We’re fans of the British professional liability system. Across the Pond, the loser pays the legal fees of the winner. Not surprisingly, there, medical malpractice cases are screened more diligently before going forward. The cost of getting it wrong is stiff.
So, what happened to the convicted Lockerbie bomber? His tale has nothing to do with medical malpractice, but everything to do with how “experts” can control the outcome of a legal case.
The background is familiar to most. The Libyan, Abdel Baset Al-Megrahi was convicted for his role in the bombing of Pan Am Flight 103 in 1988. That tragedy killed 270 people. Al-Megrahi was imprisoned where the pieces of the plane littered the landscape, in Scotland. He was sentenced to life in prison.
Al-Megrahi was diagnosed with metastatic prostate cancer. He appealed to be released on “compassionate grounds” arguing that he had less than three months to live. He was released on August 20, 2009, returned to Libya, and remains alive today.
What happened to three months?
All medical prognostication is subject to quirks of the body and nuances of disease. Fair enough. But, that’s not what appeared to happen here.
The August 6, 2010 Wall Street Journal reported “the prognosis was made by Andrew Fraser, a doctor who administers Scotland’s prison health service, and became the sole basis for Justice Secretary Kenny MacAskill’s controversial decision to set Megrahi free.”
“In his report, Dr. Fraser portrayed his conclusion as the outcome of a detailed consultation with Mr. Megrahi’s doctors and other specialists. But an examination of the report shows that one key group never explicitly assented to Dr. Fraser’s conclusion: the specialists from the U.K. National Health Service who treated Mr. Megrahi’s cancer.”
Apparently, Megrahi was scheduled to begin a course of chemotherapy at the time of his release. Being a candidate for such treatment likely signaled a prognosis with greater promise than three months.
As the Wall Street Journal reported, “The report appeared to put significant reliance on the observations of a primary care doctor who wasn’t a cancer or urology specialist.”
Further, “People familiar with the matter say the two urologists [Megrahi’s treating doctors] weren’t even consulted in the period leading up to the report, and didn’t offer any prognosis at all.”
The outcome of this process sparked international outcry. Physicians are all too aware of this process. When experts testify outside the scope of their expertise, the results often resemble a work of fiction, rather than an honest narrative of the medical story.