Category Archives: dogmatism

‘Dogmatism’ is enough to get you struck off

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Waney Squier is a consultant neuropathologist to the Radcliffe hospitals and honorary clinical lecturer at Oxford university. She has been a consultant neuropathologist since 1984, having trained at the Institute of Psychiatry and Great Ormond Street Hospital for sick children. Dr Squier is a member of the British Neuropathological Society and of the British Paediatric Neurology Association, and a fellow of the Royal College of Physicians and of the Royal College of Pathologists

Maoist England

British doctors, writes Dalrymple,

live in fear.

They

  • fear that their patients might sue them
  • fear to say what they think to their managers
  • fear that they might fall foul of the Crown Prosecution Service if one of their patients dies unexpectedly
  • fear to protest when they are subjected to absurd and meaningless bureaucratic procedures
  • fear the General Medical Council

The General Medical Council’s striking off the medical register of Waney Squier, the neuropathologist who gave evidence in trials concerning babies allegedly shaken to death by their parents,

will have sent shivers down the spine of many a medical expert witness in Britain. Among Dr Squier’s faults, apparently, were dogmatism and failure to give due weight to the opinion of her colleagues. Where are we, one feels like asking? The Soviet Union? Maoist China?

In the witness box, Dalrymple is

firm, not rigid or dogmatic. It is my colleagues who appear for the other side who are rigid or dogmatic. Not that we experts take sides, of course: we are merely assisting the court. We give scientific evidence; we do not make a case.

Dalrymple points out that

if medical experts are to be struck off because their evidence is deemed deficient in some way, there will soon be a deficiency of experts.

It is the duty of the courts

to sift the evidential wheat from the chaff, and in my experience they do it rather well — considering the imperfectability of man.

My hand shakes; I want to interrupt, to shout

Zeven Hoofdzonden (detail), attr. Jheronimus Bosch, c. 1485 or after. Museo del Prado

Zeven Hoofdzonden (detail), attr. Jheronimus Bosch, c. 1485 or after. Museo del Prado

Dogmatism, writes Dalrymple,

is the reaction of those who want to know best but suspect that the metaphysical foundations of their supposed knowledge are shaky. Ambiguity disturbs them: how can there be rational criticism founded on argument and evidence, when at the same time there is no disputing taste? The solution to the tension is to stand behind a stockade of indubitable truth.

The search for certainty

is much more important than the search for truth. I know a man, an eminent writer, who has changed his opinion many times in his long life, often by 180°, but never admits to having done so. He has held every successive opinion with angry intransigence. Challenges by people of another opinion make him turn red with rage: they do not merely differ from him in opinion, they are attacking him personally. It is not true that bigotry is the exclusive province of the ignorant and stupid; there is the clever and well-informed variety, the more dangerous because the less easily recognised.

Dalrymple does not exclude himself.

When someone expresses an opinion that is very different from my own, I often feel a mounting tension, though the subject may be one that, if I am honest with myself, is of little importance or consequence to me. Certainly it cannot harm me that someone thinks differently from me about it; yet my heart begins to beat wildly, and I am sure that my blood pressure has risen. I feel an excitation, I tell myself to keep calm but I don’t succeed; my hand shakes; I want to interrupt, to shout. I am not defending truth, but my opinion. Generally I succeed in controlling myself, but occasionally I do not, especially when my interlocutor is young. I immediately feel ashamed of myself afterwards; I even feel ashamed that, at my age, I am still so little capable of detachment.