Child Abuse 1: A brief account of Dr David Southall's research.

After further research, I think I am now in a position to join up the dots sufficiently to create a coherent narrative of David Southall's journey from medical research to the GMC's disciplinary committee. I do not claim this post is either an authoritative or exhaustive account and would, therefore, welcome any corrections or amplifications. However, I am satisfied that it is a coherent basic outline of events which clears up the major confusions I had when I first read of Professor Southall's case.

We are dealing with one small corner of a much wider field of medical research known as Sudden Infant Death (SID), or cot death. The sudden, unexpected death of a significant number of babies under the age of about one year old has long baffled medical researchers. In 1977, Professor Roy Meadow, claimed to have identified a pattern of behaviour in which some mothers deliberately harmed, or even killed, their children. Meadow labelled such behaviour Munchausen Syndrome By Proxy.

It will be convenient to deal with Meadow at this point. Despite its wholly theoretical nature, over the ensuing decades Munchausen Syndrome By Proxy became accepted as a proven fact by the medical community and was even used by the legal system to convict individuals of murdering their children. In other words, the legal yardstick of proof beyond a reasonable level of doubt was replaced by statistical probability, as determined by experts such as Meadow in so-called "expert testimony" to the court. Meadow's statistical evidence has since been discredited and some of the convictions have been recently squashed by the Appeal Court. Hopefully, it is doubtful that any similar convictions will follow or that Meadow, or any one like him, will be giving such so-called expert testimony in future.

Returning to the 1980s, to be fully accepted as valid, any scientific research has to be capable of being repeated ( in the jargon, replicated) in order to show the results were reliable and not a freak outcome. Meadow's work presented obvious difficulties in this respect, not least persuading potentially infanticidal mothers to allow themselves and their babies to be observed, to see if they were actually harming or killing their children. Here David Southall enters the story. As far as I can work out, Southall decided to solve this particular problem by installing surveillance equipment so he could secretly observe mothers and their babies. In itself, that raises serious ethical research issues relating to an individual's privacy but Southall did not stop there.

Southall kept records of his dealings with parents in secret files, known as SC, or Special Case, files. It is not entirely clear exactly what was in the SC files. The parents involved are still trying to gain full access but it seems probable that they detailed his suspicions of child abuse based on no evidence stronger than his opinion. Indeed, Southall seems to have seen Munchausen Syndrome By Proxy everywhere. Notoriously, after seeing a television programme, he accused Sally Clark of infanticide by MSBP, a piece of arrogance which, after Clark's aquittal on appeal, led to Southall's first visit to the GMC disciplinary panel, in 2004. For reasons known only to themselves, the GMC were content with a ruling that Southall should not be allowed to work in child protection for a period of three years. In its (pdf) response to the ruling, the Royal College of Paediatrics and Child Health seemed to be more concerned that doctors should be able to continue making unfounded allegations than with any miscarriage of justice for which Southall was directly responsible.

Opinion-based serious accusations are bad enough but there is more. As far as I can tell, Meadow's work, on which Southall's secret surveillance sought to build, only interpreted the observed behaviour of the mothers involved. In the mid 1980s, Southall decided to take the next logical step and attempt to identify any medical factors which might contribute to SID (cot death). A laudable aim but with obvious difficulties in finding a of supply babies in the act of dying, in order to measure their responses. Southall solved the problem through not asking for parental consent and simulating the required environment by depriving the babies of oxygen and feeding them CO2. These experiments were codenamed Protocol 85/02. According to John Hemming, MP, (23rd August 2006) who has taken an active interest in the case, Southall does not appear to have published any results from the case. It is most unusual for any research not be published but it seems a reasonable assumption that the results are hidden somewhere in the SC files. Southall appears to have continued this line of research into the 1990s, with the ethical approval of his hospital (scroll down to "Commentary: Ethical approval of study was warranted").

Despite the disturbing nature of Southall's experiments, as John Hemming has observed, (15 November 2006) the GMC seems to be more interested in other, "relatively minor issues rather than the major issue of doing harm to patients (particularly babies) through dangerous research." Those relatively minor issues relate mostly to Southall's manner of dealing with records. There, for the moment things stand, with Southall's GMC hearing in progress. If this post either saves other people time in piecing together what happened or introduces readers for the first time to the nightmare innocent individuals found themselves suffering, it will have served its intended purpose.

Tags: Child abuse, Child protection, David Southall, Medical research, Roy Meadow