MEDICAL FRAUD and the criminal assault of boys
Letter regarding the Coroner's findings on the death of Ryleigh Roman Byron McWillis who bled to death after a non-therapeutic circumcision at the Vancouver, B.C., Children's Hospital on August 22, 2002.
Office of the General Counsel
Doctors Opposing
Circumcision, (D.O.C.)
1727-14th Ave., Suite 18 Tel/ fax: 206. 568. 0566 cell 206. 465. 6636
Seattle, Washington 98122 E-mail: kiwijohn2@cs.com
"Fear, pain, crippling, disfigurement and humiliation are the classic ways to break the human spirit. Circumcision includes them all."
January 26, 2004
(Letters addressed to: )
Ministry of Public Safety, - BC Coroner's Services
College of Physicians and Surgeons of BC - Complaints Section
Office of the Solicitor General - The Honourable Rich Coleman
Dr. John Turner, President .. BC Medical Association
Dear Chief Coroner and Honorable Rich Coleman:
We have read with alarm the BC Coroner’s 19 January 2004 findings on the death of Ryleigh Roman Bryan McWillis, DOD 22/8/02, the 1-month old who bled to death after a non-therapeutic circumcision at the Vancouver, BC, Children’s Hospital, an accounting 17 months tardy.
Our international physician’s organization is shocked at the BC Coroner’s astonishingly bland recitation of facts which collectively establish, on their face, gross ethical lapses and criminal negligence by the medical practitioners involved that surely call for recommendations and referral to the Solicitor General.
The Coroner’s failure to make a recommendation more stern than a mere call for ‘better communication with parents’ does a shabby disservice to the memory of this child, whose life was forfeit only by unethical medical behaviour, and whose death from an unnecessary surgery was itself completely unnecessary and pointless.
Your coroner apparently failed to note the following, which I list merely to ease reading:
Circumcision is an unethical, non-therapeutic procedure the child does not need and would not likely have chosen for himself. Your own medical authorities have asserted as much. The proper physician response upon a parental request is NOT to say, "I will do it if you insist, but think it ill-advised," a disingenuous endorsement.
The proper response is, "The child is my only patient and I see no medical need for surgery here, and no need to risk his life to make a quick $200; I decline; I need to protect my patient."
With no arguable medical benefit, what happened to Ryleigh is pure assault, battery and manslaughter.
2.) We have little doubt the physician is continuing to circumcise children the day you receive this letter, as it is fast, lucrative, simple, and habit-forming. The patient can hardly complain or resist, and, with the assistance of your office, these physicians have no reason to fear any professional sanction whatsoever, even if, apparently, a patient dies. Every death or injury will be ‘an accident.’
3.) It is clear from the narrative that the parents were not told death was a genuine risk; they are better informed now, but what does that avail Ryleigh?
4.) At no time did the first physician order simple blood tests that might have showed contraindications, as the parents clearly mentioned the family history of a blood disorder. The child clearly had delayed capillary refill time, over 2 seconds. Why was that fact, demonstrated to the physician by the parents, not enough to put the physician on notice?
Entirely too conveniently, that evidence is now spoliated. What was the big rush that those simple, inexpensive, blood tests could not have been ordered and reviewed prior to his circumcision?
5.) It is clear the parents were not told that an infant can die of hypovolemic shock with the loss of as little as 3oz (80ml) of blood, 20% of total infant volume, an amount so small it can easily be absorbed within a single disposable diaper, without exterior stain. This amount would only be alarming to a pediatric professional. Were they told that fact? Pouring 80ml of Merlot into a disposable diaper would have been an inexpensive demonstration. Where was the parent training about infant blood loss?
6.) Gomco clamp fumbles — these clamps are notorious for bending, warping and mismatched parts of different sizes and makes, and there have been clear warnings about this world-wide. A warped clamp, the wrong mating parts, or one with stripped threads, creates a poor crush and limits haemostasis. The coroner mentioned nothing about this potential for injury and negligence, though he discussed the circumcising doctor’s confusion during the procedure with several different clamp components. What actually happened?
7.) It is manifestly clear there is total patient abandonment when medical providers hand back the infant so soon after surgery with the vaguest, most inadequate advice for post-op care to the parents. Would it make any actual difference if Ryleigh had stayed at the hospital, the staff had gone home, and the night janitor was told to check on him occasionally? How does having the family, without proper instruction, observing Ryleigh at home, improve his odds of survival? Does parental love imbue them with better medical judgement than strangers?
