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Our View: Era of arrogant, super-confident doctors is coming to an end

THIS MONTH, the Cyprus courts, in two separate cases, found doctors guilty of medical negligence and awarded damages to the plaintiffs. Although these were not the first such court rulings, they have reinforced the view that things were changing and the days when it was unheard of for one doctor to give testimony against a colleague in medical negligence cases are over.

This had been the attitude for decades, motivated both by professional solidarity and a sense of self-preservation – a doctor who testified against another doctor was in danger of having colleagues testify against him or her in the future. But the code of silence appears to have been broken in the last years and there are more cases being driven to the courts, as long as a plaintiff is prepared to put up with years of hearings – one of the lawsuits mentioned above was filed in 2001.

There has also been pressure on the medical profession from changing social attitudes, people having greater confidence to question decisions by doctors, seeking second opinions and carrying out their own research. The aura of infallibility that surrounded doctors – patients trusting doctors’ judgment and actions absolutely because they were highly-educated and respected professionals – has ceased to exist as people have acquired a more critical mindset and recognised that even doctors make mistakes.

The era of the arrogant, super-confident doctors, who did not feel any obligation to explain decisions and the treatment they prescribed to patients and enjoyed the unequal doctor-patient relationship is coming to an end. This was underlined by the ruling of one judge, this month as he questioned the lop-sided doctor-patient relationship. He noted that the doctor had failed to inform his patient of the risks of the operation he was to undertake and said: “Medical paternalism no longer rules in modern law, and a patient has a prima facie right to be informed by a surgeon of a small but well-established risk of serious injury as a result of the surgery.”

A big step forward, as was the admission by the court of the evidence provided by the son of a patient who had had her leg needlessly amputated, because doctors and nursing staff had failed to diagnose leg embolism, despite being alerted to the black marks on her leg, on her admission to the hospital, by her son. This was another example of an individual not accepting the myth of doctors’ infallibility, seeking justice and winning his case.

It appears that even the Cyprus Medical Council has sensed that times were changing. Last June it issued an announcement urging doctors to testify in good faith when asked to do so. It did not mince its words. “We call on doctors, whose primary duty is to serve patients and protect their health, to overcome the valid, legitimate and natural sentiments of collegial solidarity, and testify their expertise honestly, ethically and professionally, where allegations of medical error or negligence are examined,” it said.

Things are certainly changing. Earlier in the week it was reported that the Attorney-General had ordered a criminal investigation against state pathologist Eleni Antoniou in connection with an alleged cover-up of an alleged medical negligence case. A 52-year-old woman died after a routine spinal surgery at Nicosia General Hospital in 2009, but her family questioned the autopsy results and demanded additional tests. These showed that the cause of death was not what had been given in the autopsy report. Once again, people doubted the doctors’ verdict and they were correct to do so.

Hopefully, these cases will bring about a change of attitude among doctors and they will feel the obligation to explain their decisions to patients; in fairness, many doctors already do so. More important though, has been the breaking of the code of silence and willingness of some doctors to put their professional integrity and honesty above what the Medical Council described as the “natural sentiments of collegial solidarity”. This is a big step forward that could contribute to the raising of healthcare standards.

It could also contribute to a rise in medical litigation, with lawyers trying to cash in on suspected negligence cases, and it would be up to the courts to keep matters under control because there is a strong tendency towards litigation in Cyprus.




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