Court dismisses appeals of two mothers
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《英国医生杂志》
BMJ
Two mothers who were trying to get their children back from care have had their appeals dismissed.
But in the first case, two paediatricians who were expert witnesses in a case involving a mother suspected of having Munchausen syndrome by proxy were wrong to conclude, in the absence of a medical explanation, that she had deliberately harmed her child, the Court of Appeal ruled last week.
The child, who had a chromosomal abnormality and was in hospital for failure to thrive, had rigors 11 times while her mother, a paediatric nurse, was in the hospital. Four other experts had said they were unable to conclude that the mother had interfered with the child's cannula.
Elizabeth Butler-Sloss, president of the High Court's family division, said the two paediatricians' postulation that the mother had deliberately interfered with the cannula and administered a harmful substance "rested partly on the foundation that science had no answer and partly on extraneous circumstances culled from the mother's medical history."
She said that the unnamed doctors and the judge, Mrs Justice Bracewell, had fallen into error in concluding that the medical evidence proved the mother had harmed the girl, named only as LB. But there was plenty of non-medical evidence that was "clear and cogent" on which the judge had been entitled to rely, and the mother's appeal was dismissed.
The mother has lodged complaints with the General Medical Council against the two paediatricians.
Dame Elizabeth, sitting with Lord Justice Thorpe and Lord Justice Mantell, was giving judgment in the first two care cases to come to the appeal court since the Angela Cannings judgment in January. After Mrs Cannings successfully appealed against her conviction for murdering two of her children, the court warned against prosecutions of parents for killing their children where medical experts disagreed ( BMJ 2004;328: 183).
Ministers suggested that miscarriages of justice may also have occurred in care cases and took steps to ease the way for parents and local authorities to refer cases back to court. In these two care cases, the appeal court dismissed one mother's appeal and gave reasons for having dismissed the second mother's application for permission to appeal last March.
Lawyers for the two mothers had argued during the appeal court hearing that family courts should now adopt the more stringent criminal standard of proof—beyond reasonable doubt—in care cases. But Dame Elizabeth said that approach was "mistaken," and the judge had to be satisfied only "on the balance of probabilities" (the civil standard of proof).
In the second case, that of LU, the mother's lawyers had accused the three paediatricians who had unanimously concluded that she had repeatedly tried to smother her child of "paediatric dogma."
But giving reasons for refusing the mother permission to appeal, Dame Elizabeth said no criticism could be made of the evidence offered by the three experts, also unnamed, and the judge was entitled to rely on it in concluding that the mother had deliberately obstructed the child's airway(Clare Dyer, legal corresp)
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But in the first case, two paediatricians who were expert witnesses in a case involving a mother suspected of having Munchausen syndrome by proxy were wrong to conclude, in the absence of a medical explanation, that she had deliberately harmed her child, the Court of Appeal ruled last week.
The child, who had a chromosomal abnormality and was in hospital for failure to thrive, had rigors 11 times while her mother, a paediatric nurse, was in the hospital. Four other experts had said they were unable to conclude that the mother had interfered with the child's cannula.
Elizabeth Butler-Sloss, president of the High Court's family division, said the two paediatricians' postulation that the mother had deliberately interfered with the cannula and administered a harmful substance "rested partly on the foundation that science had no answer and partly on extraneous circumstances culled from the mother's medical history."
She said that the unnamed doctors and the judge, Mrs Justice Bracewell, had fallen into error in concluding that the medical evidence proved the mother had harmed the girl, named only as LB. But there was plenty of non-medical evidence that was "clear and cogent" on which the judge had been entitled to rely, and the mother's appeal was dismissed.
The mother has lodged complaints with the General Medical Council against the two paediatricians.
Dame Elizabeth, sitting with Lord Justice Thorpe and Lord Justice Mantell, was giving judgment in the first two care cases to come to the appeal court since the Angela Cannings judgment in January. After Mrs Cannings successfully appealed against her conviction for murdering two of her children, the court warned against prosecutions of parents for killing their children where medical experts disagreed ( BMJ 2004;328: 183).
Ministers suggested that miscarriages of justice may also have occurred in care cases and took steps to ease the way for parents and local authorities to refer cases back to court. In these two care cases, the appeal court dismissed one mother's appeal and gave reasons for having dismissed the second mother's application for permission to appeal last March.
Lawyers for the two mothers had argued during the appeal court hearing that family courts should now adopt the more stringent criminal standard of proof—beyond reasonable doubt—in care cases. But Dame Elizabeth said that approach was "mistaken," and the judge had to be satisfied only "on the balance of probabilities" (the civil standard of proof).
In the second case, that of LU, the mother's lawyers had accused the three paediatricians who had unanimously concluded that she had repeatedly tried to smother her child of "paediatric dogma."
But giving reasons for refusing the mother permission to appeal, Dame Elizabeth said no criticism could be made of the evidence offered by the three experts, also unnamed, and the judge was entitled to rely on it in concluding that the mother had deliberately obstructed the child's airway(Clare Dyer, legal corresp)