… and various cases where bad decisions were made, but procedures ‘carried out correctly’
The final report on surgeon’s suspicions of “deaths and mutilations” caused by the surgical team at Amadora-Sintra hospital (official name: Hospital Fernando Fonseca) has been concluded, with ‘expert medical opinion’ accepting that one of the 22 cases put forwards was indeed a situation in which bad medical practices were involved, and which resulted in the death of the patient.
But as for the other 21 incidents highlighted, these were put down to “bad decisions in the face of various possible options, but without the existence of bad medical practice”.
In other words, “the surgical team opted for the procedure that was apparently less than correct, but carried it out correctly”, says Expresso.
A bit like a mechanic replacing an alternator when the real problem was a duff battery. Or a dentist removing a tooth when all it needed was a filling. The problem with these comparisons is that they do not lead to an unnecessary death, or desperate suffering.
Says Expresso, the next steps are in the hands of the (outgoing) president of the General Medical Council, Miguel Guimarães.
He is due to inform the minister of health Manuel Pizarro on the report’s conclusions, and refer “necessary matter to disciplinary bodies”.
Mr Guimarães will be doing this “supported by the other 11 members of the council’s College of Surgery” – and according to Expresso, a press conference is expected at some point.
The crux of the matter, however – the fact that bad decisions were made (that did not address the problems of the patients, and lead to deaths and unnecessary procedures) – must still be addressed.
No-one has faith in a bad mechanic, many more times less so in doctors who make bad decisions that end up being the last decision their patients are ever aware of.
And this is where the whole story starts to unravel horribly.
“Obviously the case cannot close here”, André Dias Pereira, director of the centre of biomedical law at Coimbra’s legal faculty, explains.
The whole conclusion of “bad choice” is very abstract, he believes, while the concrete result was that people suffered (in some cases died).
“Any medical decision has to be discussed with the patient, who has to be informed of the diagnosis, prognosis, alternatives and risks, precisely to avoid tragedies”, he tells Expresso.
“If this wasn’t done, it is very serious. It is a crime that carries three years in prison”.
Says the paper, “for the specialist the General Medical Council’s effort to understand this tragedy ‘is to be applauded, but it is evident that the republic has to use all its means to investigate’.
“Obviously the case cannot close here”, insists Dias Pereira, particularly as the report cannot be viewed as a “decision, because there has been no adversarial procedure, which is required under the democratic process”.
In the opinion of this expert in bioethics “administrative, penal and civil instances must investigate”.
Investigations within the hospital are being undertaken by health regulatory body ERS and IGAS, the general inspectorate of health activities, concludes Expresso.
One of the surgeons behind the original complaints that set off these investigations stressed that he felt it was his duty “ethically, professionally, personally and as a citizen to alert to situations of serious loss of life and quality of life, with unnecessary, avoidable mortality and mutilations, resulting from the provision of care to patients that does not coincide with legis artis” (correct treatment) at one of the busiest State hospitals in the country.