Dr David Richmond, RCOG President, writes…
The RCOG has been silent for a year on the decision, in March 2014, to prosecute Dr Dhanuson Dharmasena, wrongly accused of carrying out FGM during his care of a woman in labour. The case was sub judice and it was important to allow the CPS case to run its course. Now the jury has decided, the judge has ruled and common sense has prevailed. Dr Dharmasena has been acquitted of the very serious charges against him. Every single professional I have encountered in the last 12 months was astonished at the prosecution of this young doctor but assumed, wrongly it transpires, that the CPS must have strong evidence. Dr Dharmasena was a junior doctor providing emergency obstetric care to save the baby of a young mother in labour who had suffered FGM as a young girl. He was doing, to the best of his ability, what obstetricians do every hour of every day.
Every member of this College abhors FGM as the very serious abuse of girls and young women. We must do everything we can to end this obnoxious practice. But this was the wrong prosecution at the wrong time of the wrong individual. It has generated an enormous degree of anger at the process, sympathy for the patient and concern for the trainee involved. It is difficult to understand how a case that took a year to bring to court was so flimsy that it took the jury less than 30 minutes to dismiss.
Unfortunately that isn’t the end of the story for Dr Dharmasena who will now be investigated by the General Medical Council, with different procedures and degrees of proof. However, this is not just about one junior doctor: obstetricians and midwives face similar scenarios daily and have now to manage the clinical complexities caused by FGM wondering if they will be the next to be accused of offences against women they are trying to help.
Dr Dhanuson Dharmasena is innocent. In an emergency situation, having never met the pregnant woman, he acted to save the life of a baby. In the heat of the moment some of his clinical decisions may, with hindsight, be regarded as wrong choices. But that’s what happens in medicine. We try our best in very difficult circumstances and sometimes we don’t get it right. But obstetricians – indeed all clinical staff – must be able to exercise their clinical judgement to provide safe, high quality care for the women they serve without the shadow of prosecution.
FGM is illegal and it is abhorrent. This College has taken a very strong line in condemning the practice and working with national and international organisations to tackle FGM wherever it is practised. Sadly, this year-long prosecution has put back action against FGM, as many organisations awaited its conclusion. I cannot believe that was what the DPP intended. Nor do I believe that prosecuting Dr Dharmasena was, in any sense, in the public’s interest.