Research helps define and improve the management of ‘medical manslaughter’ cases
Dr Oliver Quick is a recognised authority in Criminal Law and Medical Law, with a special interest in patient safety. His recent research has focused on how prosecutors and experts negotiate criminal law and process in these controversial cases.
A health care professional who delivers exceptionally bad treatment causing the death of a patient may be prosecuted for manslaughter by gross negligence. In 2006, the Journal of the Royal Society of Medicine published a paper by Ferner and McDowell which looked at the number of doctors charged with medical manslaughter between 1795 and 2005. A total of 85 had been charged, 38 of them since 1990. Of these 60 were acquitted, compared to 22 recorded convictions and three guilty pleas. Added to this, the test for gross negligence manslaughter has long been the subject of criticism for its vague, circular nature.
The Crown Prosecution Service (CPS) indicated it was willing to support new research seeking to better understand the data on these cases and the processes for managing them. Cases involving the apparent manslaughter by gross negligence of patients by medical professionals are amongst the most evidentially complex and sensitive dealt with by the CPS. No decision to prosecute is ever taken lightly, and charges will only be brought where there is sufficient evidence to give a realistic prospect of conviction, and where doing so would be in the public interest. This has become a highly controversial and sensitive area with recent examples highlighting the need to improve the efficient and transparent management of these ‘medical manslaughter’ cases.
In response to such cases, the General Medical Council set up the Independent Review of Gross Negligence Manslaughter and Culpable Homicide in Medical Practice, led by DrLeslie Hamilton with a working group that included ten experts from a range of relevant backgrounds, including Rosemary Ainslie, Head of Special Crime at the Crown Prosecution Service. The Review considered gross negligence manslaughter and culpable homicide in relation to the perceived vulnerability of the medical profession to these criminal charges. The aim of its recommendations was to encourage a renewed focus on a just culture, reflective practice, and individual and systemic learning.
Dr Oliver Quick is a recognised authority in Criminal Law and Medical Law, with a special interest in patient safety. His recent research has focused on how prosecutors and experts negotiate criminal law and process in these controversial cases. In 2018 Oliver won ESRC Impact Acceleration Account funding for a Knowledge Exchange (KE) secondment to the SCCTD, to spend time with Rosemary Ainslie and her team of specialist prosecutors. This included facilitating close discussions with the most senior lawyers and policy officials within the Unit, considering how the criminal justice system may improve efficiency and transparency in the management of these cases.
The KE secondment project delivered its twin objectives of better understanding the current arrangements for handling medical manslaughter cases and identifying ways of enhancing efficiency. The value of Oliver’s input was reflected in the fact that CPS invested significantly more time than originally planned in the project in providing additional data, as well as in lengthy meetings to discuss the project findings and identify ways of improving the understanding of the processes for handling these cases. This enabled Oliver both to explore and increase the impact of his research, and to work with the CPS to identify ways of improving the efficient and transparent handling of such cases. This work has been published by the University of Bristol Law Research Paper Series.
Overall, his work actively informed and influenced both the Independent Review and the CPS guidance published subsequently. The Independent Review’s Report was published in June 2019, and included 29 recommendations for a range of organisations across the UK, covering local, coronial, criminal and regulatory processes. The Offence-specific Guidance for the Crime of Manslaughter by Gross Negligence was published by the CPS in March 2019.
Oliver said, “The publication of this guidance is a significant outcome … and may be considered a major piece of impact evidence for this project.”