Christine Margaret Puxon
2008; BMJ; Volume: 336; Issue: 7659 Linguagem: Inglês
10.1136/bmj.a476
ISSN0959-8138
Autores Tópico(s)Ethics and Legal Issues in Pediatric Healthcare
ResumoMargaret Puxon was a barrister and Queen’s Counsel who specialised in medical negligence. She usually acted for plaintiffs, and she made major contributions to case law. In what was probably the first case under the Congenital Disabilities (Civil Liability) Act 1976 she won substantial damages for Sunil Krishnamurthy, profoundly handicapped from negligent management at Addenbrooke’s Hospital in Cambridge. In the 1980s (Scuriaga v Powell) she handled the first case of failed termination of pregnancy. The plaintiff, who was devastatingly crippled from polio in childhood, claimed the cost of raising the child. The defence could have settled the case for a pittance but hoped for a judge who would disapprove of rewarding a claimant for having a baby. Again, Margaret won substantial damages for the plaintiff. She made case law again in the 1980s when acting for a young married woman who had been sterilised on the advice of her nephrologist. The woman had suffered a kidney infection in her teens and had been told that she was physically unfit for motherhood, would die young, and that vasectomy was not the answer as her husband would probably want to remarry after she died. When a different nephrologist asked when she was going to start a family she questioned whether she had been properly advised. It was the first case law on sterility for 30 years, and Margaret won substantial damages for her client. The Family Planning Association consulted her when threatened with legal action for “aiding and abetting a miscarriage” when prescribing the morning after pill. Margaret’s opinion was that “if there was no carriage there can have been no miscarriage”: if the pill was taken within 72 hours the ovum had not embedded in the womb and therefore there was no abortion within the meaning of the act. Shortly afterwards Sir Michael Havers, the attorney-general, gave the same opinion in the House of Lords. In the early 1980s Bourn Hall, the private fertility clinic, consulted Margaret on the wording of the consent form for sperm and egg donors. Margaret was born in Stourbridge, Worcestershire; her father owned and ran a metalwork company. She turned down a place at Oxford to study English literature in order to study veterinary medicine at Birmingham. She switched to medicine, attracted by the science. She married Ralph Weddell while still a student and had two children without interrupting her studies. She graduated with honours and the gold medal in obstetrics and gynaecology in 1942. After her pre-registration year she was gynaecology registrar at Queen Elizabeth Hospital, Birmingham. She divorced, married Peter Puxon, a solicitor, and moved to Colchester in 1944. She did general practice locums and studied for her MRCOG, which she got in 1946. Birmingham University awarded her an MD in obstetrics a year later, and she was appointed consultant gynaecologist by Essex County Council. In 1949, after two miscarriages, she became pregnant again and gave up work on medical advice. She kept her mind active with a correspondence course in law, passed her exams, and found a place in chambers. The clerk refused to put any work her way. She took on legal aid work and divorce cases for returning servicemen, which few other barristers wanted. Solicitors soon made their way to her door. She moved to London, where most of the work was. She divorced and married another solicitor, Morris Williams, in 1957. She eventually built up a fashionable divorce practice. Over the following 15 years she built up a distinguished reputation in family case law. Later, in the 1970s, she was head of chambers that had offices in Colchester and Norwich, and she continued to practise in London at the same time. Her clients included rock star Bill Wyman in his divorce from Mandy Smith. He pays tribute to her on the Rolling Stones’ website. She acted for an adopting mother in J v C, where the natural mother wanted to regain custody of a child she had given up for adoption; Margaret established that the welfare of the child was paramount in wardship proceedings, always trumping other considerations. By 1970 she was a leading authority on family law when she switched to medical negligence, usually representing plaintiffs. This failed to endear her to the Royal College of Obstetricians and Gynaecologists, which did not invite her to join their medicolegal committee when it was established in the 1980s. In 1979 she was elected fellow of the royal college at the instigation of Janet Bottomley and Dame Josephine Barnes. Margaret was chairman of the Society of Medical Doctors in Law. She edited Medical Law Reports (now called Lloyd’s Reports, Medical) was appointed by the Privy Council to the council of the Pharmaceutical Society, was a deputy circuit judge from 1970 to 1978, and a recorder from 1986 to 1993. She served on several ethics committees, including that of the Lister Hospital and the Royal College of General Practitioners. She wrote or contributed to The Family and the Law (1963, 1971), Progress in Obstetrics and Gynaecology (1983), In Vitro Fertilisation: Past, Present and Future (1986), Gynaecology (edited by Shar, Souter, and Stanton) (1991), and Safe Practice in Obstetrics and Gynaecology (edited by Clements) (1994), as well as writing many papers for medical and legal journals. In court Margaret was described as “charming, persistent, and fearless.” Judges liked her because she could make them laugh. She may have appeared the epitome of an establishment figure but she had a deeply rebellious streak, was bothered that the establishment was bureaucratic and small minded, and cared passionately about justice and equity. She leaves two sons and a daughter. A fuller account is published in Clinical Risk http://cr.rsmjournals.com/cgi/content/full/14/3/104
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