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Bloodgate scandal offers harsh lessons

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John Beattie | 09:56 UK time, Monday, 6 September 2010

When it comes to sport can doctors really say: "I am sorry, but I was bullied into this?"

So, bloodgate is over. A player swallowed a blood capsule, the doctor was coerced into cutting his mouth, the coaching staff lied about it and rugby leapfrogged into the professional era in the most unsavoury way.

The doctor kept her job. And before I pass comment let me assure you I am not squeaky clean in any aspect of my life.

Every doctor will know what it is like to be forced to do the wrong thing. "But doc, it was only a small concussion!"

Substitute that for sprained ankle, sore shoulder, stitches, knee pain, and "please give me a pain-killing jag!"

All to allow a player to play when he or she should not.

Bloodgate took it to a different level, though, with a co-ordinated attempt at getting round rules by including the faking of an injury (not new) and the co-operation of a doctor.

It goes further than this.


Doctors, in many sports, claim that they are bullied into making the wrong decision. The reason that cyclists take drugs, sprinters take drugs, runners get blood doped, players find themselves injected, and all manner of medical cheating takes part... is that doctors give in. They cave in to pressure.

They then become the conduit for cheating. Doctors are central to the action every time a drug cheat is caught.

Doctors should be stronger than that; the medical profession should be much tougher.

I find it incredible that any doctor would agree to cut someone deliberately, or supply performance-enhancing drugs deliberately.

"Doc, please give me something that will make me stronger."

Maybe this is a turning point for rugby.

You see, I read a fascinating article suggesting that the doctor should have been struck off because of all the above facts.

Our sport, it was suggested, has given a little bit of encouragement to every doctor out there who is tempted to cheat.

I felt so sorry for her as I read the evidence in court. Can you imagine being in the middle of the perfect medical storm with highly-paid grown men exerting maximum pressure? No? Me neither.

Are you sure you would have resisted the pressure? No? Me neither.

For that reason I think she found herself in an unprecedented situation and rightly kept her job.

Until this all happened I did not know that clubs had fake blood capsules and neither did she, probably.

But now that we all know, doctors in rugby must know that the next time anything like this happens they will, indeed, be struck off.

Comments

  • Comment number 1.

    The whole "bloodgate" issue throws up many difficult questions, and as a doctor and a rugby player (just about)I can sympathise with Dr Chapman. Your team mates, who also happen to be your patients are always pressursing you for a green light to play or for a quick fix for an injury. You can but advise and let the grown men make their own decisions. However, deliberately inducing and injury goes against your duty to sport and to patient care. It's the first thing you sign up for when they chuck you out of medical school and into the big bad world - "first do no harm."
    It appears Dr Chapman kept her job because of the extreme circumstances i.e the bullying of a tyrant director of rugby and the extreme insistence of the player involved. I'd love to say I wouldn't have done it, if I had been in her position, but I probably would have.

  • Comment number 2.

    "So, bloodgate is over."

    You said it John. Lets move on - it was more than a season ago and the new season is upon us. Surely there must be fresher things to discuss.

    As for the doctor, I'm with the Pitbull when he says:

    "Has Dr Chapman been admonished? Yes and publicly so. It is almost certain she will not act as an unpaid volunteer rugby doctor again and thus there is no fear of a recurrence of the act.

    The real question is surely this – if you find yourself in Maidstone A&E and Dr Chapman is attending, does her mistaken, yet isolated and instantaneous act, under inordinate and personal pressure created by others, outweigh her many previous years of competent and professional service, witnessed by thousands of patients she has treated?
    Do you really and legitimately feel unsafe? No. Well then, enough is enough – let the severely chastened doctor continue to help people."

  • Comment number 3.

    I think it's fair to say we can all imagine the pressure put on this Doctor. Yes, she caved-in and she did wrong. She has (quite rightly) been publicly rebuked for this and in my opinion, the matter as it affects her involvement should now be closed.

    Our ire should be trained on the club officials and the player who coerced her into causing the injury. These are the untrustworthy ones and their conduct was shameful. Each should be banned sine-die from the sport!

  • Comment number 4.

    Honetly John I would of thought that with the opening weekend of the Magners league and premiership just gone you could of found something else to have written your blog about rather than an, admitedly shocking, event that happened well over a year ago. Also the rugby sides of this was dealt with over a year ago and this, whilst involving an incident at a rugby pitch, is something to be dealt with by the medical community.

  • Comment number 5.

    And before I pass comment let me assure you I am not squeaky clean in any aspect of my life.

    Suggest "any" becomes "every"

    Best laugh on a Monday for a while! The perils of self editing personified!

  • Comment number 6.

    Agreed John! Of all the unbelievable aspects of the Bloodgate saga (rugby players having easy access to blood capsules is surely a new kind of low, in any sport), the one that I find/found to be particularly off-putting was that a medical doctor, someone dedicated to healing, would, in fact, deliberately take a scalpel and cut someone. It does boggle the mind!

