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THE GENERAL MEDICAL COUNCIL AND THE MEDICAL DEFENCE ORGANISATIONS
1205 these states are often accompanied by acidosis, treatment with rapid fructose infusion will be even more disadvantageous. Department of Pharmacology, University of Aarhus, 8000 Aarhus, Denmark.
IB HESSOV.
THE GENERAL MEDICAL COUNCIL AND THE MEDICAL DEFENCE ORGANISATIONS
SIR,-The Secretary of the Medical Defence Union was the complainant who reported Dr. Caroline Deys to the General Medical Council and charged her with advertising. Many doctors will wonder why it is the place of the Secretary of a body upon whom most of us rely to protect us from this or similar charges to suddenly reverse his role and initiate such proceedings. It has been suggested that in fact neither he nor any member of the M.D.U. Council made the complaint and that he is protecting the anonymity of some other doctor, possibly a member of the Union. It would appear that when charged before the G.M.C., the accused may not, of right, know the name of his accuser. Thus he may not be in a position to expose the possibility of bias or rancour. In the recent case did the G.M.C. itself ever know the name of the original plaintiff ? Whatever the truth of the recent case, it has demonstrated that the present G.M.C. lacks the machinery to 4c police " the profession, and it would seem that the Council is virtually unable to initiate charges unless a complaint is first laid before it. Once such a complaint has been made the Council has accepted the apparently conflicting tasks of investigation, prosecution, judgment, and sentencing. If the new G.M.C. is truly to fulfil its role of protecting the public, then it ought to have powers to survey the medical scene and to investigate for itself any apparent abuses. I would suggest that the commercial abortion scene of recent years would have fully justified investigation initiated by the G.M.C. Now to return to the medical protection organisations. Do we, as members, wish to put ourselves into the position of policemen and to allow our agencies to so act on our behalf ? Whatever the original constitutions of these two bodies, should they be undertaking such a role nowadays ? How far do they actually investigate before laying a charge ? The record of the two agencies would seem to an outsider to be very different: the Medical Defence Union has made several charges of advertising against doctors in recent years, and the Medical Protection Society none. Is it not time that both bodies stated their positions on this issue ? Finally, there is just one simple factor which may influence them: do they initiate charges against their own members, or only, as in the recent case, against members of their rival agency ? Kingston Hospital, Wolverton Avenue,
Kingston upon Thames, Surrey.
PETER DIGGORY.
% * We showed Mr. Diggory’s letter to the Secretary of the Medical Defence Union and his reply follows.-ED. L. SIR,-One of the objects of the Medical Defence Union, which has had a place in the Union’s Memorandum of Association since its foundation in 1885, is " to promote honourable practice ". It has never once been suggested that this should be deleted. Pursuant to this object, the Union has been instrumental in bringing cases to the notice of the General Medical Council from time to time; more often than not the complainant is a member of the Union particularly affected by the conduct of the accused doctor but this is not invariably so. The Medical Protection Society is understood to take similar action.
The article published in the Sunday People which gave rise to the decision to lay a complaint against Dr. Deys with the G.M.C. was brought to the notice of the Union by a highly respected member of the medical profession, and the Union shared his view that the article constituted a prima-facie case against Dr. Deys for inquiry by theG.M.C. because the article appeared to draw attention to Dr. Deys’ professional skill, knowledge, and services, and that it might be interpreted as promoting her own pro-fessional advantage. The matter was considered by the Penal Cases Committee of the G.M.C., which saw fit to refer the matter to, the Disciplinary Committee for inquiry. At the inquiry, which took place on Nov. 22, 1972, the Union’s solicitorsplaced the facts before the Disciplinary Committee. In the course of the inquiry Dr. Deys admitted that she had sanctioned and acquiesced in the publication of the article and she admitted that the article did draw attention to her professional skill, knowledge, and services. She contended, however, that her motive had not been to promote her own professional advantage but to draw public attention to the advantages and simplicity of vasectomy as a method of birth control. This contention was accepted by the Disciplinary Committee and accordingly Dr. Deys was found not guilty of serious professional misconduct. The Union fulfilled its function of promoting honourable practice by drawing attention to the matter which the Penal Cases Committee of the G.M.C. resolved was worthy of inquiry by the Disciplinary Committee. The duty of deciding what inferences to draw from the conduct which Dr. Deys freely admitted is that of the Disciplinary Committee. If Mr. Diggory and any others who may feel as he does. wish to direct the Council of the Medical Defence Union in regard to its future policy in such matters, it is for them, as members of the Union, to write to the Secretary; their views will then be considered by the Council. There can be no question of the M.D.U. drawing the attention of the G.M.C. to the conduct of any of its own members. But, when it is felt that any such member has been guilty of unprofessional conduct, it is the Union’s policy to write to him pointing out the error of his ways. Unless the member then amends his ways, the Union may not support him if a complaint is made against him. In the Union’s experience this policy invariably produces thedesired result. PHILIP H. ADDISON, Secretary,
Tavistock House South, Tavistock Square, London WC1H 9LP.
