Editorials

Medical manslaughter

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f5609 (Published 18 September 2013) Cite this as: BMJ 2013;347:f5609
  1. Sarah E McDowell, knowledge transfer senior research associate1,
  2. Robin E Ferner, director2
  1. 1University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
  2. 2West Midlands Centre for Adverse Drug Reactions, City Hospital, Birmingham B18 7QH, UK
  1. r.e.ferner{at}bham.ac.uk

More prosecutions won’t ease the problems for lawyers, doctors, or patients

“It would be most fatal to the efficiency of the medical profession if no one could administer medicine without a halter round his neck.” Baron Pollock (1859)1

A doctor who makes a “bad enough” medical error to cause the death of a patient can be prosecuted for criminal negligence manslaughter,2 3 but prosecutions were rare until the 1990s. When we surveyed cases previously, the numbers of doctors charged had increased during the period 1990-2005, although few were convicted.4 Those who were convicted were rarely imprisoned, and if they were, sentences were generally short. Negligent acts, however reckless, that have non-fatal consequences, are not crimes in English law. In France, by contrast, claimants can invoke criminal proceedings for involuntary harm short of death, and not necessarily as a consequence of recklessness.5 Some have suggested that a similar approach be adopted in England.6

Three new factors will alter the relationship between medicine and criminal law in England and Wales. Firstly, the Court of Appeal’s ruling that a sentence of two years’ imprisonment imposed on a surgeon who pleaded guilty to manslaughter was “not manifestly excessive.”7 Secondly, …

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