GMC: harsh punishment is a sword of Damocles

The GP who didn’t refer a patient with suspected cancer symptoms early enough undoubtedly made a mistake.1 The patient was deprived of an opportunity for an earlier diagnosis that might have led to a better outcome.

The GP was said to have “had an otherwise unblemished record, and his practice at Askam-in-Furness was rated ‘good’ by the Care Quality Commission.” The question is whether every error by a doctor needs to be punished by suspension or erasure to “uphold the public interest in marking the seriousness of a doctor’s misconduct.”

A BMJ paper published in 2000 estimates that “in the United States medical error results in 44 000–98 000 unnecessary deaths each year and 1 000 000 excess injuries.”2 If one were to assume similar rates of medical errors in the UK, and if even a tiny proportion of such medical errors were regularly punished by suspension or erasure, many doctors would be practising medicine that is even more defensive with the “sword of Damocles” hanging over them every day.3

Although there is a need to punish doctors who persistently underperform, society also needs to decide whether honest mistakes by doctors with good insight should be punished harshly every time. Harsher punishments would certainly deliver justice to the victims, but society could be worse off with punitive justice.