Public Health: Doctor suspended over diagnosis of cause of death

When (now) 60 year old Dr KWAN Kah Yee certified the death of a patient in 2009 to be due to "congestive cardiac failure," he erred so seriously that the Singapore Medical Council has ordered he be suspended from practice for three months from 12 August, according to local media reports.

The family of the deceased objected to the diagnosis and in an inquiry, the SMC determined that the medical records did not include sufficient information upon which such a determination could be made: indeed, it says in a report, that the only firm evidence of a medical condition points to "hypertension."

But the report goes further and says that KWAN's diagnosis of the patient as suffering from ischaemic heart disease for some six years prior to death was also incorrect.

KWAN is a general practitioner attached to a hospice in Singapore and he contested the charge. In addition to the suspension, he was censured (which seems otiose) and fined SGD5,000.

It is not known why the patient's family objected to strongly to the diagnosis but it is not unreasonable to assume that it is related to the risks of heart disease being hereditory which has obvious conclusions in terms of worry for offspring and, of course, potentially adverse consequences for health and life insurance purposes with the possibility of exclusions or increased premiums.

However, the decision calls into question the long-established practice of blaming death on some form of heart failure, often to save the feelings of relatives who are not satisfied with the actual cause of death which, in doctors' black humour, is known by the acronym JPFROG: just plain fucking ran out of gas. Somehow "died of old age" doesn't seem to be a good enough reason for many people.