Monday, 23 June 2014

Assisted Dying Bill and Dr Michael Irwin

MichaelIrwinDr Michael Irwin (photograph on the left, click on it to read more) worked as the medical director at United Nations. He is known for his humanitarian work in assisted dying which led to him being struck off medical register by the General Medical Council. He campaigned tirelessly for the right to die before and since. Now, new proposed changes (private bill by Lord Falconer) in law would mean that at least those with mental capacity and physical ability to take medication that would end their life would be able to do so if they have less than six months to live. Doctors would be allowed to prescribe such medication but not administer it themselves.
Dr Michael Irwin is a prominent member of the National Secular Society(NSS). Each year Irwin Prize, which he funds, is awarded to a prominent secularist.  Recently, NSS wrote about him HERE 
And here is the judgment by the General Medical Council to erase him from the medical register:
 
Fitness to PractiSe Panel
26 – 27 September 2005
Hearing Room 2, Regent’s Park, 350 Euston Road, London


Name of Respondent Doctor:       Dr Michael Henry Knox IRWIN

Registered Qualifications:              MB BS 1955 Lond

Registration Number:                      0014922

Type of Case:                                     New Misconduct/Caution

Panel Members:                                Professor K Hobbs, Chairman (Medical)
                                                               Mr R Bergman (Lay)         
                                                               Mr M Chapman (Lay)
                                                               Dr M Johnson (Medical)
                                                               Mrs L Lloyd (Lay)
                                                              
Legal Assessor:                                Mr R Hay    

Secretary to the Panel:                    Christine Challis

Representation:
GMC: Miss Alison Foster QC, instructed by GMCLegal represented the GMC

Doctor: Dr Irwin was present and not represented

allegation
A.

“That you were on 6 July 2004, at Guildford Police Station, cautioned for an offence, which you admitted, that on 18 October 2003 at Cranleigh in Surrey, had in your possession 30 20mg tablets of Temazepam, a controlled drug of class C, with intent to supply it to Mr PK.” Admitted and found proved

B.

“And that, being registered under the Medical Act 1983,

‘1.        On the dates specified in the allegations set out below, you were a UK registered medical practitioner; Admitted and found proved

‘2.        You were interviewed under caution by the Surrey and Sussex Police on 2 March 2004; Admitted and found proved

‘3.        At the interview under caution you admitted that,

a.         On 18 October 2003 and at Moss Pharmacy, Cranleigh, Surrey, you submitted a prescription for and obtained, in your own name and using your GMC registration number, 30 x 20mg tablets of Temazepam, Admitted and found proved

b.                  You travelled to Isle of Man on/about 19 October 2003 to visit
Mr PK, Admitted and found proved

c.         On your visit to the Isle of Man you had in your possession, a quantity of approximately 60 Temazepam tablets, which included the 30 x 20mg tablets obtained by you on 18 October 2003 at Moss Pharmacy, Cranleigh, Admitted and found proved

d.         You intended to supply Mr K with the quantity of Temazepam to assist him to commit suicide, Admitted and found proved

e.         i.          you also obtained travel-sickness tablets to provide to
Mr K to take with the Temazepam, Admitted and found proved

ii.         the travel sickness tablets would have assisted Mr K to hold down the Temazepam, which may otherwise have been difficult for him; Admitted and found proved

‘4.        You did not eventually supply to Mr K, the Temazepam that you had intended to supply to him, as he had become too ill to take it himself; Admitted and found proved

‘5.        On 6 July 2004, you accepted a caution from Surrey Police, for the offence of having in your possession with the intent to supply to Mr K, a Class C controlled drug, namely Temazepam; Admitted and found proved

‘6.        Your actions as set out at paragraphs 3.a., c., d. and e. above were,

a.         Unprofessional, Found proved

b.         Inappropriate, Found proved

c.         Irresponsible, Found proved

d.         Likely to bring the profession into disrepute; Found proved

[In reaching its findings in relation to allegations 6a, b, c and d, the Panel took into account the undisputed evidence that you obtained in your own name Temazepam, a Class C controlled drug, immediately before travelling to the Isle of Man intending to supply it to Mr K.  This was an act of deception.  Moreover, on 6 July 2004 you admitted an offence contrary to the Misuse of Drugs Act 1971 and, as a consequence, you were cautioned at Guildford Police Station. 

It is for these reasons that the Panel has found your actions in relation to allegations 3a, c, d and e to be unprofessional, inappropriate, irresponsible and likely to bring the profession into disrepute].

