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Scottish Legal News: Orthodoxy on trial I: the pathogenesis of a diagnosis
Published 1 June 2021
David J Black
David J Black explores the dangers of orthodoxy in the first in a four-part medico-legal series.
Published 1 June 2021

David J Black explores the dangers of orthodoxy in the first in a four-part medico-legal series.
“Orthodoxy” wrote Bertrand Russell “is the death of intelligence”. Before placing this in a medico-legal context with specific reference to the 2009 case Fraser and another v The National Institute of Clinical Health and Excellence, consider the quandary of three anxious doctors gathered around the bed of a dangerously ill 67-year-old man fighting what appeared to be a severe attack of croup.
Two of the doctors were roughly his age. The third doctor, who was in his mid-thirties, had an inspired, if unorthodox, idea. With a simple tracheotomy procedure, the inflammation blocking the windpipe could be bypassed, and the patient might be saved. The problem was that it was December 1799, and the patient was George Washington, the nearest thing the secular United States had to a deity. Cutting his throat may well have saved his life, but the outcome, had the operation gone wrong, would not have been such a good one for the three Scots-American physicians concerned.
In the event Surgeon-General William Craik, the President’s brother-in-arms who had known him all his adult life, and Doctor Gustavus Brown, his neighbour from the other side of the Chesapeake, over-ruled Dr Elisha Cullen Dick of Alexandria, whom they clearly regarded as their junior............