David Southall

Professor David Southall, OBE, is a UK paediatrician who is a controversial expert in Fabricated or Induced Illness (FII, also known as "Munchausen Syndrome by Proxy"),^[1] and who has performed significant research into sudden infant death syndrome.^[2]

Prior to becoming a paediatrician, Southall spent four years in general adult medicine, one year in obstetrics and two years as a general practitioner.^[3]

Between 1986 and 1994, Southall led a pilot research project into FII involving video surveillance of young hospital patients in an effort to observe their carers (such as parents or guardians) harming them.^[2] The project, which was conducted at the Royal Brompton Hospital in London, and the North Staffordshire Royal Infirmary in Stoke-on-Trent, observed carers using methods such as suffocation and poisoning to harm the children.^[2] As a result of the project, thirty-three parents or stepparents who had harmed their children were prosecuted, and twenty-three were diagnosed with FII.^[2]

The project attracted controversy for its methods and for the ethical implications of the research. Critics argued that the desire of the researchers to observe the carers harming the children exposed the children to further abuse, that the betrayal of doctor-patient trust necessarily involved in the surveillance could cause harm to the subjects, and that "a diagnosis should lead to treatment, not punishment".^[4] However, the researchers argued that the surveillance saved the lives of many of the children involved, and Southall himself said that "[b]y doing covert video surveillance we are betraying the trust of parents... [b]ut if a parent has been abusing his or her child in this way then the trust between child and parent has already gone."^[4]

In the early 1990s, Southall led a study which pioneered continuous negative extrathoracic pressure therapy, a treatment for breathing difficulties in young children involving the application of negative pressure to the patients' chests.^[5] The study was controversial, with some parents of the children involved suggesting that the treatment was linked to subsequent death or brain injury.^[5] The research was the subject of investigations by the hospital involved and inquiries from police. An independent follow-up study concluded in 2006 that there was "no evidence of disadvantage, in terms of long-term disability or psychological outcomes" from the use of the technique.^[5]

In 1993, during the Bosnian War, Southall traveled to Sarajevo as a participant in a medical evacuation programme for sick children from the area.^[3] Prompted by his experiences there of what he described as "trauma inflicted on children and their families, not only by warring factions, but also by the indolence of the international community", Southall established Child Advocacy International on his return, to advocate for international child health issues.^[3]

In 2004, Southall was found guilty of serious professional misconduct by the General Medical Council (GMC), after alleging to police that the husband of Sally Clark was responsible for murdering the couple's children.^[6] Southall made the claim to child protection officers of the Staffordshire police after watching a television documentary about the case.^[1] The GMC banned Southall from child protection work for three years; the Council for Healthcare Regulatory Excellence challenged the decision as insufficient and argued that he should be deregistered, but a High Court of Justice decision in 2005 held that the sanction was not unduly lenient.^[7]

In February 2007, Attorney-General Lord Goldsmith announced that a review would be held into a number of criminal cases in which Southall gave evidence for the prosecution, following allegations that Southall kept up to 4,450 personal case files on child patients which were kept separate from the official hospital records.^[8]

On 4 December 2007, Southall was struck off the medical register after being found guilty of professional misconduct by the General Medical Council.^[9] Southall appealed this decision in the High Court, but the appeal was dismissed.^[10] In his judgement, Mr Justice Blake stated that Southall "had speculated on non-medical matters in an offensive manner entirely inconsistent with the status of an independent expert."

On 1 June 2009 Dr Southall was the subject of an episode of the BBC's current affairs programme Panorama, title 'A Very Dangerous Doctor'.^[11] The interest group 'Professionals Against Child Abuse' commented in the medical journal The Lancet that the "GMC should never have brought this case" (against Southall) ^[12] and has criticised disciplinary proceedings brought against doctors.^[13]

On 4 May 2010 Dr Southall is back on the medical register after winning an appeal over a long-running dispute with the General Medical Council. The Appeal Court's decision means he is able to practise medicine again.^{[14] [15]}

References

1. ^ ^{a b} "Murder theory doctor resumes job". BBC. 2004-06-16. http://news.bbc.co.uk/2/hi/uk_news/england/staffordshire/3812199.stm. Retrieved 2007-11-27. 
2. ^ ^{a b c d} "Profile: Professor David Southall". BBC. 2005-04-14. http://news.bbc.co.uk/2/hi/health/4443577.stm. Retrieved 2007-11-27. 
3. ^ ^{a b c} Abbasi, Kamran (1998-03-28). "The children's advocate". British Medical Journal 316 (7136): 960. PMID 9550952. 
4. ^ ^{a b} Brahams, Diana (1993-10-16). "Video surveillance and child abuse". Lancet 342 (8877): 944–947. doi:10.1016/0140-6736(93)91999-3. 
5. ^ ^{a b c} "Baby breathing aid study cleared". BBC. 2006-03-31. http://news.bbc.co.uk/2/hi/health/4860888.stm. Retrieved 2007-11-27. 
6. ^ Carter, Helen (2006-11-13). "Paediatrician faces new misconduct allegations". Guardian Unlimited (London). http://www.guardian.co.uk/society/2006/nov/13/childrensservices.health. Retrieved 2007-11-27. 
7. ^ "Southall avoids being struck off". BBC. 2005-04-14. http://news.bbc.co.uk/2/hi/health/4443491.stm. Retrieved 2007-11-27. 
8. ^ "Legal review of Southall's cases". BBC. 2007-02-20. http://news.bbc.co.uk/2/hi/health/6378691.stm. Retrieved 2007-11-27. 
9. ^ "David Southall struck off by GMC". BBC. 2007-12-04. http://news.bbc.co.uk/1/hi/health/7127485.stm. Retrieved 4 December 2007. 
10. ^ "High Court judgment on David Southall". High Court. 2009-08-31. http://www.theoneclickgroup.co.uk/documents/vaccines/David%20Southall%20Vs.%20GMC.pdf. Retrieved 31 August 2009. 
11. ^ 'A Very Dangerous Doctor' BBC Panorama, accessed 1 June 2009
12. ^ http://paca.org.uk/2009/06/04/paca-letter-published-in-the-lancet-on-the-outcome-of-the-southall-appeal/
13. ^ http://paca.org.uk/
14. ^ Boseley, Sarah (2010-05-04). "Controversial paediatrician David Southall wins appeal". London: Guardian News. http://www.guardian.co.uk/society/2010/may/04/david-southall-wins-appeal. 
15. ^ "Paediatrician David Southall back on medical register". BBC. 2010-05-04. http://news.bbc.co.uk/1/hi/health/8659529.stm. 

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