Doctor defends shredding of records

By Niall Hunter - Editor

A leading psychiatrist has defended his decision to destroy medical records relating to an experimental treatment programme, involving the use of the drug ketamine, which he ran at Dublin's St Brendan's Hospital in the early 1990s.

The Information Commissioner, acting on a request for the records from a female patient who took part in the programme, has criticised the decision to destroy the records and the fact that the records of the treatment programme were kept separately from the patient's ordinary hospital records.

However, Prof Ivor Browne, who ran the programme, and who was Clinical Director of the hospital at the time, said he felt he had no choice but to destroy the records.

He told irishhealth.com that while in general he accepted the principle of the importance of maintaining records, as the treatment programme in question involved patients who had been the victims of trauma and abuse, on his retirement from the hospital in the 1990s he felt he had to destroy the records because of their intimate nature and for fear of them falling into the wrong hands,

He said he was concerned that the records might be accessed by administrators and psychiatrists who might not understand the therapy involved and would not be sympathetic.

Information Commissioner Emily O'Reilly, in her annual report published last week, was highly critical of the decision to destroy the records relating to the woman patient.

She said records should only be destroyed in accordance with general agreed protocols, and staff members, no matter how senior, should not be allowed to destroy records on their own initiative.

The Commissioner also said it was counter-productive to hold records separately from the main patient files. The files held by Prof Browne, her report states, did not form part of the patient's ordinary hospital record.

The patient concerned had taken part in a regression therapy form of group treatment run by Prof Browne, involving the use of ketamine, and which was regarded as an innovative form of therapy.

Ketamine has anaesthetic, pain relief and hallucinatory effects, and is used in animals and humans. It is also used illicitly as a recreational drug, often known as 'Special K'.

According to the Commissioner's report, the former patient had suggested that the failure to record the administration of ketamine on her hospital file constituted bad practice, not least, she claimed, because any side-effects of the drug might not be recognised and because of the possibility of some adverse situation developing in the future.

Prof Browne, however, has said this was unlikely to occur. "I never felt it to have side effects as it goes through your system very quickly." He said he was not aware of long-term effects with ketamine.

Prof Browne said he had used ketamine at the time as part of a programme to help people who had gone through trauma and abuse in the past and who were suffering from depression as a result, in order to help them get over their experience.

Prof Browne said St Brendan's did not continue with the psychotherapy unit he was running after he retired from the hospital, and under those circumstances he felt he could not leave the records behind.

He said he would welcome if the woman patient concerned would contact him about the matter.

Prof Browne, who retired from St Brendan's in the 1990s, still sees patients at a clinic in Dublin once a week.

He said, however, that he no longer uses ketamine in treatment.

Ketamine has been used experimentally in the past in the treatment of depression. There have been some research reports that its possible long-term effects may include brain damage.

John Redican of the Irish Advocacy Network says many psychiatric hospital records have been destroyed over the years, especially before the introduction of the Freedom of Information Act in the late 1990s, and many people who seek records of previous psychiaitric treatment find it difficult to access them.

He said this should not happen and every effort must be made to preserve records.


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