Challenging a medical diagnosis

13th October 2015

Challenging a medical diagnosis

The tragic case of Mackenzie Cackett, a four-year-old who died after battling brain and spinal tumours, highlights a fundamental change in the way health care is dispensed and received.

When Mackenzie complained of a sore head and sickness in August 2010, doctors initially told his parents, Danielle and James, there was nothing to worry about – but the severity of his condition was revealed six months later following an MRI scan.

The East Anglian Daily Times reports that the youngster underwent surgery to remove a tumour and a scan of his brain shortly afterwards showed the procedure had been successful. However, had doctors also scanned his neck, the family believe they may have found a second, ultimately fatal, tumour on his spine.

After seeking legal advice, the couple, from Halstead in Essex, took civil action against Colchester and Cambridge University Hospitals NHS Foundation Trusts. They recently reached an out-of-court settlement with the hospitals, both of which admitted they should have detected the tumour earlier.

Aside from the very real human tragedy, this case emphasises the importance of clinicians acknowledging that patients – and in this instance, parents or guardians – are no longer passive recipients of care. Instead, they should be actively involved in the method and administration of their treatment, pushing doctors for further action if they cannot be reasonably reassured that the correct diagnosis has been made.

Patients should be aware that they have a choice of where they seek their medical treatment and that they shouldn’t be afraid to request a second opinion if they are not satisfied.

The decision in the recent case of Montgomery v Lanarkshire Health Board emphasises the importance of doctors understanding the concerns of patients and acting upon them. The Supreme Court held that changes in society and in the way that health care is provided mean that it is no longer appropriate to view patients as uninformed, incapable of understanding medical matters or as being wholly dependent on information from doctors. ¬¬

This represents a significant – and welcome – shift in the policy and approach of the medical profession.

And it’s a change that is wholly supported by the General Medical Council (GMC). One of the GMC’s documents currently in force (Good Medical Practice (2013)) states, under the heading ‘The duties of a doctor registered with the General Medical Council’, that doctors should “work in partnership with patients. Listen to, and respond to, their concerns and preferences. Give patients the information they want or need in a way they can understand”.

Indeed, NHS England’s own guidance states that patients should be “active participants in the design of their care” and that there are “significant opportunities to design services that enable patients with their family, friends and professionals to decide how their care should be designed and delivered”.

In Mackenzie’s case, his parents did challenge the initial diagnosis. Sadly though, his condition had deteriorated so rapidly and to such an extent that their persistence wasn’t enough to save his life.

But the four-year-old’s story does emphasise the need for patients to take an active role in their treatment, to complain when they are unhappy with their care, and to push for further investigation if they are not reassured.

Gotelee is a leading Suffolk firm of solicitors offering a range of legal services, including medical negligence advice. Get in touch by visiting www.gotelee.co.uk or calling 01473 211121.

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