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THE ENCASED DRIVER
151
appeal. It was contended on behalf of the Minister that since regulation 7 (2) provided that any party to an investigation was entitled to appeal to the Minister against any decision of the council, a complainant who was dissatisfied with a decision had a right of appeal. Lord Justice DIPLOCK said that while regulation 6 of the 1956 regulations enabled the council to take action in one of four ways, regulation 7 dealt with appeals to the Minister. The question was whether the broad words of the regulations should be construed so as to deprive the complainant of his right of appeal in this case. Prima facie, where a right of appeal against a decision was conferred upon a person, the decision had to be adverse to the person seeking to appeal. If a complaint was rejected, that would be an adverse decision and the complainant would have a right of appeal. If, however, the Service Committee and the council had found that there was a breach of the terms of service, the council’s decision whether or not to take action was not one in which the complainant had an interest. That decision was not adverse to him unless he alleged that he had incurred expenses as a result of the breach and sought to recover them under regulation 6, whereupon, he would have a right of appeal against refusal. The decision recommending a reduction of remuneration was not one in which the complainant had an interest and it was not adverse to him, and so he had no right of appeal. An order of prohibition would be granted, with costs.
Mr.
Justice,
Justice WIDGERY and Lord PARKER,
the Lord Chief
concurred.
Regina v. Minister of Health and Another, ex parte Ellis. Queen’s Bench Division: Lord Parker, C.., Diplock, L.J., and Widgery, 7: July 5, 1967. Counsel and solicitors: J. A. C. Spokes (Le Brasseur & Oakley); Nigel Bridge (solicitor, Minister of Health). STELLA SOLOMON Barrister-at-Law.
Round the World New Zealand The New Zealand Government has authorised the University of Auckland to call for tenders for the first building of its medical school. This is to cost EN.Z.750,000 as it was (or N.Z.$1,500,000 as it became this week). The site chosen is opposite the Auckland Hospital. The Government’s green light is expected also to cover the approval for staff appointments for the preclinical period. The Auckland version of this is to be a 3-year course leading to a B.SC. in human biology. With this firm encouragement the university feels able to stick to its plan to enrol the first 50 entrants to the B.sc. course at once and to begin teaching them in March, 1968. The Auckland Hospital itself is being rebuilt; the first stage of the N.Z.$13-million buildings (one of fourteen storeys) is nearly finished. The whole complex, with the Grafton hall of residence nearby, is to take 305 students, and will be a substantial new medical and educational centre.
Tanzania
95% of the 412 Dar es Salaam students who were mass-rusticated for two years some nine months ago have been pardoned and are to be allowed to return to their studies in July. 20 medical students were involved; 19 return-the 20th was president of the national students’ association and he remains in limbo. The original two-year sentence would have fitted in quite well with the two-year syllabus some of the students were embarking on. Their return now, a year out of step, presents problems in a small school, but this makes us none the less glad to have them back. A school without students is like a bog without snipe.
Letters
to
the Editor
THE ENCASED DRIVER SIR,-The 7000 men, women, and children who die and the 100,000 who are injured annually on our roads would smile wryly if they could see the variously encumbered state of many of our car-drivers. I refer to the tendency for orthoptdic patients in limb casts, plaster jackets, and cervical collars to continue driving their vehicles with or without their doctor’s permission. This situation was forcibly brought to my attention when a patient, on whose lower limb I had recently applied a plaster cast with the foot in plantarflexion, thanked me for leaving his toes free so that he could work the accelerator. He assured me that his insurance company knew all about this and had merely commented that, if he had an accident, they would have to accept all responsibility and he would lose his noclaim bonus. Surely it is time that the medical and legal professions defined the conditions which constitute a physically safe driver. Guy’s Hospital, M. A. NELSON. London S.E.1.
A NEW DILEMMA SIR,-In this centre a study is in progress of the full chromosome complement of all babies born in one large
hospital, karyotypes being prepared from lymphocyte cultures of cord blood. Two examples of the XYY constitution have been found. These newborn babies seem to be normal physically. It is their mental potential that must cause anxiety. The XYY chromosome complement seems to carry with it an especial liability to criminal insanity,! and yet we do not know how great that risk may be. We have some knowledge of how many inmates of institutions for the criminally insane have an XYY chromosome complement. We do not know how many apparently normal men are thus endowed. What, if anything, should the doctor tell the parents concerning such a finding gathered from a research survey. Should he mention only that a chromosome abnormality of dubious significance has been found, and allow the parents, with the aid of the public libraries and books on popular biology, to form their own fearful conclusions ? Should he tell them that their new baby may grow up to a life of insanity and crime, or should he hold his peace and keep his embarrassing knowledge to himself ? The staff of this department of paediatrics have concluded that since the invariable association of XYY with criminal insanity is far from certain, since no immediate remedy can be applied, and since such grave anxieties as must arise in the minds of the parents would certainly lead to an abnormal upbringing of the child, the knowledge should be kept secret. Only the cytogenetic investigator, the family practitioner, and a paediatrician associated with the conduct of the investigation are aware of what has been found. No mention is made of the matter in the hospital records. Special precautions are taken to ensure that the parents do not know that their baby is an object of medical interest. The family practitioner will covertly follow the progress of the child. Is this the right solution to this dilemma ? We should be interested to learn the opinions of your readers. Department of Pædiatrics, University of Western Ontario, and G. H. VALENTINE Children’s Psychiatric Research Institute, F. SERGOVITCH. Canada. London,
KARYOTYPE AND COLCHICINE-EXPOSURE TIME SIR,-We have found that increasing the time of exposure of leucocyte cultures to suitably diluted colchicine will significantly increase the number of well-spread metaphase figures of analysable quality. The proportion of suitable figures does 1. Br. med. J. 1967, i, 64.
