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December 15, 2003

More Medical Experts

While on the subject of dubious 'experts' (see my post on African AIDS), the British newspapers in the last week have had a lot of coverage of Professor Sir Roy Meadows. Sir Roy is about as eminent as doctors get: recognised as one of the world's leading p(a)ediatricians, top professor at a medical school, recipient of a knighthood and other honours, and President of the Royal College of Paediatricians.

Sir Roy's reputation has been built largely on his 'discovery' in the 1970s of Munchhausen Syndrome By Proxy. Plain old Munchhausen Syndrome is the familiar mental disorder whereby people invent fictitious symptoms - or perhaps inflict real harm on themselves - just to obtain medical attention. The variant 'By Proxy' is where people invent (or inflict) symptoms on other people under their control - usually their children - for the same purpose.

There is little doubt that MSBP exists, as there are some solidly documented cases, including those where parents have been secretly filmed giving their children drugs or poisons, even in their hospital beds.

Alas, Sir Roy's great discovery seems to have gone to his head, and he started seeing MSBP everywhere, even where there were perfectly natural explanations for the symptoms observed. But such was his reputation that his evidence was taken as conclusive in several criminal trials for murder or attempted murder, and in an unknown number of child custody cases, possibly running into hundreds.

Now it is all unravelling. Several murder convictions have recently been thrown out on appeal, and there are demands for a comprehensive review of all the cases in which he gave evidence. The turning point came when Sir Roy gave an opinion of the statistical odds against more than one 'cot death' (Sudden Infant Death Syndrome) occurring by natural causes in the same family, which rested on such a blatant statistical fallacy that the Royal Statistical Society wrote officially to the Court authorities to protest. After that, people began to wonder 'if he could make an error like that, what else can we trust?'. A further problem (which make this relevant to GNXP!) is that he habitually neglected genetic factors which might be responsible for unexplained deaths or illnesses. In one of the recent murder appeals, an old lady, the grandmother of the appellant, came all the way from India to give evidence on the prevalence of sudden infant death in the family.

Not sure there is any moral to all this. I'm not saying 'don't trust doctors' - just don't think they are infallible. If anything, doctors and other medical experts seem to have even more authority in the US than in Britain, and it would be surprising if there were not similar cases waiting to be discovered.

Posted by David B at 12:06 PM