PUBLISHER'S NOTE: The now-defunct disastrous 'Motherisk' program at Toronto's Hospital for Sick Children raises questions which go to the heart and soul of the revered institution - and those who run it. What motivated the hospital to initially defend the program so aggressively and to conceal its defects, and its nightmarish consequences from the press? Was it the the desire to continue attracting famed practitioners and researchers (reputation), to secure wealthy benefactors (prestige), and to raise massive funds (money)? Why didn't the hospital play it straight with the public by telling the truth - and closing the lab down as soon as the defects became apparent. Similar questions were raised by the Charles Smith saga, where so many innocent parents and caregivers may have been their spared nightmarish experiences if the hospital had removed Smith as head of the hospital's forensic pediatric pathology unit at that early stage when his incompetence began surfacing? As the late Peter Kormos, a wonderful, passionate, civic-minded veteran MPP told the legislature:
"Smith didn't work in a vacuum. What about the coroner? Wasn't the
coroner's office concerned? During the course of, if not the first or
the second or third of those 24 years, at least well into the 15- and
20-year range, wasn't the coroner's office a little concerned about how
effective Smith was at providing evidence that supported the crown's
case and didn't support the defence argument? What about his colleagues?
What about other pathologists? What about other people in the medical
profession? What about the Hospital for Sick Kids, who kept him in their
employ?" These 'nature' of Sick Kids was directly addressed by Toronto lawyer Sharon Shore - long before the Motherisk scandal erupted - in her book
"No Moral Conscience: The Hospital for Sick Children and the Death of Lisa Shore, published by Trafford Publishing in 2004. (As set out on the back cover to Shore's book: "Why did Lisa die? When her parents brought 10-year-old Lisa Shore to a world renowned children's hospital for treatment of non-life threatening pain, they expected as any parents would, she would receive competent and compassionate care. Less than 12 hours later, Lisa was dead. The Hospital for Sick Children denied any responsibility, even after an inquest found that Lisa's death was a homicide. Unwilling to admit that two of its employees had been grossly negligent, the hospital and its lawyers instead tried to paint Lisa's mother as an obsessed fanatic intent on destroying the careers of two conscientious nurses.") As will be seen in his balanced, thoughtful and insightful review of Shore's book, professor Howard A. Doughty of Seneca College touches on several other revealing controversies involving the hospital: it's treatment of researcher Dr. Nancy Olivieri - and the events leading to the prosecution of nurse Susan Nelles for the alleged murder of babies in the cardiac care unit of the Hospital for Sick Children. Prof. Howard Doughty teaches cultural anthropology and political economy at Seneca College in Toronto, Ontario. ( He can be reached at howarddoughty@post.com). His review of
"No Moral Conscience: The Hospital for Sick Children and the Death of Lisa Shore" appeared in Issue 1 of Volume 9, of Seneca's "College Quarterly" in the Winter 2006 edition. I can't help noticing with dismay that the concerns about the hospital which Professor Doughty expressed a decade ago have been proven by Motherisk and intervening events - including the Charles Smith saga - to be still valid. I am grateful to the "College Quarterly" for permission to republish his cogent review.
Harold Levy: Publisher; The Charles Smith Blog;
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"The Toronto Hospital for Sick Children, known familiarly as “Sick
Kids,” is an institution with a deservedly excellent reputation for
patient care and for caring. It is one of the premier pediatric
institutions in the world. It is also, on occasion, a site of
controversy. Twenty-five years ago, the controversy centred on Nurse Susan
Nelles. A suspicious number of infants had died in the cardiac care
unit. Nurse Nelles was arrested and charged with four counts of murder,
although the prosecution let it be known that as many as two dozen
babies may have perished. The alleged victims were said to have died of a
massive overdose of the heart medication, digoxin. Nurse Nelles, as I
wrote in the Toronto Star at the time, was
brought under suspicion because of her demeanor. When accused by police
of the alleged murders, she immediately (as they say on “Law and Order”)
“lawyered up.” Other nurses, when confronted, tended to react by
weeping and protesting their innocence. Nurses Nelles, a pretty, petite
blonde, calmly asked to speak to an attorney. That seemed to be all the
evidence that was needed. Why would she need a lawyer if she were
innocent? In time, a sensible judge dismissed all charges. Not only was
there no evidence linking Nurse Nelles to the crime, there was scant
evidence that a crime had been committed at all, for the test used to
reveal the large quantities of digoxin was “experimental” and had a
history of delivering false positives. It is notable that the nursing
staff displayed extraordinary solidarity and blamed hospital policies
for the entire mess. The hospital denied any responsibility. In the end,
the only real victims may have been Nurse Nelles, her father (a
physician who died during the ordeal, possibly of stress related to his
daughter’s legal troubles), and the reputation of Sick Kids hospital. Ten years ago, the controversy centred on Dr. Nancy Olivieri. Her
case has become a lightning rod for discussions about academic freedom.
