Leonard Arthur

Dr Leonard John Henry Arthur MB, BCh, MRCP, D Obst RCOG (20 April 1926 - 1983) [http://www.thepeerage.com/p12583.htm#i125826 thePeerage.com - Person Page 12583 ] ] was a British doctor tried in 1981 for the attempted murder of John Pearson, a newborn child with Down's Syndrome. He was acquitted.

The case was highly controversial, garnering huge media interest, and led to the British Medical Association (BMA) changing its Ethical Guidelines "to ensure that newborn handicapped babies were treated with the same respect as normal children". [http://www.spuc.org.uk/ethics/art/intrusion-on-nature Man’s Intrusion on Nature ] ] The case also confirmed the principle established in the trial of suspected serial killer Dr John Bodkin Adams that "the administration of a drug by a doctor when it is necessary to relieve pain is a proper medical practice even when the doctor knows that the drugs will themselves cause the patients' death". [http://www.actrtla.org.au/euth/bookeu/smith.htm#E12E17 Killing the Willing ... And Others! Legal Aspects of Euthanasia and Related Topics ] ] Furthermore, the defence's concealment of a certain aspect of Arthur's defence (that the baby had a congenital heart defect), led to a change in the law regarding the disclosure of technical evidence. [http://bmj.bmjjournals.com/cgi/content/full/317/7170/1457 Alan Usher • David Walter Hugh Barnes • Henry Herbert Evans Batten • Thomas Roy Farrimond • John Ferrington • Donald Kellock • Thomas William Aitken McKay • Basil Elystan Mile... ] ]

Family

The descendant of Sir George Arthur, Arthur's father was a civil servant in India. In 1954 Arthur married Janet Stella Brain, daughter of Walter Russell Brain, a former president of the Family Planning Association. [http://www.eugenics-watch.com/briteugen/eug_a.html British Eugenics Society - A ] ] Together they had one son and five daughters.

Career

After attending Aldenham School in Elstree, Hertfordshire, Arthur received an MB and BCh at Cambridge University in 1951, an MRCP in 1951 and a D Obst RCOG in 1956. He was a Pediatric Registrar in South Devon and East Cornwall Hospital in Plymouth from 1958, and Medical Registrar at the Royal Victoria Infirmary in Newcastle. Arthur was a member of the British Eugenics Society in 1955 and 1957.

John Pearson

From 1978 he worked in Derbyshire Children's Hospital where, at the behest of the parents [http://www.nuffieldbioethics.org/go/browseablepublications/criticalCareDecisionFetalNeonatalMedicine/report_581.html Nuffield Council on Bioethics ] ] , he ordered "nursing care only" for John Pearson who was born on 28 June 1980. Pearson had Down's Syndrome and he died 60 hours later. The nursing care given amounted to sedation, (dihydrocodeine a drug whose manufacturers recommended it should not be given to children under the age of 4, [http://findarticles.com/p/articles/mi_qn4158/is_20020410/ai_n12614843 The Independent] ] ) water and starvation. A colleague reported his actions to the police. Arthur certified the cause of death as bronchopneumonia.

Arthur was subsequently charged with murder, but the possibility of congenital heart failure caused the original charge to be reduced to attempted murder.

Trial

Sir Thomas Hetherington, Director of Public Prosecutions, described the decision to prosecute Arthur as the "most difficult" of his career. [ [http://books.google.pl/books?id=dRhunvkHpOEC&pg=PA219&lpg=PA219&dq=%22Leonard+Arthur%22+dr+down+syndrome+law&source=web&ots=mM6TPuxASN&sig=OTMoV8Q6YBudsl28IV-FRKjQUDw&hl=pl&sa=X&oi=book_result&resnum=3&ct=result Google Books] ] Arthur was tried on 5 November 1981 in Leicester Crown Court and defended by George Carman. Like Dr John Bodkin Adams, [Cullen, Pamela V., "A Stranger in Blood: The Case Files on Dr John Bodkin Adams", London, Elliott & Thompson, 2006, ISBN 1-904027-19-9] Arthur did not give evidence in his own trial. [ [http://www.catholicdoctors.org.uk/CMQ/Nov_1999/culture_of_death_g_wright.htm The Culture of Death - Gerard Wright ] ] His defence did call other distinguished expert witnesses though, such as Sir Douglas Black, the then President of the Royal College of Physicians, who said:

