the general public. When a death is related to any healthcare professional treating a patient there is a different set of rules that need apply, this is in place to stop everything that has happened and will happen now, that there is threat of a trail by media and premature arrest.
As per the HPCSA....
“The board calls upon the legal authorities to exercise due diligence in terms of the laws of the country in dealing with death of persons undergoing a procedure of therapeutic, diagnostic or palliative nature,” it added.”
The legal process to investigate this case was not followed or reported fairly, the trail by media and premature arrest prior to the medical investigation completing is what is is causing the “emotions”
There is a lot more to this case that meets the eye and the sad thing is the premature arrest is diluting the issues at hand. It will distract away from the main topic.
A child passed away following a surgery and the parents and community want to know why, so they can move on.
Hopefully the a fair process can continue, common sense and logic will prevail.
6). What have you heard in the medical field regarding this case? Has it been a mixed reaction or a does everyone seem to agree with each other?
The 66 000+ people are supporting the call for proper medical negligence/inquest procedures to be followed prior to the arresting the two medical doctors for “homicide”.
Many patients are confusing their poor experiences with the doctor in question with regards to the premature arrest and charge of culpable homicide.
What is culpable homicide?
Culpable homicide is the unlawful, negligent causing of the death of another human being.
Does Prof Beale’s alleged arrogance, poor bedside manners and lack of communication account to “homicide”? Or is it just horrible bedside manner/behavior?
The above mentioned complaints will be reviewed in the formal medical negligence/HPCSA investigation, which is what the petition and every medical doctor with a conscience is asking for.
Culpable homicide is the only common law crime for which proof of negligence as opposed to intention is sufficient.
At this moment there is no proof of negligence because there has been no formal medical investigation completed.
Please remember that there is still a family that require the answers for the tragedy of losing a child.
The anger, emotive thinking and actions that have lead to the culmination of “criminalizing” this investigation, will now cloud the medical negligence claim and paralyze the medical profession.
Hence the #dropitandwait for the proper investigations to take place #beforeitistoolate
7). The procedure that Zayyaan and baby Alyssa underwent, the nissen fundoplication, is that a routine procedure?
Medicine is not an exact science. There is no such word as “routine” especially when discussing surgery.
Any procedure wether termed major or minor can encounter complications from almost anything relating to the patient, surgery or doctor, this is why patients, parents or family always sign detailed consent and indemnity forms prior to any surgery.
This is an agreement that confirms you are allowing the doctor to perform the procedure knowing that a complication can or might occur.
I often tell my patients, when they ask about risk in surgery: deciding to have surgery it is like crossing a street to get to the other side, you can get knocked by a car every time you do it or never, So if you choose to have surgery you have to cross the street because you must in order to continue functioning, knowing there is a risk that is always present.
Complications can and will occur especially the longer you operate and if you operate in difficult complex cases that no other surgeon has the experience to perform. No matter how “good” a surgeon or doctor can be the human body is human after all. The risks of being human will always be a risk.
A doctor or surgeons actions and profession is a difficult one, you’re only as good as your last complication and your good cases will never make the front page.
.....Is there anything else you’d like to say that I haven’t asked you?
8.) Have doctors noted any trends in complaints, litigation and patients attitude toward them?
If a patient’s family suffers a tragic loss and the family want answers immediately and allow their anger to dictate their decisions, what is stopping them from laying a charge of homicide and expecting the doctor to be arrested immediately without waiting for the inquest or the medico-legal investigation to take place?
Why should that family be treated any different to this case?
This is why we are so concerned that in the event that we do everything we can and a family suffers a loss, their anger now has channel to directly effect the doctors involved without allowing due, fair and prescribed processes to be followed.
The knock on effect is disastrous:
Medical insurance will rise to include criminal legal fees.
Doctors will be performing more tests resulting in the cost of healthcare rising due the increasing practise of defensive medicine.
Patient will be paying more and waiting longer.
But the Most concerning is as per the HPCSA:
“If the legal approach used in the case of Professor Beale and Dr Munshi is perpetuated, the board is concerned that medical doctors will in future allow patients to die naturally without their intervention for fear of being criminally prosecuted,”
This can not be stressed any more and South Africa needs to be concerned.
9). Where does this leave doctors and especially specialists?
We don’t know, that is the most upsetting and frustrating thing. Since the arrests in Mid December, the medical fraternity have been looking for leadership from at bare minimum our department of health.
Sama and The HPCSA have also pledged to get us clarity from the department of justice and the NPA but till today, as we speak, there has been no response from any of the four entities cited in the 66000 strong petition.
There has not even been an acknowledgement that they understand the current difficulties doctors, patients and South African healthcare is facing at the moment.
So we wait and put up a brave front and continue trying to treat patients under this dark cloud because if we don’t do it, who will?
As a final thought:
There are some very sinister forces that have influenced the public/media by the way they managed to get these cases reported.
Many suspect it was a calculated move that intended to cause the premature arrest of the said medical practitioners.
Whether the motivation was anger, frustration, revenge, guilt, grief or a “power play”
There is one thing everyone wants and needs as soon as possible ....that is answers and the truth.
A child passed away post-operatively and it has to follow the set international due process when dealing with death under medical circumstances.
It is the only way everyone can move on and heal. It also will stop and highlight how the said complications/circumstances can be avoided in future cases.
This unprecedented and premature act of arresting the doctors following an organised “trail by media” and without waiting for the formal medico- legal investigation to be completed should be raising alarm bells for the public as it has with the all the medical professionals.
The action was short-sighted as it did two things:
It has sent shockwaves through the medical field and as indicated in all the responses from the medical societies. It has and will further paralyse the medical field and will cause major negative implications on patient care. The threat of charges and now unopposed premature action of arresting doctors for pre-investigated patient deaths will and has become a new tool to be used to further bully the profession and to cause early settlements. Aggrieved angered families can now use this weapon for revenge, even if the doctor tried their best to help.
Secondly:
It has diluted the fact that there is still an active Medico-legal investigation that needs to be completed. It will hamper a neutral view naturally, with the threat of criminal arrest looming over the same medical professionals that are reviewing the case.
The one good thing about this criminal case proceeding is that the “criminal evidence” will be public knowledge, the process and influences will become apparent and motives will be uncovered.
It could be very embarrassing, heart breaking and shocking if most doctors suspicions are correct.
The public, media and medical Fraternity will get their questions answered.
Who knows there might be other criminal, civil, defamation and HPCSA charges to follow