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Alan Stanton
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{{NeedsImage}} '''Alan Stanton''' is a community pediatrician at University Hospitals Birmingham, [[United Kingdom|UK]]. He follows the [[Biopsychosocial model|biopsychosocial]] theory of understanding of [[ME/CFS]], which purposes that a person's [[Illness beliefs|"dysfunctional illness beliefs"]] and related behaviors perpetuate the illness, and that [[Cognitive behavioral therapy|CBT]] psychotherapy is an appropriate treatment.{{Citation needed}} == GMC complaint == In the late 1990s Alan Stanton was investigated by the UK's General Medical Council for using child safeguarding measures to attempt to force a particular type of treatment on a child under the care of another pediatrician, an issue that only arose after the child's school requested a different medical opinion on a child's health after consulting with the child's current doctor.<ref name="BBC-video" /><ref name=":1" /> Doctors or local authorities' inappropriate use of child protection or safeguarding measures to control the medical care and treatment of children and adolescents who are seriously ill with ME/CFS has been previously highlighted by the [[Tymes Trust]] charity, and by the case in Denmark of [[Karina Hansen]], a 15 year-old girl who was forcibly removed from her home and locked in a psychiatric in-patient unit. ==Sick and Tired documentary == The BBC documentary [[Sick and Tired - BBC|Sick and Tired (Panorama)]] described the background to the General Medical Council complaint about Alan Stanton, along with cases of several doctors who later lost their license to practice as a result of falsely accusing a parent of child abuse.<ref name="BBC-video">[http://news.bbc.co.uk/hi/english/static/audio_video/programmes/panorama/transcripts/transcript_08_11_99.txt TRANSCRIPT - PANORAMA "SICK AND TIRED"]</ref> Viewers left comments on the BBC web site after the show aired.<ref>[http://news.bbc.co.uk/1/hi/programmes/panorama/archive/521037.stm Monday 8 November - Sick and Tired. This forum lists your first comments on Sick and Tired]</ref> Several letters of complaint referring to the programme were published by the [[BMJ]], one of which falsely claimed one mother had been found guilty of perjury; the BMJ published a correction.<ref name=":1">{{Cite journal | last = Marcovitch | first = Harvey | author-link = Harvey Marcovitch | date = 1999-11-20 | title = Diagnose and be damned | url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117104/ | journal = BMJ : British Medical Journal | volume = 319 | issue = 7221 | pages = 1376|issn=0959-8138|pmc=1117104|pmid=10567164|quote=Dr Alan Stanton, a community paediatrician who had intervened in a case where parents' views and those of the local medical team were in conflict. This child's case had already led to www.msbp.com targeting Stanton for his stance in this case, and he has had to deal with complaints to his hospital trust and the GMC.|via=}}</ref><ref>{{Cite journal | last = | first = | author-link = | date = 1999-11-27 | title = Diagnose and be damned. Additional article information. | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117173/ | journal = BMJ : British Medical Journal | volume = 319 | issue = 7222 | pages = 1444|issn=0959-8138|pmc=1117173|pmid=10574891|quote=In this article by Harvey Marcovitch (20 November, pp 1376-7) on the problems faced by doctors who deal with child abuse it was wrongly stated that Sharon Payne (also known as Sharon Wraxall) was convicted of perjury. The BMJ wishes to apologise to Ms Payne for this error.|via=}}</ref> A comment on [[The BMJ|The British Medical Journal]] (BMJ) web site referred to the show as "a hatchet job".<ref>{{Cite journal | last = Garralda | first = Elena | author-link = Elena Garralda | date = 2018-11-04|others= | title = Sick and tired | url =http://www.bmj.com/rapid-response/2011/10/28/sick-and-tired-0 | journal = The BMJ|language=en | volume = | issue = | pages=|quote=|via=}}</ref> ==Child safeguarding and parental consent to treatment == In 2012, Dr Stanton co-authored an article in the 'Child Abuse Review' journal stating that discharging a child from medical care against medical advice is a form of child abuse, and that Discharge Against Medical Advice forms must not be made available to parents of sick children.<ref name=":0">{{Cite journal | last = Stanton | first = Alan | author-link = | last2 = Powell | first2 = Robin | author-link2 = Robin Powell | date = 2012-11-13 | title = Discharge Against Medical Advice (DAMA) Forms - A Damaging Document | url = https://onlinelibrary.wiley.com/doi/abs/10.1002/car.2234 | journal = Child Abuse Review|language=en | volume = 22 | issue = 5 | pages = 377–380|doi=10.1002/car.2234|issn=0952-9136|quote=Discharge Against Medical Advice (DAMA) forms are sometimes used when parents wish their children to be discharged against medical advice.