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Is treatment wrong, if patients benefited? Channel NewsAsia - Thursday, January 14Send IM Story Print
Is treatment wrong, if patients benefited?
SINGAPORE: If a doctor were to use a medical treatment that was not generally accepted by the profession or had not undergone formal clinical trials — would this constitute professional misconduct, if the treatment benefited the patient?
This poser was put before the Court of Three Judges on Wednesday, as a neurologist appealed against a Singapore Medical Council (SMC) Disciplinary Committee ruling.
Dr Gobinathan Devathasan argued, the committee’s original decision was "unsafe, unreasonable or contrary to the evidence".
He was found guilty of professional misconduct last August, after he recommended Ultrasound Sonolysis in 2006 to an elderly woman with Parkinson’s Disease. The committee had ruled there was no experimental evidence or physical proof of its safety, and that Ultrasound was not appropriate for use in clinical neurology practice.
Dr Devathasan’s lawyer, Dr Myint Soe, argued on Wednesday the neurologist had successfully treated more than 700 patients using Ultrasound with no complications. Dr Devathasan had also shared findings of a study at an international conference, added his lawyers.
But SMC’s lawyer, Senior Counsel Alvin Yeo, pointed out Dr Devathasan’s study had involved only 15 patients. And treatment information relating to the bulk of his patients was not shared and no clinical trial was conducted, he said.
Given the number of patients involved, Chief Justice (CJ) Chan Sek Keong — one of the three judges at the hearing — wondered why no one had red—flagged Dr Devathasan’s treatment earlier. The doctor, who runs a clinic at Mount Elizabeth Medical Centre, had treated some 200 patients before the complaint surfaced, and in all 700 patients up to the hearing’s end.
While officially there were several complainants including the elderly patient, Dr Myint Soe alleged that the true person behind the complaint against his client was an unnamed professional rival. But Mr Yeo noted, it was generally not easy to get a complainant to come forward to report malpractices.
Calling the case "unusual", Judge of Appeal V.K. Rajah said this was "not a question of a clandestine treatment" as patients were treated openly.
Another point Dr Devathasan’s lawyers raised was that the SMC’s disciplinary committee had, in its own words, "reluctantly" found the neurologist guilty. This seemed to perplex the judges, with CJ Chan wondering: "Why did they use the word, ’reluctantly’?"
But Mr Yeo urged the Court not to change the earlier ruling. "The use of Ultrasound was inappropriate, regardless of the patient’s medical condition and the purpose of such treatment," he said. "If a treatment is not sufficiently known or sufficiently covered in medical publications, it should not be carried out in a research setting for the purpose of testing the safety and efficacy."
Prior to this case, Dr Devathasan had had an unblemished 30—year record. The court reserved judgment after a two—hour hearing, as CJ Chan noted that this was "a very difficult issue". — TODAY
Is treatment wrong, if patients benefited?
SINGAPORE: If a doctor were to use a medical treatment that was not generally accepted by the profession or had not undergone formal clinical trials — would this constitute professional misconduct, if the treatment benefited the patient?
This poser was put before the Court of Three Judges on Wednesday, as a neurologist appealed against a Singapore Medical Council (SMC) Disciplinary Committee ruling.
Dr Gobinathan Devathasan argued, the committee’s original decision was "unsafe, unreasonable or contrary to the evidence".
He was found guilty of professional misconduct last August, after he recommended Ultrasound Sonolysis in 2006 to an elderly woman with Parkinson’s Disease. The committee had ruled there was no experimental evidence or physical proof of its safety, and that Ultrasound was not appropriate for use in clinical neurology practice.
Dr Devathasan’s lawyer, Dr Myint Soe, argued on Wednesday the neurologist had successfully treated more than 700 patients using Ultrasound with no complications. Dr Devathasan had also shared findings of a study at an international conference, added his lawyers.
But SMC’s lawyer, Senior Counsel Alvin Yeo, pointed out Dr Devathasan’s study had involved only 15 patients. And treatment information relating to the bulk of his patients was not shared and no clinical trial was conducted, he said.
Given the number of patients involved, Chief Justice (CJ) Chan Sek Keong — one of the three judges at the hearing — wondered why no one had red—flagged Dr Devathasan’s treatment earlier. The doctor, who runs a clinic at Mount Elizabeth Medical Centre, had treated some 200 patients before the complaint surfaced, and in all 700 patients up to the hearing’s end.
While officially there were several complainants including the elderly patient, Dr Myint Soe alleged that the true person behind the complaint against his client was an unnamed professional rival. But Mr Yeo noted, it was generally not easy to get a complainant to come forward to report malpractices.
Calling the case "unusual", Judge of Appeal V.K. Rajah said this was "not a question of a clandestine treatment" as patients were treated openly.
Another point Dr Devathasan’s lawyers raised was that the SMC’s disciplinary committee had, in its own words, "reluctantly" found the neurologist guilty. This seemed to perplex the judges, with CJ Chan wondering: "Why did they use the word, ’reluctantly’?"
But Mr Yeo urged the Court not to change the earlier ruling. "The use of Ultrasound was inappropriate, regardless of the patient’s medical condition and the purpose of such treatment," he said. "If a treatment is not sufficiently known or sufficiently covered in medical publications, it should not be carried out in a research setting for the purpose of testing the safety and efficacy."
Prior to this case, Dr Devathasan had had an unblemished 30—year record. The court reserved judgment after a two—hour hearing, as CJ Chan noted that this was "a very difficult issue". — TODAY
