Chiropractor A is a well respected paediatric chiropractor with over 20 years experience. She was charged with a number of allegations including instilling fear in the parents of Baby A by advising them that their baby was missing four primitive reflexes and might suffer learning difficulties later in life if they weren’t addressed. It was also alleged that she encouraged the baby’s parents to lie to their GP in order to delay a vaccination appointment in preference of chiropractic treatment. Jonathan was instructed by Alex Lane and John Williams of Bankside Law. Chiropractor A was cleared of all allegations and found not guilty of unacceptable professional conduct.
This was an interesting case in that it involved not only chiropractic expert evidence but also medical evidence from a paediatric consultant. One of the issues that arose was the effect of torticollis (restricted head rotation and position) on the reliability of the primitive reflex tests. Another issue was the extent of any link between plagiocephaly (flat head syndrome) and learning difficulties later in life.
Many of the facts in this case were disputed. Chiropractor A did not accept that she told the parents that the missing reflexes were a cause of concern. On the contrary her evidence was that she advised the parents that there was nothing to worry about and that she expected the reflexes to normalise once the torticollis had resolved. Further she disputed that she had aroused fear in the parents by suggesting the reflexes were linked to learning difficulties. Chiropractor A also disputed that she had advised the baby’s parents to lie to their GP in order to cancel a vaccination appointment or that she had encouraged them to delay or cancel the baby’s immunisations.
Clearly this was a case that turned almost exclusively on the facts. It is very common in regulatory proceedings for there to be a direct conflict in the evidence between that which the patient remembers and that which the practitioner recalls. In such cases, credibility is the central issue.
There are a number of ways that committees can resolve factual disputes:
- They might decide that a witness is deliberately lying in which case it is easy to dismiss their evidence.
- They might conclude that taking into account all that they have heard they prefer the evidence of one witness over another.
- They are entitled to find that whilst on the one hand a witness is credible and trying their best to assist them, they are also confused or conflating their recollection of events.
- More unusual but also acceptable is when both witnesses appear to be credible and the committee simply cant decide which version of the facts they prefer. Whilst committees are encouraged to resolve factual disputes, particularly where there are direct conflicts in the evidence, occasionally they cant. In these circumstances committees must remind themselves that the burden of proving the case will always be on the council and if they have not discharged that burden then the case is not proved.
Whichever of these decisions a committee makes when resolving factual disputes, good character is a crucial component to a registrant’s case. The fact that a practitioner has never had a complaint of a similar nature goes a long way when assessing both their credibility and the likelihood of them acting in the way that is alleged. Character references should be varied and numerous when credibility is in issue. It is of course also important that the character references set out that they are aware of the allegations for their evidence to hold any real weight. It is common for character evidence to also include examples of usual practise. This can be very useful when arguing propensity.
In this case, chiropractor A was able to advance a considerable number of character references that spoke very highly of her both in terms of her integrity, general skills and her communication ability. These references had a considerable impact on the case and were referred to throughout the committee reasons.