Arthur Henry Douthwaite
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Arthur Henry Douthwaite (13 February 1896 – 24 September 1974) was a British medical doctor, Vice President of the
Royal College of Physicians The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...
Ockham's Razor - 23 July 2006 - The Strange Case of Dr John Bodkin Adams
/ref> and a prolific medical
textbook A textbook is a book containing a comprehensive compilation of content in a branch of study with the intention of explaining it. Textbooks are produced to meet the needs of educators, usually at educational institutions. Schoolbooks are textboo ...
writer. He was described as the foremost expert on
heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...
in Britain in the 1950s,Cullen, Pamela V., ''A Stranger in Blood: The Case Files on Dr John Bodkin Adams'', London, Elliott & Thompson, 2006, or as a leading authority on opiatesDevlin, Patrick. ''Easing the passing: The trial of Doctor John Bodkin Adams'', London, The Bodley Head, 1985. and he was called as an
expert witness An expert witness, particularly in common law countries such as the United Kingdom, Australia, and the United States, is a person whose opinion by virtue of education, training, certification, skills or experience, is accepted by the judge as ...
for the prosecution in the trial of Dr John Bodkin Adams for the murder of Mrs Edith Morrell.


Career

Douthwaite was a senior
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
at
Guy's Hospital Guy's Hospital is an NHS hospital in the borough of Southwark in central London. It is part of Guy's and St Thomas' NHS Foundation Trust and one of the institutions that comprise the King's Health Partners, an academic health science centre. ...
,The teacher who influenced me
/ref> and an Honorary Physician at All Saints' Hospital for Genito-urinary Diseases. Douthwaite was Britain's foremost expert on dangerous drugs, and was instrumental in dissuading the Home Office from banning
heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...
for medical use. Dr Douthwaite was greatly respected for his diagnostic skills. One story told of how he had walked into the
casualty Casualty may refer to: *Casualty (person), a person who is killed or rendered unfit for service in a war or natural disaster **Civilian casualty, a non-combatant killed or injured in warfare * The emergency department of a hospital, also known as ...
department in his usual morning dress and greeted the casualty officer, "I am Arthur Henry Douthwaite and I have just perforated my
duodenal ulcer Peptic ulcer disease (PUD) is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower esophagus. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines ...
, please arrange my admission." According to the story, he had.