"I say that it is ethical, in the case of a child suffering from Down’s, and with a parental wish that it should not survive, to terminate life providing other considerations are taken into account such as the status and ability of the parents to cope in a way that the child could otherwise have had a happy life."

Carman argued in his closing speech:

"He could, like Pontius Pilate, have washed his hands of the matter. He did not, because good doctors do not turn away. Are we to condemn him as a criminal because he helped two people [the mother and child] at the time of their greatest need? Are we to condemn a doctor because he cared?"

The jury deliberated for 2 hours and found Arthur not guilty. [ [http://books.google.pl/books?id=PvEC5g3dPKoC&pg=RA3-PT176&dq=%22Leonard+Arthur%22&ei=9SxpSOzZAYaKsgPfxfWyBg&sig=ACfU3U3RKNjaXMyhRp7bL4qLjMDinwqidA#PRA3-PT176,M1 Google Books] ]

Legal legacy

The case was highly controversial and the public interest in it led to the British Medical Association (BMA) changing its Ethical Guidelines "to ensure that newborn handicapped babies were treated with the same respect as normal children".

The case also confirmed the principle established in the trial of suspected serial killer Dr John Bodkin Adams that "the administration of a drug by a doctor when it is necessary to relieve pain is a proper medical practice even when the doctor knows that the drugs will themselves cause the patients' death".

The Crown Pathologist, Alan Usher, who worked on the Arthur trial later complained:

"I had looked at more than thirty slides from all this child's major organs with a specialist pediatric pathologist before writing my report. We had agreed that apart from pneumonia [...] no other abnormality was present in these sections. It later transpired that the same specialist paediatric pathologist was retained to advise the defence and changed his opinion materially [...] as a result of studying further material stained by a variety of sophisticated methods. These new slides were made privately and never shown to me and the defence pathologist's change of opinion was deliberately kept secret (he was actually expressly forbidden to speak to me about the matter) until I was in the witness box [...] I was then permitted a short time [...] to study this new histological material before being cross-examined on it [...the question being] whether (the new 'defects') [...] played any significant part in the fate of this neonate [...] My opinion is that they did not [...] Those who trust in secrecy, it seems to me, have little faith in the justice of their cause [...] The sole effect of the secret technical defence [...] is to foil proper investigation by late declaration" [Alan Usher, Cons. Pathologist to the Home Office, BMJ Vol. 283 5 Dec. 198X p. 1542]

As a result of this, the law was changed so that technical evidence had to be disclosed to a court prior to trial, much like an alibi defence.

Criticism

M.J. Gunn and J.C. Smith are critical of the judge's summing up. ["Arthurs Case and the Right to Life of a Downs Syndrome Child" (1985), Criminal Law Review 705] Arthur had admitted to the police that the effect of the drug given, apart from being a sedative, was also to stop the child seeking sustenance and that this had been intended by him. A witness, Professor Campbell, concurred that this was a justifiable practice. The judge made no mention of this potential homicidal intent during the summing up however, something which has been criticised, amongst others, by Gerald Wright, QC.

ee also

*Dr John Bodkin Adams - suspected serial killer and the only previous British doctor tried for murdering his patients
*Dr Nigel Cox - British doctor convicted of attempted euthanasia in 1992
*Dr David Moor - British doctor acquitted in 1999 of murdering a terminally ill patient. Moor admitted in a press interview to having killed 300 patients over 30 years

References