appeal. It was contended on behalf of the Minister that since regulation 7 (2) provided that any party to an investigation was entitled to appeal to the Minister against any decision of the council, a complainant who was dissatisfied with a decision had a right of appeal. Lord Justice DIPLOCK said that while regulation 6 of the 1956 regulations enabled the council to take action in one of four ways, regulation 7 dealt with appeals to the Minister. The question was whether the broad words of the regulations should be construed so as to deprive the complainant of his right of appeal in this case. Prima facie, where a right of appeal against a decision was conferred upon a person, the decision had to be adverse to the person seeking to appeal. If a complaint was rejected, that would be an adverse decision and the complainant would have a right of appeal. If, however, the Service Committee and the council had found that there was a breach of the terms of service, the council’s decision whether or not to take action was not one in which the complainant had an interest. That decision was not adverse to him unless he alleged that he had incurred expenses as a result of the breach and sought to recover them under regulation 6, whereupon, he would have a right of appeal against refusal. The decision recommending a reduction of remuneration was not one in which the complainant had an interest and it was not adverse to him, and so he had no right of appeal. An order of prohibition would be granted, with costs.
Mr.
Justice,
Justice WIDGERY and Lord PARKER,
the Lord Chief
concurred.
Regina v. Minister of Health and Another, ex parte Ellis. Queen’s Bench Division: Lord Parker, C.., Diplock, L.J., and Widgery, 7: July 5, 1967. Counsel and solicitors: J. A. C. Spokes (Le Brasseur & Oakley); Nigel Bridge (solicitor, Minister of Health). STELLA SOLOMON Barrister-at-Law.
Round the World New Zealand The New Zealand Government has authorised the University of Auckland to call for tenders for the first building of its medical school. This is to cost EN.Z.750,000 as it was (or N.Z.$1,500,000 as it became this week). The site chosen is opposite the Auckland Hospital. The Government’s green light is expected also to cover the approval for staff appointments for the preclinical period. The Auckland version of this is to be a 3-year course leading to a B.SC. in human biology. With this firm encouragement the university feels able to stick to its plan to enrol the first 50 entrants to the B.sc. course at once and to begin teaching them in March, 1968. The Auckland Hospital itself is being rebuilt; the first stage of the N.Z.$13-million buildings (one of fourteen storeys) is nearly finished. The whole complex, with the Grafton hall of residence nearby, is to take 305 students, and will be a substantial new medical and educational centre.
Tanzania
95% of the 412 Dar es Salaam students who were mass-rusticated for two years some nine months ago have been pardoned and are to be allowed to return to their studies in July. 20 medical students were involved; 19 return-the 20th was president of the national students’ association and he remains in limbo. The original two-year sentence would have fitted in quite well with the two-year syllabus some of the students were embarking on. Their return now, a year out of step, presents problems in a small school, but this makes us none the less glad to have them back. A school without students is like a bog without snipe.
Letters
to
the Editor
THE ENCASED DRIVER SIR,-The 7000 men, women, and children who die and the 100,000 who are injured annually on our roads would smile wryly if they could see the variously encumbered state of many of our car-drivers. I refer to the tendency for orthoptdic patients in limb casts, plaster jackets, and cervical collars to continue driving their vehicles with or without their doctor’s permission. This situation was forcibly brought to my attention when a patient, on whose lower limb I had recently applied a plaster cast with the foot in plantarflexion, thanked me for leaving his toes free so that he could work the accelerator. He assured me that his insurance company knew all about this and had merely commented that, if he had an accident, they would have to accept all responsibility and he would lose his noclaim bonus. Surely it is time that the medical and legal professions defined the conditions which constitute a physically safe driver. Guy’s Hospital, M. A. NELSON. London S.E.1.
A NEW DILEMMA SIR,-In this centre a study is in progress of the full chromosome complement of all babies born in one large
hospital, karyotypes being prepared from lymphocyte cultures of cord blood. Two examples of the XYY constitution have been found. These newborn babies seem to be normal physically. It is their mental potential that must cause anxiety. The XYY chromosome complement seems to carry with it an especial liability to criminal insanity,! and yet we do not know how great that risk may be. We have some knowledge of how many inmates of institutions for the criminally insane have an XYY chromosome complement. We do not know how many apparently normal men are thus endowed. What, if anything, should the doctor tell the parents concerning such a finding gathered from a research survey. Should he mention only that a chromosome abnormality of dubious significance has been found, and allow the parents, with the aid of the public libraries and books on popular biology, to form their own fearful conclusions ? Should he tell them that their new baby may grow up to a life of insanity and crime, or should he hold his peace and keep his embarrassing knowledge to himself ? The staff of this department of paediatrics have concluded that since the invariable association of XYY with criminal insanity is far from certain, since no immediate remedy can be applied, and since such grave anxieties as must arise in the minds of the parents would certainly lead to an abnormal upbringing of the child, the knowledge should be kept secret. Only the cytogenetic investigator, the family practitioner, and a paediatrician associated with the conduct of the investigation are aware of what has been found. No mention is made of the matter in the hospital records. Special precautions are taken to ensure that the parents do not know that their baby is an object of medical interest. The family practitioner will covertly follow the progress of the child. Is this the right solution to this dilemma ? We should be interested to learn the opinions of your readers. Department of Pædiatrics, University of Western Ontario, and G. H. VALENTINE Children’s Psychiatric Research Institute, F. SERGOVITCH. Canada. London,
KARYOTYPE AND COLCHICINE-EXPOSURE TIME SIR,-We have found that increasing the time of exposure of leucocyte cultures to suitably diluted colchicine will significantly increase the number of well-spread metaphase figures of analysable quality. The proportion of suitable figures does 1. Br. med. J. 1967, i, 64.