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Views And Reviews

Offending in theatre: the case of Ian Paterson

BMJ 2017; 357 doi: (Published 30 May 2017) Cite this as: BMJ 2017;357:j2583
  1. Gwen Adshead, forensic psychiatrist and psychotherapist
  1. gwen{at}

What is the psychology and motivation for doctors who do wrong?

Ian Paterson is a surgeon who has recently been found guilty of grievous bodily harm with intent. He faces a life sentence for deliberately carrying out operations, mainly on women, that he said were necessary to save their lives, but which had no therapeutic effect and put their lives at risk. Many of the women had been referred to him for surgery as part of treatment for suspected breast cancer.

This highly trained and experienced doctor seems to have deliberately conned people into having surgery that they did not need, and in doing so convinced them that they were seriously ill and he was saving their lives. The question has been raised as to what his motivation could be. There have been references to Lancelot Spratt, surgeons with a God complex, and other familiar tropes. Making money seems an obvious motivator, and malevolence is implied, although many patients said that he was kind and charming. Inevitably the term …

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