  • Comment number 7.

    The hypocricy in this is what grips my sheugh, how many forwards have rucked a little "aggressively", how many props have "squeezed" a hooker, how many Hookers throw a Ball into a lineout not straight, how many players have stamped, punched, pulled armpit hair etc, etc, its all to gain an advantage, in this case there has been hysterical baying from officials and ex-players but the punishments have been wristslaps, Dean Richards got a 3 year Ban but it turns out he has done this before, twice, a lifetime ban from all Rugby Union would be the deterant which would make other Coaches stop and think but the lily-livered RFU dont have the stomach for that!.

  • Comment number 8.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 9.

    Sorry John,she probably didn't know about previous blood capsules....
    She was the club Doctor players were pulled off injured yet she did not know it was fake... wasn't it her job to know.
    I think this is part of a bigger issue - are we rolling down the soccer slippery slope where everyone falls over and winning is all no matter what?
    As a game rugby has to robustly tackle foul play and cheating and the only way to do this, is to show it does not pay, blood capsules, eye gouging deserve lifetime bans, other dangerous actions and deliberate calculated cheating deserve severe punishment and adjudicated by an independent body NOT the national association. We want more and more youngsters playing we want to show them what our sport is all about.
    I don't want to be in the position over Rugby where I hear a comment similar to one I heard from a taxi driver talking about his soccer playing nephew and the last soccer World cup - 'so uncle can you only win if you cheat..'

  • Comment number 10.

    OK so I think I need to apologise to someone - I do not know who for breaking the house rules. I really don't know what I did, I certainly didn't use any language that was intended to offend - nor do I think I wrote anything that was liablous. If I did scandalise anyone - I apologise.

    In short my comment were as follows:
    1.The first point I made was that doctors are trained from day 1 to resist pressure, physical intimidation and bullying before conducting any procedure. That is part of their job and is enshrined in the Hippocratic oath. As such comments made above in sympathy to pressure placed on the doctor by members of staff for Harlequins rugby club must be placed in that context.

    2. That I feel that following my interpretation of the hippocratic oath and other ethical frameworks that the medical profession must adhere to, including the BPS code of standards, then the GMC ruling may not have served the public nor the medical profession well. I am reminded that in 1894, ‘infamous conduct in a professional respect’ had been defined by Lord Justice Lopes in Allinson v General Council of Medical Education and Registration1 in the following terms:

    ‘If a medical man (SIC) in the pursuit of his profession has done something with regard to it which will be reasonably regarded as disgraceful or dishonourable by his professional brethren of good repute and competency, then it is open to the General Medical Council, if that be shown, to say that he has been guilty of infamous conduct in a professional respect.’

    3. I would hope that any practicing Doctor must find the General Medical Council a more intimidating arena than the medical room of any club.

    My final point was

    4. That rugby is great, sport is great, but they all fade into insignificance compared to maintaining the integrity of the medical profession. From the start of this distasteful affair, rugby has been the context not the crux of these events.


    Could the moderators or the participants on this board tell me which of these opinions is so offensive?

  • Comment number 11.

    So Imager614 believes Dean Richards should have been banned for life because "it turns out he did it twice before." Yes. He supplied that information. On both previous occasions it was to bring off a player he felt needed to come off for their own benefit not to gain any advantage. He also decided to cover up the whole affair to protect the Doctor as he realsied, once he found out about the cutting of the player's mouth, what an awkward position she was in.
    I think a life ban "pour encourager les autres" is over the top. The man has given a huge amount to rugby. One year would have been appropriate.

  • Comment number 12.

    "Are you sure you would have resisted the pressure? No? Me neither. For that reason I think she found herself in an unprecedented situation and rightly kept her job"

    Sorry John, I can't agree. The situation of adhering to ethics is not unprecedented. It happens everyday. She knew what she was asked to do was wrong and still did it. She had the right to refuse but didn't.

    By that logic, her case be used as precedence for the next case of "highly-paid grown men exerting maximum pressure".

  • Comment number 13.

    I'm with Hookers_armpit and those of his ilk. Let's not get too precious. Sure it wasn't a credit to anybody. Smacks have been meted. Let's get over it.

    At least our game hasn't been ruined by gambling money ...! What can be done to make sure that it never will be? Or is there something I don't know?

  • Comment number 14.

    Agree with Segnes - I suspect that Tam Shepherd's joke and trick shop in Glasgow did not announce a surge of blood capsule sales after this...

  • Comment number 15.

    Do I think she should have been struck off? No.
    If I'm ill and she happens to be the doctor treating me, would I doubt her ability because the bloodgate incident? No.
    Do I think her actions call into question her ability to give a patient adequate care? No.
    Do I think there is doubt on the integrity of any action she might take during a game of rugby (or any other sport)in the future? Possibly.

  • Comment number 16.

