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If evidence were ever needed that not performing a surgical procedure can be very different from medical negligence, the recent news about a Hereford teenager refusing medical treatment would provide it.
The media appear to be united in support of the young woman's decision, despite the likelihood that it will prove fatal. Having already suffered with leukaemia and the effects of chemotherapy, including damage to the muscles of her heart, she decided that the risks of a heart transplant, and the necessity to take drugs for the rest of her life if it were successful were too much to ask.
On the other hand, the motives of the doctors who insisted so forcefully that the girl should be treated, against her will if need be, can be understood. Perhaps it can be suggested that they simply made an emotional misdiagnosis - mistaking their ability to perform the operation for the conviction that they should?It is easy, therefore, to understand why the young woman's father said, "It is outrageous that the people from the hospital could presume we didn't have our daughter's best interests at heart."The young woman has clearly considered the options, and thought through the consequences; she carries the clarity of informed conviction in her simple statement that "I have made the right decision at the moment and I'm not going to change it." In fact, rather than changing her own mind, she was able to achieve the opposite, by changing the mind of the authorities; the child protection representative that was sent to the family's house was convinced by the young woman's arguments and carried that case to the courts, closing the hospital's attempts to withdraw her from her parents' custody. In our no win, no fee compensation offices, we've been discussing this case without any commercial interest; we tend to deal with Erbs palsy and MRSA and suchlike, where some damage has been done. In this case, there's no suggestion that any treatment has been incorrectly prescribed, or any incorrect medical diagnoses have been made, just this difference over the value of the patient's opinion. The General Medical Council's official guidance on the weight of young patients' opinions includes the awareness of such dilemmas. The Chairman of the GMC's Standards and Ethics Committee has been reported as saying, on this issue, that, "We say to doctors that you have to make a judgement about whether they have the ability and maturity to weigh up the risks and understand what is happening. "What we find is that children, when they have been having treatment for many years, are often experts in their own condition. "And with complex cases, where the treatment outcomes are uncertain, the doctor is much more willing to listen."As this is a case in which the doctors have, now, listened, it appears to have come to the conclusion that the patient and her family have chosen to accept. That means there is nothing for a group of people who work in medical negligence claims to do but to send positive wishes; and this we do.