Responsible body of opinion definitions

What is a responsible body of practitioners? This question can be broken down into two: What is a body of practitioners professing a particular art? What makes it responsible? The first question could be important to critical care specialists, who may not have their own college distinct from anesthetists, physicians, and surgeons.

This point has recently been addressed with reference to spinal surgery ( De Freitas v, O!B.Ei®^,,&„Connglly,,11995]). In defense to a course of action condemned as negligent by orthopedic surgeons, it was argued that there was a subspecialty of spinal surgeons who supported the criticized action. This subspecialty had 11 members in the United Kingdom, of whom one was the defendant and two others were expert witnesses on his behalf. It was decided that size alone was not a determining factor in recognizing a distinct body of practitioners and that spinal surgeons are such a body, and the responsible minority defense was accepted.

The second question (what makes a minority responsible?) has also been addressed recently ( Hepwo^rtLy Kerr,,[19.95]). An anesthetist was accustomed, over many years and in over 1500 patients, to dropping the systolic blood pressure to 35 to 40 mmHg for up to 2 h during middle-ear surgery. A patient developed anterior spinal artery syndrome, and sued. The practitioner was undoubtedly in a minority, perhaps of one. In deciding whether the body of practitioners was responsible and whether the technique was negligent, the judge remarked that there was no published academic support for dropping the blood pressure so low, with the whole weight of publication being against. Although the practitioner himself had published a series of cases on this technique, this was flawed, and there was no scientific validation of what was admittedly experimental, stepping right outside conventional wisdom. Without scientific validation, the use of this experimental technique was not responsible and therefore was negligent. Thus scientific validation is at least one way that a body of opinion achieves responsibility.

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