According to foreign media reports, the High Court in London, England, recently ruled that a family doctor suffered from a congenital defect caused by the "pre-pregnancy advice negligence" 20 years ago, and was responsible for millions of pounds of compensation for his "personal injury caused by natural disability".
The British Physicians Association and hundreds of doctors are "very concerned" about the "landmark" legal decision. The association said birth defects can be caused by a variety of genetic or environmental factors, but the ruling means that the country's health care professionals may in the future be held liable for fetal health problems for negligence in preconception advice.
Medical experts point out that the ruling will "cast a shadow" on britain's future medical path, with distrust and endless litigation between doctors and patients likely to follow.
The plaintiff claimed that "he would not have been born" and accused the doctor of giving insufficient advice
Evie Toombes, 20, was born with spina bifida, a rare congenital disease caused by abnormal neural tube development in embryos. It is reported that six out of every 10,000 babies suffer from this irreversible congenital deformity, which may lead to leg weakness, incontinence or even complete paralysis of the lower limbs.
As the condition worsens and the function decreases, Tumus may gradually lose the ability to walk.
Although Toumes became a professional equestrian athlete with her perseverance, the disease of the neural tubes of the spine limited her ability to move, and as she grew older, she developed gastrointestinal diseases, sometimes even taking 24 hours to connect the infusion nasal tube. As his condition worsens and his function declines, Toums may gradually lose the ability to walk, perhaps spending the rest of his life in a wheelchair.
For a series of health problems caused by congenital diseases, Turms believes that the reason is that his mother did not absorb enough folic acid when she was pregnant. Vitamin B9 (folic acid) is said to play an important role in the development of fetal neural tubes and the division of brain cells. In general, ordinary people can consume enough folic acid through daily diet, while pregnant women have a greater demand for folic acid intake, from pregnancy to early pregnancy to supplement 400 micrograms per day, generally through folic acid tablets or supplements.
Evi Tumus, who suffers from spina bifida, has become a professional equestrian athlete.
Last November, Turms sued his mother's 20-year-old family doctor, Philip Mitchell, for "preconception advice negligent," saying he had failed to inform her mother of the importance of "folic acid intake in preventing spina bifida" during her pregnancy and pregnancy. In the indictment, Tums said that if Dr. Mitchell had given adequate advice, her mother might have delayed pregnancy or even "would not have been born herself."
In February 2001, Turms' mother, Caroline, gave Dr. Mitchell a "preconception consultation" to find out what to consider during pregnancy preparations. But Dr. Mitchell argued that the diagnosis from 20 years ago read "folic acid supplementation if needed," and that he generally recommends that women who are trying to conceive take folic acid supplements every day. However, Caroline said that Dr. Mitchell did not tell that folic acid can reduce the risk of neural tube defects such as spina bifida, but only said that "as long as there is a good dietary intake, there is no need to take folic acid supplements."
Spina bifida
At present, the cause of spina bifida deformity is not clear, some scholars believe that it is related to the chemical or physical damage of embryos in the first trimester of pregnancy, and the intake of adequate folic acid by pregnant women is indeed an important means to prevent fetal malformations, but it is not the only determining factor.
Still, in early December, the London High Court ruled that Dr Mitchell was "negligent" in his preconception advice, which led to a "congenital disability of the child" and was liable to pay compensation to Thums. The case will reportedly enter the damage assessment phase, but the specific amount of compensation has not yet been calculated. Thums' lawyers revealed the amount was "significant", potentially in the millions of pounds, as the compensation would cover The cost of care for Tums' lifetime.
The verdict sparked discontent in the doctors' profession or exacerbated staff shortages
After the verdict of "pre-pregnancy negligence" was made public, attorney Susan Rodeway noted that the landmark ruling meant that "medical professionals may now be found liable for birth defects for negligent advice."
Clyde Law Firm, which represents general practitioners in the UK ( i.e. family doctors ) , noted that there is still a need to prove a "causal link between the circumstances during conception and the congenital disability", adding that the case "reminds medical practitioners of the need for clear and detailed records of their counselling".
But Dr John Hughes, head of GP Survival, a UK general practitioners' organisation, said: "There is a general perception that every GP is likely to sit in the dock because almost all have similar deficits in recall and record-keeping. ”
Hundreds of GPs across the UK and representative organisations such as the British Doctors Association were "greatly dissatisfied" with the ruling, with more than 400 expressing concern about the decision on an online message board created by the British Doctors Association. "We understand that young people born with disabilities may have many challenges to overcome and financial help." The comments said, "However, we are very concerned about the impact of this decision, which could drive the growth of defensive care, and the possible negative impact on the future of the doctor-patient relationship." ”
Thomas Pearceonek, MD, also noted that this "groundbreaking" ruling will only fuel a growing number of physicians to turn to "defensive medicine" practices, where excessive or unnecessary examinations are conducted in clinical practice, or avoiding treating high-risk patients thereby reducing the risk of litigation. This practice will lead to an increase in the cost of health care systems and will slow down the process of treating patients, resulting in more and more patients waiting to be treated. Worse still, the practice tends to avoid high-risk surgeries, often ignoring patients with intractable diseases that, ultimately, can cause damage to the patient, health care, and doctors.
"The impact of this ruling on GPs is significant. In the future, doctors may practice medicine more as lawyers than as clinicians. Dr Hughes added that the UK already faces a shortage of GPs," said many junior doctors, saying the decision made them less likely to adopt GPs as a career option. At the same time, some GPs say the verdict reinforces their willingness to retire early, both of which exacerbate the industry crisis of severe labor shortages. ”
Red Star News reporter Wang Yalin Intern reporter Hu Yiling
Edited by Zhang Xun
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