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BMA supports full inquiry into the Shipman case

BMJ 2000; 320 doi: (Published 05 February 2000) Cite this as: BMJ 2000;320:336
  1. Linda Beecham
  1. BMJ

    The BMA supports a full inquiry into the case of Dr Harold Shipman, who was convicted this week of murdering 15 of his women patients.

    The chairman of the BMA's council, Dr Ian Bogle, said that he was shocked and horrified by the sequence of events but did not believe that the case would damage the trust between doctors and patients. “It was Shipman who was found guilty,” he said, “not the medical profession and not GPs.”

    He said that it was important to differentiate the issues surrounding the evil criminal acts of a murderer who happens to be a doctor from the issue of the protection of patients from underperforming doctors.

    The BMA believes that many of the laws governing the registration and certification of death, the provision of certificates of cremation, disposal of the body, and the coroner's system are antiquated, and in the inquiry it would like to see:

    • A better definition of the categories of death which the coroner is required to investigate;

    • A statutory obligation on doctors to notify such deaths directly to the coroner;

    • A similar statutory obligation on nurses, undertakers, and others involved in the disposal of the dead to notify any concerns to the coroner;

    • Changes to the system of registering deaths and recording cremations, which would allow better collection of data and monitoring of events that may cause concern;

    • Larger, regional coroners' officers, controlled by coroners qualified in both medicine and law, replacing the current multiple small coroners' districts;

    • Greater emphasis on the importance of the office of the crematorium medical referee, whose training, duties, and powers should be strengthened; and

    • Improvements in education on forensic medicine at undergraduate and postgraduate level for all doctors.

    The association says that the inquiry should also look at the opportunities for better liaison between registrars and coroners and the development of a joint monitoring role using advances in information technology. And it said that the case also raised issues concerning the prescription, regulation, use, and destruction of controlled drugs.

    At a press conference this week the chairman of the BMA's General Practitioners Committee, Dr John Chisholm, said that no system could completely prevent a determined mass murderer, but the introduction of primary care groups (and their equivalent), clinical governance, and revalidation would make such action difficult to conceal. “I accept,” he said, “that doctors should be more accountable in the future.”

    Dr Chisholm said that he believed that patients should continue to have the choice of consulting singlehanded GPs because they liked the continuity of care.

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