    @ post #13 - as long as you can bet on apparently meaningless facits of a game there will always be gambling and the opportunity for corruption. Rugby wouldn't be the most obvious. But ask yourself might the following be ripe for a rigged bet;
    - the kick off doesn't go ten
    - the kick off goes out on the full
    - the kick off gets knocked on / or even the odds of a scrum in the first xx minutes of a game
    - the number of scrums in a game
    - how long before the first lineout
    Small items in a game. Might not decide the winner. But could make someone a nice couple of quid if the could get to someone on the field.

  • Comment number 17.

    That's what I was contemplating, thebandwagonsociety. Any ideas on how to safeguard rugby union from related scandal?

  • Comment number 18.

    Brcue,

    As a doctor I must point out that I had no formal training as to how to resist pressure, physical intimidation and bullying. Throughout my career I have experienced a varying degree of all those things and what has pulled me through is the strength of my personality firstly, and secondly increasing experience and seniority. I can 100% guarantee that if Dr Chapman had been asked to do something like that in her A and E department in Maidstone, where she is the boss, she would have told someone where to go in no uncertain terms. But being in that medical room must have felt like being a house officer again with more important people than you putting pressure on you to do things. All doctors know that it is much easier to say "No" as you get more senior, but in that room on that day, did she feel like a junior? As AudaciousBeaver pointed out, I would love to think that if I had been in that situation I would have refused but maybe the potential loyalty I would have felt to the team and Dean Richards coupled with their pressure would have seen me cave. Overall I'm glad she wasn't struck off. Her actions were wrong, but it does not impact on her ability to perform her (day)job properly. Medicine is vocational; she has given 20 odd years of her life to training and getting where she is, and has not been able to work for a whole year (without pay). For something that in medical terms of errors and botched jobs is on the lower scale, I think that is punishment enough.

    I also reckon there were a LOT of club doctors who were sweating a bit when they heard the GMC were looking in to it. Because we all know this certainly wasn't the first, and it wasn't isolated to Quins.

    Now I think we should, as Dr Chapman would like to, all move on from it.

  • Comment number 19.

    Segnes - off hand I can't think of way to truly eliminate it (if I did, I think I would look to licence it to all major sports).

  • Comment number 20.

    John, the first line of the hippocratic oath is "I will do no harm". The individual involved knew this as all doctors do and yet continued to cut this player on purpose in an act so despicable that I, as a doctor myself, am ashamed.
    As a rugby fan the shame runs deeper as the people involved were great players and a personal hero of mine, yes as a Scot I did admire Dean Richards as a player, and has soured me to our great game. Also I can't help wondering if these guys got caught what are all the others up to?

  • Comment number 21.

    It's quite simple - either have an independent doctor at the games who has the responsibility to assess the player, or have the opposition team doctor do it.

    Remember this is just blood injury stuff, pretty black and white if you ask me.

    By having the doc as part of the team if you like, human nature means they have the same will to win (at all costs in this case). Take it away.

    As for Deano, great player who I remember changing international games on his own (replacing Tim Rodber once against the sweaties for instance), but this will haunt the ex-copper for the rest of his life...

  • Comment number 22.

    Every active participant in the sordid affair should be banned for life and nor allowed to participate at any level of rugby or enter a rugby club ever again.
    Requesting that this incident is forgotten about or stating that similar events have occurred elsewhere is turning a blind eye to this disgraceful event. Has rugby dipped that low in this professional era that bloodgate is acceptable in our sport?

  • Comment number 23.

    kiwibill,
    would that include Nicky Evans? Presumably he knew about the plan as well...

  • Comment number 24.

    So the HPC has struck-off the physio, who did not damage the player, but only deceived the referee. Whereas the GMC only gave the doctor that had willingly injured a person, and also endeavoured to deceive the referee a 'warning'.
    Yet again doctors get away with anything, but any non-doctors practising their profession seem to get harshly disciplined in comparison. I believe the HPC was correct, and the GMC was far to lenient.
    When will the GMC get a proper and effective disciplinary panel established?

  • Comment number 25.

    Dear BennyBianco

    I find it quite interesting that you had no training, I am not a practising doctor, but did help write a few medical education syllabus over the past 20 years and almost all of them had both a formal violence and aggression element and at least an informal line in dealing with users in A&E. I know for a fact that the basic nurse education syllabus has a formal element on drugs and users in A&E and that is pretty well what I was alluding to. I know Maidstone General isn't Tooting or Hackney but it I bet its seen its fair share of unsavoury people on a variety of substances in a state of distress and trying to secure preferential treatment, or a particular form of treatment or dare one suggest trying to use the hospital as a method of getting a hold of some category A drugs. It might have been a very long time ago when I studied in Glasgow but that was certainly my experience, it was also my experience that I was shown from day 1 how to deal with them.

    So I am sorry but like nhsemployee above I am deeply suspicious of any system where the doctor who one would have thought was the medical supervisor gets a hand slap while the physio gets struck off. I am not sure that either the GMC or the HPC got it right, but I would err on the side of the HPC.

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