Court 'wrong place for midwife case'

The case of a midwife cleared of manslaughter has prompted condemnation of the decision to prosecute her in the courts.

Midwife Jennifer Joan Crawshaw was yesterday found not guilty of manslaughter at the High Court in Dunedin.

Crawshaw, 44, denied the manslaughter of a baby she delivered to a first-time mother on March 14, 2004.

The Crown had alleged she departed from the standard of care expected of a midwife by trying to accommodate the mother's wishes for a natural delivery, although the baby was a breech presentation.

Health leaders say that while death cases involving clearly criminal behaviour should be prosecuted in the courts, those involving questions of adherence to professional standards should go to bodies such as the Health and Disability Commissioner's office.

"That's a much better avenue for a case like this," said Professor Alan Merry, Auckland University's head of anaesthesiology.

"There are almost certainly important questions about how to manage patients. The case [in court] doesn't look at those; it looks at whether this was a crime. What we want is to improve standards."

College of Obstetricians and Gynaecologists president Dr Ken Clark said charging health workers with manslaughter over their professional judgments, rather than referring them to the commissioner or the relevant health practitioner council, was "extremely worrying".

"The ripple effects of such prosecutions ... need to be considered carefully. It has the potential [to encourage] defensive medicine."

QC Harry Waalkens said that since 1997 changes to the Crimes Act increased the degree of negligence that must be proved to convict a health worker of manslaughter, fewer cases had come before the courts.

The act now said they must be guilty of a "major departure from the standard of care expected".

"Juries would be cautious before convicting a health professional who, in the course of their work, is trying to do his or her best."


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