GP advice on ‘natural therapies’

Medical Board of Australia v Nuttall [2017] WASAT 58 is a recent disciplinary decision giving rise to a professional misconduct finding.  One aspect of interest arises from the parent of a child (for whom chemotherapy had been recommended) telling the doctor that the parents provided the child with ‘natural remedies’ consisting of a diet of fruit, vegetables and herbs and the application of mud or clay to the child’s body: [41].

The doctor (at hearing) conceded that he said ‘whatever you are doing, keep doing it‘ (at [73]) which the Board contended constituted an express or implied approval of the parents treating the child’s diagnosed cancer with fruits, vegetables, herbs and the application of mud or clay to her body: [74].

The doctor also provided a ‘fitness to fly’ certificate to assist the parents to take the child overseas (at [84]).

At [123] – [126] the Tribunal commented:

There was no evidence that the (parents) natural therapies were working. When (the doctor) was questioned as to whether he knew that the natural therapies could not possibly cure the Patient’s cancer, (the doctor) answered ‘The single answer is I didn’t know it couldn’t’. That was an extremely flippant answer. Here was a Patient who required urgent medical attention. Here was a doctor ignoring scientific based treatment in favour of what at best he could describe, as treatment that he did not know that it could not cure the Patient’s cancer ­ a double negative.

… The circumstances required (the doctor) to take care not to give any advice about the Patient’s disease that he was not qualified to give, to avoid giving the (parents) false hope by giving advice that was wrong or advice which misled them as to the efficacy of their alternative treatments and to avoid any action that would reinforce their reluctance to consider chemotherapy and which expressly and/or tacitly supported their decision to take the Patient to El Salvador.

(The doctors) conduct fell substantially below the standard reasonably expected of a medical practitioner of an equivalent level of his training or experience.

The Tribunal found that the doctor behaved in a way that constitutes professional misconduct for the purposes of s 193(1)(a)(i) of the Health Practitioner Regulation National Law (WA) Act 2010, in that he should not have given (specified) advice and he expressly or impliedly approved of the parents providing alternative therapies to the child and/or expressly or impliedly recommended that they continue to administer natural therapies to the child.

A coronial inquest had previously reported on the death of the child.



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