Intended for healthcare professionals

Feature Doctors’ Wellbeing

Julien Warshafsky: how this doctor died and what it tells us about the system that failed him

BMJ 2018; 361 doi: (Published 14 June 2018) Cite this as: BMJ 2018;361:k2564


Warshafsky did not intend to kill himself with fentanyl, coroner concludes

  1. Clare Dyer, , legal correspondent, The BMJ
  1. claredyer4{at}

The story of this trainee anaesthetist lays bare the tensions between the treatment and regulation of ill doctors and could prompt changes. Clare Dyer reports

At 14.03 on 28 June 2016, Julien Warshafsky sent an email to the Medical Defence Union (MDU), which was representing him in an investigation by the General Medical Council into suspected drug abuse. The email was the last he would ever send.

The MDU replied at 16.34, but he never opened the message. At 17.55 his wife of 10 days, Mariana, returned from work as an intensive care nurse to find him on his knees, slumped over a bed in the spare room. He had stopped breathing.

Julien, a trainee anaesthetist, was 31. He was on sick leave after collapsing at work from a suspected overdose of fentanyl in December 2015. After an earlier incident involving the theft of fentanyl, he was subject to regular testing for illicit drugs by the GMC.

His father, Robin Warshafsky, a general practitioner, spoke to him the night before he died. He recalls that his son was “upset and agitated” after receiving an email that day from the MDU, which wanted to discuss the GMC process. “He was in great turmoil about whether to resign or try to hold on to his registration. Julien spent his last 24 hours preoccupied with the GMC investigation and scrutiny.”

Why did Julien die and what could have been done to save him? His father has used his own medical training and experience and spent thousands of hours searching for answers. He has spoken to many of the people involved in Julien’s training, care, supervision, and monitoring and describes the way clinician addiction is handled in the NHS as “amateurish.”

An inquest due to reconvene from 18 June will look into what caused Julien’s death. …

View Full Text

Log in

Log in through your institution


* For online subscription