Wrongful conception – the latest weapon in culling disability?
by Dr Rick Thomas, Christian Medical Fellowship:
At the end of November, in the High Court, the case of Toombes v Dr Philip Mitchell was heard before Rosalind Coe QC, acting judge.
The claimant, 20-year-old Evie Toombes, sued her mother’s GP, Dr Mitchell, on the grounds of her own wrongful conception. Had her mother been given the appropriate advice at the time, namely, to take folic acid supplements before getting pregnant as well as during the first trimester, she would have postponed getting pregnant until her folate levels were optimal. She would therefore have given birth to a genetically different child from Evie, it was claimed.
Evie was born with a rare form of neural tube defect, known as lipomyelomeningocele (LMM). She suffers from a neuropathic bladder and bowels, gut motility issues and weakness of her lower limbs. She requires frequent self-catheterisation and is fed via a nasogastric tube and parenteral nutrition via a Hickman line.
The ruling
Unlike more common forms of Spina Bifida, the incidence of LMM is not reduced by folic acid supplements in pregnancy. But causation was not at issue in the hearing. The judge had to decide between conflicting recollections of the pre-pregnancy consultation. She found Evie’s mother’s account more credible than that of the GP, Dr Mitchell. He unsurprisingly had no clear recollection of the conversation some 20 years previously. Relying upon his brief note in the medical record, he assumed that he would have given his standard advice at the time – that folate supplements were optional for patients on healthy diets. His note was found to be inadequate, and his standard advice somewhat short of that recommended in the BNF and the Practical General Practice textbook of the time. The judge took the view that, had she received appropriate advice, Evie’s mother would have delayed becoming pregnant and, on the balance of probabilities, would subsequently have given birth to a ‘normal’, healthy child. Evie was awarded damages in an amount yet to be confirmed but sufficient to cover her considerable healthcare requirements for as long as she lives.
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