Doctors Can Be Suspended For Giving “False Hope” To Patient, PM Lee’s One-Time Doctor Discovers

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Doctor Who Treated PM Lee Suspended For 8 Months

Dr Ang Peng Tiam, a veteran cancer specialist, once treated Prime Minister Lee Hsien Loong, but on Tuesday (June 27), he was suspended for professional misconduct.

But don’t worry, it wasn’t related in any way to the care that our PM received — his offence was in giving “false hope” to another patient over her cancer.

Yup, apparently being optimistic over a patient’s chances of survival, and being wrong, can get a doctor charged by the Singapore Medical Council (SMC).

Top Doctor

Dr Ang’s case came as a surprise to those who were familiar with his work, for he’s known to be one of the top in his field.

He’s the chief executive of medical oncology firm TalkMed, which runs Parkway Cancer Centre, and was even the principal doctor to Mr Lee in 1992 when the then Deputy Prime Minister was diagnosed with lymphoma.

Here’s a video profile of him:

70% Chance

But Dr Ang’s career hit a road bump when he was handed a notice of inquiry in April 2015.

He treated a 55-year-old woman with lung cancer back in 2010, and after assessing her condition assured her that there was a 70% chance that the disease would respond to treatment, and that then she could achieve control with chemotherapy and targeted therapy, reported Channel NewsAsia.

Dr Ang also noted that she had a fist-sized tumour, thus he did not see fit to offer her a surgical option.

Unfortunately, the cancer soon spread from the lungs to other parts of her body, and she passed away 6 months later.

The patient’s 2 daughters then brought the matter to the SMC, which then levelled four charges of professional misconduct against Dr Ang.

Source

Defence Thwarted

Dr Ang only managed to get 2 of the 4 charges thrown out, and was fined $25,000 by a tribunal convened by the SMC.

He appealed the verdict before the Court of Three Judges but failed, and the fine was substituted with an 8-month suspension, reduced from 16 months because of the “inordinate delay” in serving Dr Ang the notice of inquiry.

False Hope

He had argued that the patient had possessed 4 key characteristics, one of which was her abstinence from smoking, which significantly increased her chances of responding to treatment. 

The doctor also claimed that a tumour of that size might not be completely removed through a surgical procedure — thus surgery had not been a viable option.

However, SMC’s lawyer Melanie Ho argued that the “70% chance” could only be deduced using a specific medical test, which Dr Ang had not conducted. Therefore, giving his own estimation of the chance of success was a form of providing “false hope” to the patient.

Moreover, Ms Ho argued that it was not up to Dr Ang to decide on treatment for patients. She explained that Dr Ang’s job was to offer all the possible options and risks, and to let the patient choose.

Source

Dr Ang also admitted that surgery was the only way that the patient could have likely been cured, with an up to 20% chance of survival is she had done it in the first place.

Professionalism

While types like Mr Tan Kin Lian do not want doctors to give them the full story, most of us may like to know as much as possible before leaping into any kind of treatment, especially if we are suffering from a life-threatening disease.

So should a top doctor like Dr Ang have known that, instead of relying purely on his own opinion?

Or should he be confident enough that his judgement is the only thing that’s needed, given that he is supposed to be the expert whose job is to evaluate the pros and cons of various treatments and depart from guidelines when there are good reasons?

To answer those questions, let’s look at what the court said in its judgement, according to CNA:

A doctor might believe that a particular treatment option is in his patient’s best interests, but ultimately, it is the patient who must make the decision on her treatment.

Featured images from ezyhealth and medscape

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