This physician relied wholly on luck and the recuperative powers of this child’s body, to the peril of his patient.
8.) The ER physicians had an obligation to inquire about all facts that would establish the blood loss quantum. Where was their careful inquiry of the parents?
9.) Your coroner mentions ‘normal penile tissue’ found at autopsy. After circumcision that could hardly be the case, which rather calls into question his entire analysis. Why was there no discussion of, or elimination of the possibility of, a severed frenular artery, the usual cause of such bleeding, easily fixed by timely ligation, and discoverable on timely autopsy?
10.) Where, in point of fact, was any ethical suggestion that this child was fundamentally, legally, entitled to his normal, intact, functioning, healthy body – and freedom from unnecessary ‘medicine’? Was this not risky, non-therapeutic, cultural, conformist surgery that he did not need, which could easily wait for actual therapeutic need, and to which only he should give consent at an appropriate age?
11.) CRIMINAL LIABILITY—Section 45 of the Canadian Criminal Code clearly states:
45. Every one is protected from criminal responsibility for performing a surgical operation on any person for the benefit of that person if: [Where was the ‘benefit’ to Ryleigh of a non-therapeutic procedure? We thought the Supreme Court of Canada had decided that the child’s best interests trumped the parent’s wishes: C.M., Appellant, v. Catholic Children's Aid Society of Metropolitan Toronto and the Official Guardian, Respondents, Indexed as: Catholic Children's Aid Society of Metropolitan Toronto v. M. (C.), File No.: 23644., 1993: December 7; 1994: May 5.]
(a) the operation is performed with reasonable care and skill; and
[Res ipsa loquitor suggests the bleeding was due to negligence in pre-op screening or surgical technique, not the fault of the child or his guardians].
(b) it is reasonable to perform the operation, having regard to the state of health of the person at the time the operation is performed and to all the circumstances of the case.
[Upon the mention of a possible blood disorder, the physician was on notice of an unusual, contraindicative ‘state of health’ of Ryleigh, which only required cheap, easy testing to discern.]
12.) A simple legal test may be of service to the Solicitor General:
SCENARIO A)--A convenience store clerk offers to circumcise an infant for $25, "to save the family some money." He has read how to do it on the Internet. CHILD BLEEDS TO DEATH.
SCENARIO B)--A physician agrees to circumcise a healthy infant "because the family asked me to." CHILD BLEEDS TO DEATH.
What is the legal difference if the College and Physicians and Surgeons of BC, and all relevant world medical societies, no longer considers circumcision ‘medical care’?
What difference does a medical license make when there is NO potential therapeutic gain?
You would charge the clerk with manslaughter but tell the physician to ‘be more careful next time’?
What actually killed Ryleigh was the circumcising physician’s fundamental ethical failure to ask himself: 1) who is my actual patient and, 2.) what are his current, conservative, medical needs.
This was assault and manslaughter after that, as your own medical ethicists have suggested.
You have a much longer way to go to explain this death than casual miscommunication –– a very long way – as this entire surgery was non-therapeutic and unethical. Saying it was ‘accidental’ as if Ryleigh were hit by lightning, only eliminates intentional death —ex., murder. But here we are talking about manslaughter by cumulative lack of medical ethics, and numerous counts of obvious criminal negligence, from the initial patient contact and thereafter.
I suggest that Ryleigh’s Roman Bryan McWillis’ memory deserves much better than this sweep-it-under-the-rug cavalier endorsement of a procedure that was unethical ab initio, from the very beginning, and arguably an assault under the Canadian Criminal Code.
A better autopsy conclusion would have been "death by exsangination, secondary to an unethical, non-medical, unnecessary procedure whose benefit could not possibly have exceeded the risk undertaken, (a risk, alas, realized) performed without the decedent’s consent."
This was no accident.
Please share with our world-wide members your further efforts to seek justice for this tiny lad, whom everyone has abandoned and written off, but whom we at Doctors Opposing Circumcision will not soon forget.
Sincerely yours,
John V. Geisheker, JD, LL.M.
Attorney at Law
General Counsel
Cc: All D.O.C. Executive Board Physicians
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