 ‘7.       You self-prescribed, during 2003, approximately 140 20mg tablets of Temazepam, using your GMC registration; Admitted and found proved

‘8.        At the interview under caution on 2 March 2004, you further admitted that,

a.         You had self-prescribed and obtained, using your GMC registration, 20 Temazepam tablets on 13 December 2003, being the day after your arrest, Admitted and found proved

b.         You had been self-prescribing Temazepam over a period of time, for the purposes of stockpiling it; Found proved

‘9.        On 25 January 2005, you self-prescribed and obtained, using your GMC registration, 30 x 20mg tablets of Temazepam, from Lloyds Pharmacy, Hove; Admitted and found proved

‘10.      On 31 January 2005, you self-prescribed and obtained, using your GMC registration, 30 x 20mg tablets of Temazepam, from Glaibyer and Kemp Dispensing Chemists, Hove; Admitted and found proved

‘11.      Your actions as set out at paragraphs 7. to 10. above were,

a.         Inappropriate, Found proved

b.         Irresponsible, Found proved

c.         Unprofessional;’ Found proved

[In reaching its findings in relation to allegations 11a, b and c, the Panel has taken account of your evidence that you self-prescribed Temazepam over a period of time with the intention of stockpiling the drug for your own use.  The Panel finds that the quantities self-prescribed were excessive.  Moreover, it is concerned that you kept these large quantities of Temazepam without secure storage arrangements.  Temazepam is a drug of addiction with a street value in the illicit drugs trade.  It is for these reasons that the Panel has found your actions to be inappropriate, irresponsible and unprofessional. ]




Determination on impaired fitness to practise

“Dr Irwin

The Panel has considered the submissions made by Miss Foster, your own comments to the Panel and the advice of the Legal Assessor.  The Panel has determined that your fitness to practise is impaired by reason of your misconduct and the Police caution.

The Panel found that the Police caution and your misconduct were sufficient for it to determine that your fitness to practise is impaired.  Indeed, the Panel regard either of these matters individually as serious enough to amount to impairment.

The Panel has referred to the May 2001 edition of ‘Good Medical Practice’; in particular it has noted the requirements that a medical practitioner must be honest and trustworthy and avoid abusing his position as a doctor.  Furthermore, paragraph 11 of the same edition states: “Some parts of medical practice are governed by law or are regulated by other statutory bodies.  You must observe and keep up to date with the laws and statutory codes of practice which affect your work”.  The Panel is of the view that you have been in breach of these requirements by committing the serious criminal offence of possessing Temazepam, a class C controlled drug with intent to supply.  This resulted in the Police caution. 

Furthermore, you admitted that you dishonestly self-prescribed this drug ostensibly for your own use when in fact it was intended for another. This, together with your repeated self-prescribing of supplies of Temazepam for the purposes of stockpiling for your own use against the advice of your general practitioner, amounts to an abuse of the trust placed in you as a doctor.  In all the circumstances, you have abused your position as a doctor.

The Panel will now invite further submissions from Miss Foster as to the appropriate sanction, if any, to be imposed on your registration.  Following Miss Foster’s submissions you will be given the opportunity to respond and to call any evidence if you wish to do so.

As is usual in these proceedings, the Panel will expect both parties to make reference to the GMC’s Indicative Sanctions Guidance when making submissions.“

Determination on sanction

“Dr Irwin

The Panel hereby revokes the order for the suspension of your registration made by the Interim Orders Panel on 3 February 2005.

On 6 July 2004 you were cautioned at Guildford Police Station for an offence under the Misuse of Drugs Act 1971.  You had admitted that on 18 October 2003 you had in your possession 30 x 20 mg tablets of Temazepam, a controlled drug of class C, with intent to supply it to Mr PK.

When you were interviewed under caution by the Surrey and Sussex Police on
2 March 2004 you admitted that on 18 October 2003 at Moss Pharmacy, Cranleigh, Surrey, you self-prescribed using your GMC registration number and obtained
30 x 20mg tablets of Temazepam, a class C controlled drug. 

You travelled to the Isle of Man on 19 October 2003 to visit Mr PK and you had in your possession, a quantity of approximately 60 Temazepam tablets.  You have admitted that you intended to supply Mr K with the Temazepam to assist him to commit suicide.  You also obtained travel-sickness tablets to provide for
Mr K to take with the Temazepam to facilitate his oral retention of the tablets.  In the event you did not supply to Mr K the Temazepam as he had become too ill to take it himself.

The Panel has found that your actions as set out above were unprofessional, inappropriate, irresponsible and likely to bring the profession into disrepute.

You also admitted that you self-prescribed, during 2003, approximately 140 20mg tablets of Temazepam, using your GMC registration.  At the interview under caution on 2 March 2004, you further admitted that you had self-prescribed and obtained, using your GMC registration, 20 Temazepam tablets on 13 December 2003, the day after your arrest. 