For those who are unfamiliar with the matter, Dr. Olivieri won a
contract with the pharmaceutical firm, Apotex, to conduct clinical
trials on a new product. The trials revealed some dangerous
“side-effects.” Concerned that harm might be done, Dr. Olivieri
published her findings, apparently contrary to a contractual stipulation
that Apotex had the right to veto any such publication. Several years
of disputation followed in which Dr. Olivieri suffered, among other
things, the loss of her position at Sick Kids and at the University of
Toronto. Academics and the public rallied to her cause insisting, on the
one hand, that researchers should be free to publish their work and, on
the other hand, that a doctor should not be punished for alerting the
public to a dangerous drug. It was widely believed that Sick Kids had
opted to protect its material interests and was prepared to sacrifice
Dr. Olivieri’s career rather than run afoul of the powerful drug
industry. In time, Dr. Olivieri was reinstated, but the damage done to
Sick Kids’ reputation was considerable. The case discussed in No Moral Conscience
is not yet eight years old. It concerns Lisa Shore, who would have been
turned nineteen this year. The book was written by her mother. It does
not pretend to objectivity, though it does claim to be accurate and
fair. It cries out for justice. I shall not rehearse the agonies—both physical and emotional—that
the child and her mother endured. It is enough to say that from her
initial treatment for a broken leg to her eventual death, Lisa Shore
experienced the worst a health care system can provide. From the outset,
Sharon Shore is direct and unrepentant in her claims that over an
eight-month period ending in death, the doctors and nurses kept up a
record of “stupidity, mistakes, indifference, incompetence and outright
negligence” made worse in some instances by “intentional and pointless
cruelty”. Lest this appear (as the staff at Sick Kids tried to make it
appear) to be an irrational lashing out by a grief-stricken mother who
experienced the worst parental tragedy—the needless death of a child—it
is important to add only that Sharon Shore’s allegations were upheld by a
coroner’s inquest and jury finding of homicide, and led to charges laid
by the Ontario College of Nurses. Throughout, says, Sharon Shore, Sick
Kids hospital and its legal counsel “never stopped trying to conceal the
truth.”.........Discerning a pattern in the three instances briefly outlined
here, the Nelles, Olivieri and Shore cases, is not immediately easy. An
inappropriate prosecution of an innocent nurse, a question of the
interpretation of research contracts and the ineffective criminal
prosecution of two nurses whom Sharon Shore accuses of gross
incompetence and negligence in the death of her daughter do not seem to
have a great deal in common. There is, however, at least one thread
joining them—the tendency of corporate structures to consider
institutional legal liability and public reputation to be more important
than the truth. Sick Kids hospital had a material interest in all three
cases and the truth has been at least the temporary victim. All would
have been better handled if the hospital administration had stood firmly
on the side of truth, admitted its mistakes, pressed for open
disclosure of research results, refrained from concealing errors and
refused to attempt to defend itself with malicious smear-campaigns
against its accusers as it did with Sharon Shore. I said at the outset that Sick Kids deserves its reputation for
excellence. Generally speaking, it does. But even the finest “world
class” institutions can be guilty of reprehensible behaviour when
revelations of isolated instances of misbehaviour are seen as greater
threats than honesty and accountability." Prof. Howard Doughty.
The entire review can be found at:
http://collegequarterly.ca/2006-vol09-num01-winter/reviews/doughty5.html
PUBLISHER'S NOTE:
Dear Reader. Keep your eye on the Charles Smith Blog. We are following this case.
I
have added a search box for content in this blog which now encompasses
several thousand posts. The search box is located near the bottom of
the screen just above the list of links. I am confident that this
powerful search tool provided by "Blogger" will help our readers and
myself get more out of the site.
The
Toronto Star, my previous employer for more than twenty incredible
years, has put considerable effort into exposing the harm caused by Dr.
Charles Smith and his protectors - and into pushing for reform of
Ontario's forensic pediatric pathology system. The Star has a "topic"
section which focuses on recent stories related to Dr. Charles Smith. It
can be found at:
http://www.thestar.com/topic/charlessmith
Information on "The Charles Smith Blog Award"- and its nomination process - can be found at:
http://smithforensic.blogspot.ca/2013/12/the-charles-smith-award-presented-to_28.html
I look forward to hearing from readers at:
hlevy15@gmail.com;
Harold Levy: Publisher; The Charles Smith Blog