Bodkin Adams trial

In 1957 Douthwaite gave evidence as an
expert witness An expert witness, particularly in common law countries such as the United Kingdom, Australia, and the United States, is a person whose opinion by virtue of education, training, certification, skills or experience, is accepted by the judge as ...
at the trial of Dr John Bodkin Adams for murder. The basis for this trial was described at the time by the trial judge, Mr Justice Devlin as: "It is a most curious situation, perhaps unique in these courts, that the act of murder has to be proved by expert evidence". Douthwaite had been a member of the prosecution team since December 1957 when, together with the pathologist Dr
Francis Camps Francis Edward Camps, FRCP, FRCPath (28 June 1905 – 8 July 1972) was an English pathologist notable for his work on the cases of serial killer John Christie and suspected serial killer John Bodkin Adams. Early life and training Camps was bo ...
, he had assured the Attorney General,
Melford Stevenson Sir Aubrey Melford Steed Stevenson (17 October 1902 – 26 December 1987), usually known as Sir Melford Stevenson, was an English barrister and, later, a High Court judge, whose judicial career was marked by his controversial conduct and ...
and the Director of Public Prosecutions that the amounts of opiates prescribed for Mrs Morrell were fatal beyond doubt, and he also gave evidence to this effect in the
Committal hearing In law, a committal procedure is the process by which a defendant is charged with a serious offence under the criminal justice systems of all common law jurisdictions except the United States. The committal procedure, sometimes known as a prelim ...
.Robins, Jane. ''The Curious Habits of Dr Adams: A 1950s Murder Mystery''. London, John Murray, 2013. Devlin commented that, having assured the prosecution of the soundness of his opinion, he was determined to stand by it in the trial. Adams had been arrested the previous year for the murder of two widows, Gertrude Hullett and
Edith Alice Morrell Edith Alice Morrell (20 June 1869 – 13 November 1950) was a resident of Eastbourne, East Sussex, England, and patient of Dr John Bodkin Adams. Although Adams was acquitted in 1957 of her murder, the question of Adams' role in Morrell's death ...
. He was tried for the murder of the latter and the prosecution, led by Sir Reginald Manningham-Buller, alleged that he had killed her with excessive doses of
heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...
and
morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a analgesic, pain medication, and is also commonly used recreational drug, recreationally, or to make ...
. Douthwaite and Michael Ashby were the prosecution's key expert witnesses. However, while Ashby was hesitant as to whether Adams had definitely intended to kill Mrs Morrell, Douthwaite was adamant that there was no doubt that Adams had intended her death. At times Douthwaite's testimony seemed overconfident and even arrogant, and it only succeeded in alienating the
jury A jury is a sworn body of people (jurors) convened to hear evidence and render an impartiality, impartial verdict (a Question of fact, finding of fact on a question) officially submitted to them by a court, or to set a sentence (law), penalty o ...
and the
judge A judge is a person who presides over court proceedings, either alone or as a part of a panel of judges. A judge hears all the witnesses and any other evidence presented by the barristers or solicitors of the case, assesses the credibility an ...
. At the start of his cross-examination, Douthwaite accepted the gravity of the murder charge against Adams, but claimed that he could think of "no legitimate reason" for Adams' to prescribe opiates, and could only surmise that it suggested "a desire to terminate life". He admitted later in that cross-examination that his evidence at the committal hearing was given without knowledge of Mrs Morrell's treatment in the first 18 months after her stroke, only that in the last 10 months before her death, and was based the assumption, later shown to incorrect, that she had been in a coma for the last three or four days of her life.British Medical Journal, The. ''Trial Of Dr. J. Bodkin Adams: Expert Evidence.'', London, No 5012, 1957. Leading defence counsel,
Frederick Geoffrey Lawrence Sir Frederick Geoffrey Lawrence QC (5 April 1902 – 3 February 1967) was a British lawyer, High Court Judge, Chairman of the Bar Council and Chairman of the National Incomes Commission.Cullen, Pamela V., ''A Stranger in Blood: The Case File ...
also secured an admission from Dr Douthwaite that, in his examination-in-chief, his evidence on possible
withdrawal symptoms Drug withdrawal, drug withdrawal syndrome, or substance withdrawal syndrome, is the group of symptoms that occur upon the abrupt discontinuation or decrease in the intake of pharmaceutical or recreational drugs. In order for the symptoms of with ...
was in response to instances selected by the Attorney-General that might not have been representative. When questioned as to whether this procedure was fair or not, Douthwaite argued that it was up to the defence to question him on that point and not his duty to comment on fairness. Douthwaite also accepted that it was be essential to his theory of an intentional killing that Adams knew that opiates would accumulate in the body of an elderly immobile patient. Douthwaite was also criticised by Lawrence for what seemed to be a change in his hypothesis half-way through the trial, when he selected a different date for when Adams had begun his attempt to kill Morrell. Lawrence put it to him thus:
"The truth of all this matter is this, Dr Douthwaite, that you first of all gave evidence on one basis to support a charge of murder and then thought of something else after you had started?"
Douthwaite replied:
"That is quite likely. In fact, I think it is probable. I had been turning it over in my mind but at what time it crystallised and became clear I do not know."
The historian Pamela Cullen defended Douthwaite, basing her defence on the hypothesis that Manningham-Buller had intentionally given up possession of vital evidence, the nurses' notebooks, which detailed Adams' treatment of the patient, adding that he actually gave them to the defence, which allowed defence
counsel A counsel or a counsellor at law is a person who gives advice and deals with various issues, particularly in legal matters. It is a title often used interchangeably with the title of ''lawyer''. The word ''counsel'' can also mean advice given ...
Frederick Geoffrey Lawrence Sir Frederick Geoffrey Lawrence QC (5 April 1902 – 3 February 1967) was a British lawyer, High Court Judge, Chairman of the Bar Council and Chairman of the National Incomes Commission.Cullen, Pamela V., ''A Stranger in Blood: The Case File ...
QC to present them on the second day of the trial. Douthwaite, she claimed, was therefore not able to examine these notebooks to prepare his evidence. However, copies of the notebooks were provided to the prosecution on the second day of the trial, and Douthwaite did not start to give his evidence until the seventh day, with a weekend intervening before he finished his evidence on the tenth day. Devlin, on the contrary, criticised the police for overlooking the nurses' notebooks: there is apparently no record that the notebooks were seized by the police, and no evidence that Manningham-Buller ever had possession of them. In any event, Douthwaite's new hypothesis did not relate to the qualities of opiates administered, so much as moving the date on which he considered the planning and execution of the act of murder began, from 7 November 1950 back to 1 November 1950. Douthwaite gave the impression that he was being inconsistent and changing his evidence speculatively, to avoid admitting he might be wrong. Devlin made a cogent criticism of the prosecution team, but aimed at Melford Stevenson rather than Manningham-Buller. This was that, as Douthwaite and Ashby were not experienced at being expert witnesses, they should have been warned to avoid speculation and prepared by the prosecution until their evidence was purged of uncertainties. The underwhelming impact of Douthwaite's evidence, coupled with defence witness
John B. Harman John Bishop Harman, FRCS, FRCP (10 August 1907 – 13 November 1994) was a British physician, president of the Medical Defence Union and chairman of the British National Formulary. He was also notable as a medical expert witness for the defence i ...
's evidence in favour of Adams and Ashby's refusal to rule out a natural cause for Mrs Morrell's death, helped secure Adams' acquittal. Douthwaite's performance at the trial however did not endear him to his fellow doctors, who resented his attempt to convict one of their peers. Douthwaite had previously been greatly respected within the profession, but his involvement is widely considered to have cost him the presidency of the
Royal College of Physicians The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...
. As Devlin later wrote in his account of the trial, the case was "a very important one for the medical profession, which was naturally worried by the thought that the prescription of drugs might lead to a charge of murder". Adams was only ever convicted on 13 counts of prescription
fraud In law, fraud is intentional deception to secure unfair or unlawful gain, or to deprive a victim of a legal right. Fraud can violate civil law (e.g., a fraud victim may sue the fraud perpetrator to avoid the fraud or recover monetary compens ...
, lying on
cremation Cremation is a method of Disposal of human corpses, final disposition of a Cadaver, dead body through Combustion, burning. Cremation may serve as a funeral or post-funeral rite and as an alternative to burial. In some countries, including India ...
forms, obstructing a police search and failing to keep a dangerous drugs register. He was removed from the
Medical Register The General Medical Council (GMC) is a public body that maintains the official register of medical practitioners within the United Kingdom. Its chief responsibility is to "protect, promote and maintain the health and safety of the public" by c ...
in 1957 and reinstated in 1961.


