WHERE REAL BLAME LIES FOR SCANDAL OF COT DEATHS
(Published in The Times, March 30, 2005)
HERE'S a news quiz. Which doctor was primarily responsible for the solicitor Sally Clark being unfairly convicted and jailed in 1999 for the murder of her two sons?
A bit easy, really. Surely everyone knows it was the "disgraced" Professor Roy Meadow, "inventor" of Munchausen's syndrome by proxy (MSBP), aka "the child-snatcher in chief" and "author of crackpot theories", who has "made a fortune wrecking the lives of women" (Pounds 50,000 over six years as an expert witness in 19 cases, according to the News of the World. And to think that all other expert witnesses give their time for free.) and who infamously suggested at Clark's trial that the chance of a mother such as her suffering two cot deaths was one in 73 million.
Except the answer isn't Meadow. Some of us would say it's Alan Williams, the Home Office pathologist who neglected to mention that one of the tests he had ordered on the body of Clark's eight-week-old son Harry had revealed the presence of a potentially fatal bacteria.
Williams, whose own "trial" by the General Medical Council was adjourned in February, is back before its Fitness to Practise Panel on the 20th of next month.
He denies professional misconduct. Next in the dock over the Clark case is Meadow, due before the GMC in the summer, but the evidence against him -contrary to the impression engendered by an often hysterical media witch hunt -is a lot less clear.
The noose dangled to hang Meadow was his statistical evidence during Clark's 1999 trial, even though he didn't -as is often implied -come up with it himself but quoted it from Sudden Unexpected Deaths in Infancy, a government-funded study.
Besides, as the first Clark appeal judges noted, the statistical evidence had never been central to Clark's conviction. The trial judge had directed the jury not to rely on it but to consider the testimony of the experts -nine, including Meadow, five of them for the defence -each of whom spoke without the benefit of the unseen Williams tests.
When Angela Cannings followed Clark to freedom in January last year (her appeal judges were persuaded that "there may have been a genetic cause, as yet unidentified", for the deaths of three of her children), the media and even the Government fell upon Meadow, with the children's minister Margaret Hodge delighting the militant enemies of MSBP by announcing that the "theory" that some mothers harmed their children to draw attention to themselves "has been largely discredited".
The Government declared that reviews would be carried out of thousands of family law proceedings and up to 300 criminal cases in which parents had been convicted of killing children. Without waiting for the results, journalists reached for their guns, with Meadow in their sights. Some fire was wilder than others: "He and his friends may be immune from prosecution for the consequence of the opinions they have so sedulously expressed in court, but that does not mean they cannot be charged with wasting police time," said The Daily Telegraph.
Oddly, the publicity was a good deal less voluble at the end of the year when it emerged that, out of 28,867 cases in which a care order was in place, only one had been changed as a result of the review. Not much of a fuss, either, on the announcement that, after a year-long trawl through 297 criminal trials dating back a decade, only six of 28 people who had had their cases referred to the Criminal Cases Review Commission had asked it to refer their convictions to the Court of Appeal. "Theory" not so crackpot, then.
Meadow, meanwhile, has been demonised. Perhaps the worst slur was that he had something to hide when, following normal protocols of confidentiality, he destroyed the case documents that had formed the basis of his seminal 1999 paper, Unnatural Sudden Infant Death. Read it (at http://adc.bmjjournals.com [http://adc.bmjjournals.com]) and you will see why the enemies of MSBP have worked so hard to discredit it.
The central point is that MSBP (or fabricated or induced illness, as spooked doctors now prefer to call it), is as tragically real today as it was in 1977, when Meadow first gave a name to a distressing condition that paediatricians had known for years, and the only result of the campaign against it will be to weaken protection for the children who need it most. (Only last month Petrina Stocker, said to have MSBP, was convicted of manslaughter for killing her nine-year-old son by putting salt in his hospital drip -although the British media, having made such a good job of representing the condition as a figment of one man's misogynistic imagination, shied away from mentioning the M-word.) The true scandal is that it took until the Cannings case for the law to realise, as her appeal judges wrote in January 2004, that "if the outcome of the trial depends exclusively or almost exclusively on a serious disagreement between ... experts, it will often be ... unsafe to proceed".
That such cases did proceed was not the fault of Meadow, nor of the many other experts who have honourably and honestly done no more than give their professional views in our adversarial courts, but of a legal system that has been content to allow a person's liberty to hinge not on objective fact but on subjective opinion.
One of many ironies surrounding MSBP is that Meadow, a scapegoat poised to be falsely judged by history as a monster, is a compassionate doctor who would be the first to say that what women such as Petrina Stocker need is not jail but help.