Medical Defence Union.
ANTI-MYOGLOBIN ANTIBODY IN POLYMYOSITIS SiR,—Polymyositis (dermatomyositis) has been regarded as one of the autoimmune diseases. The sera of polymyositis
cases were
examined for
an
autoantibody
to some
component of the muscle tissue, which is the target tissue of this disease, but no autoantibody was found.l,2 We tested for the autoantibody to purified human myoglobin in the sera of patients with polymyositis, of patients with other collagen diseases, and of healthy subjects. Human myoglobin was prepared by the method of Singer et al.3 from the skeletal muscle of adult patients who had died of non-muscular disorders within four hours of death. The myoglobin was further purified by ion-exchange column chromatography using D.E.A.E. cellulose by the method of Kagan and Christian.4 The first fraction eluted 1. 2. 3. 4.
Caspary, E. D., Gubbay, S. S., Stern, G. M. Lancet, 1964, ii, 941. Stern, G. M., Rose, A. L., Jacobs, K. J. neurol. Sci. 1967, 5, 181. Singer, K., Angelopoulos, B., Ramot, B. Blood, 1955, 10, 979. Kagan, L. J., Christian, C. L. Am. J. Physiol. 1966, 211, 656.
IB HESSOV.
THE GENERAL MEDICAL COUNCIL AND THE MEDICAL DEFENCE ORGANISATIONS
SIR,-The Secretary of the Medical Defence Union was the complainant who reported Dr. Caroline Deys to the General Medical Council and charged her with advertising. Many doctors will wonder why it is the place of the Secretary of a body upon whom most of us rely to protect us from this or similar charges to suddenly reverse his role and initiate such proceedings. It has been suggested that in fact neither he nor any member of the M.D.U. Council made the complaint and that he is protecting the anonymity of some other doctor, possibly a member of the Union. It would appear that when charged before the G.M.C., the accused may not, of right, know the name of his accuser. Thus he may not be in a position to expose the possibility of bias or rancour. In the recent case did the G.M.C. itself ever know the name of the original plaintiff ? Whatever the truth of the recent case, it has demonstrated that the present G.M.C. lacks the machinery to 4c police " the profession, and it would seem that the Council is virtually unable to initiate charges unless a complaint is first laid before it. Once such a complaint has been made the Council has accepted the apparently conflicting tasks of investigation, prosecution, judgment, and sentencing. If the new G.M.C. is truly to fulfil its role of protecting the public, then it ought to have powers to survey the medical scene and to investigate for itself any apparent abuses. I would suggest that the commercial abortion scene of recent years would have fully justified investigation initiated by the G.M.C. Now to return to the medical protection organisations. Do we, as members, wish to put ourselves into the position of policemen and to allow our agencies to so act on our behalf ? Whatever the original constitutions of these two bodies, should they be undertaking such a role nowadays ? How far do they actually investigate before laying a charge ? The record of the two agencies would seem to an outsider to be very different: the Medical Defence Union has made several charges of advertising against doctors in recent years, and the Medical Protection Society none. Is it not time that both bodies stated their positions on this issue ? Finally, there is just one simple factor which may influence them: do they initiate charges against their own members, or only, as in the recent case, against members of their rival agency ? Kingston Hospital, Wolverton Avenue,
Kingston upon Thames, Surrey.