Publications

Douthwaite wrote many textbooks:Worldcat
/ref> *''The injection treatment of varicose veins'', London, H. K. Lewis, 1928 *''The treatment of rheumatoid arthritis'', London, H. K. Lewis, 1929 *''The treatment of chronic arthritis'', London, Cape, 1930 *''The treatment of asthma'', London, H. K. Lewis, 1930 *''A guide to general practice'', London, H. K. Lewis, 1932 *''The treatment of rheumatoid arthritis and sciatica'', London, H. K. Lewis, 1933 *''An Index of Differential Diagnosis of Main Symptoms'' (with Herbert French), Bristol, John Wright, 1945 (6th edition) *''French's Index of Differential Diagnosis'', Williams & Wilkins, 1960 *''The use of heroin'', S.I., 1956 *'' Materia medica, pharmacology and therapeutics'' (with Sir
William Hale-White Sir William Hale-White (7 November 1857 – 26 February 1949) was a British physician and medical biographer. He was the son of writer Mark Rutherford. Career Hale-White was appointed an assistant physician at Guy's Hospital in 1886, a physi ...
), London, Churchill, 1949, 1959, 1963.


References


External links


A description of Douthwaite's bedside mannerBMJ reporting of Douthwaite's evidence in the Adams trial
{{DEFAULTSORT:Douthwaite, Arthur Henry 20th-century British medical doctors 1896 births 1974 deaths British medical writers