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Last week it was reported that a doctor who had made mistakes in over 20 operations was returning to work. The doctor in question, Gideon Lauffer, made some serious errors while practising as a general surgeon, including two which led to the deaths of patients. In 2007, Mr Lauffer accidentally perforated the bowel of Terry Harris, a previously fit and healthy 68-year old, during a routine gall bladder operation, and Allan Scammell died from blood poisoning after Mr Lauffer sewed his bowel to the wall of his abdomen, also in 2007.

The General Medical Council recommended that Mr Lauffer be struck off, but the ultimate decision was in the hands of an independent panel. The panel decided to suspend Mr Lauffer for a period of 6 months, and then to allow him to return to medical practice with strict conditions imposed. He is now working at St. Thomas’s hospital in London, where he is practising as a junior A&E doctor. He is being retrained, working under the close supervision of consultants, and the GMC maintain close contact, keeping his case under review.

Unsurprisingly, considerable controversy surrounds Mr Lauffer’s return to work. The Times ran with the story on its front page last Thursday, describing his return to work as a ‘scandal’. The Daily Mail wrote of ‘fury’ at the surgeon’s return to work and the Telegraph said the case raised questions over the GMC’s ability to protect patients.

Mr Lauffer took the opportunity of the media attention to apologise to his former patients and their families for the mistakes he made. I completely understand how those who lost loved ones as a result of Mr Lauffer’s errors might feel that he should be permanently banned from being a doctor. However, the decision to allow him to undergo retraining, and then to return to medical practice - as a physician as opposed to a surgeon – is not obviously wrong, and raises important ethical and social issues.

It is tragic that two people died and others suffered as a result of Mr Lauffer’s incompetence, but I do think it is important to remember that his actions were mistakes and not deliberate. He may have shown himself to be an incompetent surgeon, but that does not make him a criminal.

Being an incompetent surgeon doesn’t make you an incompetent physician any more than being a poor court room advocate prevents a lawyer from being able to offer clients the best legal advice.

Being an incompetent surgeon doesn’t make you an incompetent physician any more than being a poor court room advocate prevents a lawyer from being able to offer clients the best legal advice. If Mr Lauffer is an entirely competent physician, and if it is possible for him to retrain in non-surgical medicine and be able to practice safely, then why should his past mistakes prevent this?

There are two important issues here, which need to be distinguished – protection of patients and retribution.

As far as protecting patients is concerned, provided that Mr Lauffer is banned from surgery, and that he receives proper training and supervision, there is no reason to believe that his failings as a surgeon make him any more of a risk to his future patients than if he had never practiced as a surgeon at all. As far as retribution is concerned, he has not been convicted of a crime – his poor surgery was negligent – and the remedy is compensation through the civil courts.

Unless a medical practitioner has committed a crime, I think it is absolutely right that regulatory panels base their decisions on forward-looking considerations, and not be guided by principles of retributive justice.

Unless a medical practitioner has committed a crime, I think it is absolutely right that regulatory panels base their decisions on forward-looking considerations, and not be guided by principles of retributive justice.

There is, however, a sting in the tail. Mr Lauffer was in fact disciplined not just for performing incompetent surgery, but also for performing an operation knowing he had not had appropriate training, for covering up his lack of training, and failing to admit (in the case of at least one operation) his mistake.In my view, if a doctor lacks professional judgement, or is shown to be dishonest, this almost certainly renders him or her unfit to practice as a doctor in any branch of medicine. So, although I think the treatment of this case by the press was pretty scandalous, I’m not convinced that Mr Lauffer ought to be continuing his medical career at all.

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