PETER DIGGORY.
% * We showed Mr. Diggory’s letter to the Secretary of the Medical Defence Union and his reply follows.-ED. L. SIR,-One of the objects of the Medical Defence Union, which has had a place in the Union’s Memorandum of Association since its foundation in 1885, is " to promote honourable practice ". It has never once been suggested that this should be deleted. Pursuant to this object, the Union has been instrumental in bringing cases to the notice of the General Medical Council from time to time; more often than not the complainant is a member of the Union particularly affected by the conduct of the accused doctor but this is not invariably so. The Medical Protection Society is understood to take similar action.
The article published in the Sunday People which gave rise to the decision to lay a complaint against Dr. Deys with the G.M.C. was brought to the notice of the Union by a highly respected member of the medical profession, and the Union shared his view that the article constituted a prima-facie case against Dr. Deys for inquiry by theG.M.C. because the article appeared to draw attention to Dr. Deys’ professional skill, knowledge, and services, and that it might be interpreted as promoting her own pro-fessional advantage. The matter was considered by the Penal Cases Committee of the G.M.C., which saw fit to refer the matter to, the Disciplinary Committee for inquiry. At the inquiry, which took place on Nov. 22, 1972, the Union’s solicitorsplaced the facts before the Disciplinary Committee. In the course of the inquiry Dr. Deys admitted that she had sanctioned and acquiesced in the publication of the article and she admitted that the article did draw attention to her professional skill, knowledge, and services. She contended, however, that her motive had not been to promote her own professional advantage but to draw public attention to the advantages and simplicity of vasectomy as a method of birth control. This contention was accepted by the Disciplinary Committee and accordingly Dr. Deys was found not guilty of serious professional misconduct. The Union fulfilled its function of promoting honourable practice by drawing attention to the matter which the Penal Cases Committee of the G.M.C. resolved was worthy of inquiry by the Disciplinary Committee. The duty of deciding what inferences to draw from the conduct which Dr. Deys freely admitted is that of the Disciplinary Committee. If Mr. Diggory and any others who may feel as he does. wish to direct the Council of the Medical Defence Union in regard to its future policy in such matters, it is for them, as members of the Union, to write to the Secretary; their views will then be considered by the Council. There can be no question of the M.D.U. drawing the attention of the G.M.C. to the conduct of any of its own members. But, when it is felt that any such member has been guilty of unprofessional conduct, it is the Union’s policy to write to him pointing out the error of his ways. Unless the member then amends his ways, the Union may not support him if a complaint is made against him. In the Union’s experience this policy invariably produces thedesired result. PHILIP H. ADDISON, Secretary,
Tavistock House South, Tavistock Square, London WC1H 9LP.
Medical Defence Union.
ANTI-MYOGLOBIN ANTIBODY IN POLYMYOSITIS SiR,—Polymyositis (dermatomyositis) has been regarded as one of the autoimmune diseases. The sera of polymyositis
cases were
examined for
an
autoantibody
to some
component of the muscle tissue, which is the target tissue of this disease, but no autoantibody was found.l,2 We tested for the autoantibody to purified human myoglobin in the sera of patients with polymyositis, of patients with other collagen diseases, and of healthy subjects. Human myoglobin was prepared by the method of Singer et al.3 from the skeletal muscle of adult patients who had died of non-muscular disorders within four hours of death. The myoglobin was further purified by ion-exchange column chromatography using D.E.A.E. cellulose by the method of Kagan and Christian.4 The first fraction eluted 1. 2. 3. 4.
Caspary, E. D., Gubbay, S. S., Stern, G. M. Lancet, 1964, ii, 941. Stern, G. M., Rose, A. L., Jacobs, K. J. neurol. Sci. 1967, 5, 181. Singer, K., Angelopoulos, B., Ramot, B. Blood, 1955, 10, 979. Kagan, L. J., Christian, C. L. Am. J. Physiol. 1966, 211, 656.