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Posted: Friday 1 September, 2017 at 9:31 AM

Police and the Community (Part V)

By: James Milnes Gaskell, Syndicated columnist

    The death of Philo Wallace is again in the news. In October 2015 Philo was shot at a dance at Enriques Bar by an off-duty policeman. The then DPP called for a Coroner’s Inquiry, which convened, summoned witnesses, and having then given a finding incorporating homicide, the papers were sent to the DPP. 

     


    It is reported that the now DPP wrote on April 12th, 2017 to Commissioner of Police Ian Queeley advising him that a criminal charge for manslaughter be brought against the policeman concerned. Some four months later (August 14th) the Commissioner is quoted: “I can say that he is not charged”. Well, why not? It is not open to the Police to give their usual response, when either they have nothing to say or do not want to say anything, “Investigations are ongoing”.  

    In this case investigations have concluded. The DPP has given his advice as the senior legal prosecuting authority of the Federation, which because of his status may be termed his instructions. Refusal, without good reason to follow the DPP’s advice is likely to be dereliction of duty and in some circumstances could come perilously close to obstruction of justice.  

    Sometimes police officers may be relieved not to have to make a decision themselves to prosecute in an awkward case, and welcome such a decision being made by the DPP. Something is odd in this case. I just hope that for personal reasons, family friendships for instance, there has not been a diktat from on high. We don’t want to follow what happens in Trump’s America, where judges are criticised on account of their origin, and a man convicted of contempt of Court is pardoned for that contempt, for no reason that may be ascertained other than his agreement with and attempted implementation of Trump’s anti-immigrant policies.

    The other question is why does not the DPP undertake the prosecution himself? He has all the witness statements, now termed depositions. Let him go ahead. Remember his Title, Director of Public Prosecutions. The Public require a Prosecution. Let him direct it. He cannot be dismissed by, for instance, a wayward Prime Minister. Only the Governor General can do so, following a recommendation of a Tribunal whose members are appointed by the Chief Justice. His independence is protected as far as can be constitutionally devised. It remains the position that it is most unsatisfactory that the Police appear to have refused to follow legal advice from the Authority set up on our behalf to guide them in that regard. This does not happen in a truly democratic state, where everyone is supposed to be equal before the Law and it should not be allowed to pass unchallenged. Senior lawyers must take it up.

    Antibiotic Resistance Part II

    Part I was published in mid-July. In the same month the British Medical Journal (BMJ) featured a study by a number of infectious diseases specialists (lead author, Martin J. Llewelyn) of the appropriate length of an antibiotic (ab) course. I heard about this on a BBC, VON news item and then looked up the paper from which it derived, and because of its importance wish to share it.  

    So many scientific papers are published that it is almost fortuitous which ones come one’s way.  It is estimated that 2.5 million new scientific papers are published annually. I was glad to learn that here in the Federation our medical authorities convened a symposium about the problem of ab resistance. However, the advice they gave was that which has been current for the past 70 years, that you should always complete the prescribed course of abs (this was also what I suggested, having in July, not yet read Professor Llewelyn’s paper).

    Here is some of what Professor Llewelyn says:

    “The antibiotic course has had its day with little evidence that failing to complete a prescribed ab course contributes to ab resistance, it is time for policy makers, educators and doctors to drop the message. Abs are vital to modern medicine and ab resistance is a global urgent threat to human health.  The relation between ab exposure and ab resistance is unambiguous both at the population level and in individual patients. Reducing unnecessary ab use is therefore essential to mitigate ab resistance. The idea that stopping ab treatment early encourages ab resistance is not supported by evidence, while taking abs for longer than necessary increases the risk of resistance.”

    This conclusion is in direct conflict with the advice issued by WHO for Antibiotic Awareness Week 2016 where they advise patients “always to complete the full prescription, even if you feel better, because stopping treatment early promotes the growth of drug resistant bacteria”.  

    “Traditionally, abs are prescribed for recommended durations or courses. Fundamental to the concept of an ab course is the notion that shorter treatment will be inferior. There is however little evidence that currently recommended durations are minimums, below which patients will be at increased risk of treatment failure. Historically, ab courses were set by precedent, driven by fear of under-treatment, with less concern about overuse. For many indications recommended durations have decreased as evidence of similar clinical outcomes with shorter courses has been generated. There are reasons to be optimistic that the public will accept that completing the course to prevent resistance is wrong if the medical profession openly acknowledges that this is so, rather than simply substituting subtle alternatives such as ‘exactly as prescribed’. Research is needed to determine the most appropriate alternative messages, such as, ‘Stop when you feel better’.”

    It will be interesting to see the effect this study has upon the advice put out by the WHO. We do not need to wait for that slow-moving body to issue its deliberations. All our doctors may wish to familiarise themselves with Professor Llewellyn’s paper.

     
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