On 25 January 2005 and 31 January 2005, you self-prescribed and obtained from different pharmacies using your GMC registration, 30 x 20mg tablets of Temazepam on each occasion.   You issued the prescriptions immediately before the scheduled hearing of your case before the Interim Orders Panel on 3 February 2005. You had been self-prescribing Temazepam over a period of time, for the purposes of stockpiling it.

The Panel has found that your actions were inappropriate, irresponsible and unprofessional.

In all the circumstances, your actions fell well below the standard expected of a registered medical practitioner and the Panel determined that by reason of the Police caution and the above misconduct, your fitness to practise is impaired. 

The Panel has referred to the May 2001 edition of ‘Good Medical Practice’; in particular it has noted the requirements that a medical practitioner must be honest and trustworthy and avoid abusing his position as a doctor.  Furthermore, paragraph 11 of the same edition states: “Some parts of medical practice are governed by law or are regulated by other statutory bodies.  You must observe and keep up to date with the laws and statutory codes of practice which affect your work”.  The Panel has found that you have been in breach of these requirements by committing the serious criminal offence of possessing Temazepam, a class C controlled drug with intent to supply. 

Furthermore, you admitted that you dishonestly self-prescribed this drug ostensibly for your own use when in fact it was intended for another. This, together with your repeated self-prescribing of supplies of Temazepam for the purposes of stockpiling for your own use against the advice of your general practitioner, amounts to an abuse of the trust placed in you as a doctor.  In all the circumstances, you have abused your position as a doctor.

Medical practitioners have a duty to act honestly and within the law, and uphold the trust placed in them.  The matters before this Panel are serious and give rise to a clear and obvious risk to patients and could seriously undermine the confidence and trust that the public is entitled to place in the medical profession. 

The Panel was concerned also about your lack of insight into the seriousness of your actions and your lack of professional judgement. 

The Panel has considered the submissions made by Miss Foster on behalf of the GMC as to the appropriate sanction it should impose, your comments to the Panel and the advice of the Legal Assessor.  The Panel has also had regard to the GMC’s Indicative Sanctions Guidance and the GMC’s publication ‘Good Medical Practice’. The Panel is conscious of the fact that the purpose of sanctions is not to be punitive, but to protect patients and the public interest. Public interest includes not only the protection of patients but also the maintenance of public confidence in the profession, and declaring and upholding proper standards of conduct. 

In determining the appropriate sanction in your case, the Panel first considered whether it would be sufficient to place conditions on your registration.  In doing so it has had regard to the issue of proportionality and has balanced the interests of patients and the public interest against your interests. Any conditions would need to be appropriate, proportionate, workable and measurable. The Panel considers that your actions were so serious that it is insufficient, in the public interest, to impose this sanction. Further, the Panel considers that it would not be possible to formulate any appropriate conditions. 

The Panel then went on to consider whether it would be sufficient to direct that your registration be suspended.  Your actions amounted to a serious abuse of your position of trust. The Panel is concerned that you do not fully accept the seriousness and potential consequences of your actions for which you have expressed no remorse.  The Panel has also concluded that there would be no remedial value to a suspension of registration.

Your actions were:

  • A serious departure from the relevant professional standards set out in Good Medical Practice
  • An abuse of position of trust
  • Dishonest
  • An indication of persistent lack of insight

The Panel has therefore concluded that it would not be sufficient to suspend your registration.  Accordingly, the Panel has no alternative but to direct the erasure of your name from the medical register.

This means that, unless you exercise your right of appeal, this direction will take effect 28 days from when written notice of this determination is deemed to have been served upon you.  A note explaining your right of appeal will be provided to you.

Having reached a decision that your name should be erased from the medical register, the Panel is minded to consider whether your registration should also be suspended immediately. The Panel will now invite submissions from Miss Foster and then from you, Dr Irwin, on this matter.”

Determination on immediate sanction

“Dr Irwin

The Panel has considered the submissions made by Miss Foster as to whether or not the Panel should direct that your registration be suspended with immediate effect.  The Panel notes that you do not oppose this course of action.

In view of the serious nature of matters for which you received a Police caution and the findings in relation to your misconduct, the Panel considers that it is necessary, for the protection of members of the public, in the public interest and in your own interests, to exercise its powers under section 38 (1) of the Medical Act 1983, as amended.  The Panel has therefore directed that your registration shall be suspended with effect from today.

The effect of this direction is that your registration will be suspended from today.  Unless you exercise your right of appeal, the direction for the erasure of your name from the Medical Register as previously announced, will take effect on the expiry of the 28 day appeal period.

That concludes the hearing.”



Confirmed


October 2005                                                                                                    Chairman