Don’t jump to conclusions on Ashya King case

As an NHS GP who ultimately gets his income from looted fund via the government I feel compelled to offer some commentary before condemning the doctors involved in Ashya’s care.

It appears that the initial social services and subsequent police involvement was triggered by Ashya leaving the hospital, without staff knowing he was leaving or where he was going. This is a significant event and does need a timely response in a child who is severely ill and would need hospital care within a short period of time. The hospital would call social services, to raise concerns, and the police, as rapid contact with Ashya was needed.

Doctors involved in care are legally and professionally bound to raise safeguarding concerns in children or vulnerable adults. When this has not been done the doctors can, and have been, disciplined and struck of by the General Medical Council, as well as the usual vilification in the press and by politicians. Baby P was such an example.

It is highly unlikely that a child cancer centre, which deals with complex children and their families in extremely difficult circumstances, would flippantly aim to remove a child from their parents due to hurt professional pride or a difference in opinion, especially when this would involve multiple staff to make this decision, not just one ‘rogue’ doctor.

Once the acute concern (finding Ashya) had been dealt with it is not the doctors who determine what happens next. That is up to social services. What happens in Spain once the family are met is up to Spanish police in liaison with Hampshire police.

Just because the initial raising of the alarm led to a heavy handed police response doesn’t mean the initial action from the hospital was at fault. Bear in mind the difference in professional views that occur however (and I have first hand experience of this): doctors may feel patients are ill unless otherwise proven; social servies believe parents are bad unless otherwise proven; police think people they encounter are lying criminals until otherwise proven.

Taking an ill child abroad, without even letting the hospital know they were leaving, is a cause for concern, in a society where the current consensus is that the state has a role in protecting the vulnerable. I am liberty orientated yet on many occasions have raised concerns to social services, including in cases of unexplained injuries in the vulnerable, as well as cases where the parent is a feckless substance abusing disaster, yet is still the most responsible carer holding the baby, other family and partners having left or been kicked out for domestic violence.

Doctors disagree with patients, parents, nurses, the media, other doctors and themselves every day – it is part of the job. Vaccines are not compulsory for children in the UK and the cases where treatment is mandated by a judge are rare indeed. Much as I’d like to refer to social workers when I see a child with a head moulding helmet for plagiocephaly (they grow out of it – have you seen many adults with misshaped heads recently?) this isn’t part of medical culture in the UK.

In summary I would be cautious over the facts of this story. Every similar story I have first hand experience is reported poorly. I would also differentiate between the initial alarm and the subsequent treatment by Spanish police of the family.

As to when others can intervene in the case of vulnerable children – that is perhaps the subject for someone else to post on, yet an absolute position that acknowledges parental rights only does has demonstrable problems.

I wish Ashya and his family all the best.

  11 comments for “Don’t jump to conclusions on Ashya King case

  1. Sep 4, 2014 at 1:28 pm

    Insightful background Zach, although I disagree that the hospital did not know where they were going.
    Reasons: http://libertarianhome.co.uk/2014/09/nhs-knew-on-friday-where-ashya-had-been-taken/

    • Zach Cope
      Sep 4, 2014 at 2:56 pm

      Disagreement respectfully noted!

      One addendum re my totalitarian leanings on head helmets:

      Craniosynostosis is different than plagiocephaly. I wouldn’t suggest not asking for a medical assessment for a misshaped head, just be wary of companies offering expensive and uncomfortable head helmets without a medical assessment.

      • Zach Cope
        Sep 4, 2014 at 3:40 pm

        Related to both cancer treatments and head helmets the incentives to ‘do nothing’ where there is no evidence of efficacy are difficult to resolve in the market. Obviously payment should be for ‘expert’ advice, but being able to offer a procedure or product based on hope leads to supply of these products in the market.
        This is NOT an argument for more regulation, but it is a problem that needs an answer in the face of those who would push for collective decisions about best interests in medical matters.

        • Sep 4, 2014 at 4:09 pm

          The gap you refer to can be filled by newspapers and magazines (or their digital equivalents), because frankly what you’re talking about is a medical scandal.

          • Zach Cope
            Sep 4, 2014 at 5:18 pm

            I think there are also ongoing challenges in communicating the uncertainty and grey areas of medicine in a world that likes binary answers, particularly in the media.
            Of course having a medical ‘home’ in the form a GP (or private concierge GP…) is an excellent way to access a balanced opinion!

  2. Richard Carey
    Sep 5, 2014 at 12:45 am

    I think the hospital and the police and the media initially jumped to conclusions, making out the family were crazy and / or evil, then the truth came out. If the doctors at the hospital threatened the father with seeking a court order against him if he didn’t stfu, it’s hardly surprising if the family acted first and informed them second. Many doctors are in the profession for the best of reasons, but there are others who are there for the power and status. To those who think we should presuppose them to be good and wise, I say “Harold Shipman”. If he’d been a plumber he would have been caught first time.

    Let us hope that the case focuses attention on the despicable regime of the European Arrest Warrant and other the sins of the state.

    • Zach Cope
      Sep 5, 2014 at 9:26 am

      ‘Harold Shipman’ is a weak card to play in any debate on healthcare. It has been used by statists to exponentially increase the regulatory hoops in healthcare, with no discernible benefit to anyone. Harold Shipman was not a murderer because of the NHS, and would no doubt have been a killer whatever health system he worked in. He was actually very popular and would have sailed through the assessments subsequently introduced after his crimes.

      ‘Good’ and ‘wise’ are not the same. There are many wise people who use their skills for evil, and many people who do foolish things thinking they are good.

      There is a broader debate about the difference between access to information and the role of experts in applying and understanding information (knowledge) in the digital age, but this is not just related to health, although, as I’ve stated before, health contains many grey areas as we are all individuals, and illness affects us all in different ways.

  3. Sep 6, 2014 at 6:05 pm

    I think the doctors and hospital clearly made some mistakes, but once the social services and the police grabbed the baton they ran with it and the whole thing unravelled. It is all rather typical in a climate of mistrust of parents. They were depicted as crazies deliberately and maliciously.

  4. Duke of Anarchy
    Sep 10, 2014 at 5:37 pm

    “Just because the initial raising of the alarm led to a heavy handed police response doesn’t mean the initial action from the hospital was at fault.”

    How about this: “Just because [reporting a family of Jews in hiding] led to [them being killed in Auschwitz] doesn’t mean the [informant] was at fault.”

    The doctors in this case were accessories to the abduction and false imprisonment of Aysha King and his parents. They deserve to be imprisoned for a term of many years.

    • Sep 10, 2014 at 8:14 pm

      Hmn… Not very many years. It could be said that they were acting with intentions that were less murderous than Nazi informants.

    • Zach Cope
      Sep 10, 2014 at 9:24 pm

      Doctors = Hitler = Shipman

      I’ve seen more nuanced arguments.

      It’s starting to read like the Daily Mail around here…

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