<br> We argue that there is no place for their use in the care of children; their use may amount to collusion with medical neglect, protecting neither child nor practitioner.<br >Child safeguarding teams within healthcare provider organisations should ensure that DAMA forms are not used with respect to children ... <br >But the rights of any child to refuse treatment are only where it will not result in death or serious harm. In Re W (A Minor) (Consent to Medical Treatment) (1993) 1 FLR 1, Lord Donaldson said ‘No minor of whatever age has the power by refusing consent to override a consent to treatment by someone who has parental responsibility for the minor’ (p. 1611).Thus, the court as parens patriae may overrule a parent’s refusal of treatment, a ‘Gillick competent’ or even a 16- or 17-year-old child’s decision, when to do so is necessary to save the child’s life or prevent really serious and irreparable harm to the child, under the general principle that it is the duty of the court to preserve life and ensure, so far as it can, that children survive to attain the age of 18.<br>If agreement cannot be reached and the child genuinely remains at medical risk, it is hard to see the provision of a DAMA form as anything more than formalised collusion with neglect: The primary duty of the doctor is to the patient, the child. In those circumstances, which of course should be very rare, the only way in which a doctor can fulfil the duty of care is to make a referral to an agency with statutory child protection powers, which are the local authority, the police or the NSPCC, which should act quickly to secure the immediate safety of the child (HM Government, 2010) ... We believe that doctors and nurses with responsibility for safeguarding children should ensure that DAMA forms are not available for doctors to use when caring for children and that training for medical teams in safeguarding duties includes an understanding of why this is so.|via=}}</ref> He recommends that if parents cannot be persuaded to change their mind on their child's treatment then using Social Services, the NSPCC and the police is appropriate, including Emergency Protection Orders. Dr Stanton also explains rights of "a child" (anyone aged under 18) to refuse treatment can be overruled either by parents or those acting in the role of parents (e.g., medical staff) in cases where the child is at risk of "serious harm", a term which he does not explain further.<ref name=":0" /> Alan Stanton has been appointed to the review panel for the [[NICE guidelines]] review in October 2018, these guidelines which strongly influence [[NHS]] treatment and policy for people with [[ME/CFS]] in the UK.<ref>{{Cite web | url = https://www.nice.org.uk/guidance/gid-ng10091/documents/committee-member-list | title = Committee member list {{!}} NICE CG53 CFS/ME guidance update | last = [[NICE]] | first = | date = October 28, 2018 | website = nice.org.uk|archive-url=|archive-date=|url-status= | access-date = 20 October 2018}}</ref> ==Notable studies== 1996, Neonatal circumcision and penile cancer. Authors ignored main conclusion of study that they cited<ref>{{Cite journal | last = Stanton | first = A. | author-link = | date = 1996-07-06 | title = Neonatal circumcision and penile cancer. Authors ignored main conclusion of study that they cited. | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2351427/pdf/bmj00549-0051a.pdf | journal=BMJ : British Medical Journal | volume = 313 | issue = 7048 | pages = 47|issn=0959-8138|pmc=2351427|pmid=8664789|quote=|via=}}</ref> (letter) 2006, Tobacco cessation interventions for young people<ref>{{Cite journal | last = Grimshaw | first = Gill | author-link = Gill Grimshaw | last2 = Stanton | first2 = Alan | date = 2006-10-18 | title = Tobacco cessation interventions for young people | url =https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003289.pub4/information | journal = Cochrane Database of Systematic Reviews|location=Chichester, UK| publisher = John Wiley & Sons, Ltd | volume = | issue = | pages=|doi=10.1002/14651858.cd003289.pub4|quote=|via=}}</ref>- Cochrane review 2013, [https://onlinelibrary.wiley.com/doi/abs/10.1002/car.2234 Discharge Against Medical Advice (DAMA) Forms – A Damaging Document]<ref name=":0" /> ==Clinic location== ==Talks and interviews== ==Online presence== *PubMed *Twitter *Facebook *Website *YouTube ==Learn more == * ==See also== * [[Sick and Tired - BBC]] * [[NICE guidelines]] * [[NHS]] ==References== {{Reflist}} [[Category:Clinicians]] [[Category:British clinicians]]
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