Expert who likes to court controversy

THERE are not many paediatricians who would have contemplated carrying out a study in which infants were deprived of oxygen, writes Jeremy Laurance. Even the North Staffordshire Hospital Centre's own research ethics committee initially rejected the proposal because of fears about the possible danger to babies involved. But Professor David Southall is used to courting controversy.

He was the doctor responsible for covertly videoing parents suspected of child abuse while their children were in hospital. Between 1986 and 1994, 39 children were filmed being attacked by apparently caring parents and step-parents which led to 33 criminal prosecutions.

However, his methods were criticised by psychiatrists concerned about infringement of privacy and the risk of exposing children to further harm during the surveillance operation and he was accused of acting as an agent provocateur.

In a separate study conducted between 1989 and 1993 in which premature babies with breathing problems were placed on a new type of respirator, some parents complained they were not told their children were being given experimental treatment. In all 122 babies took part, of whom 28 died and 15 were left brain damaged.

A number of families contacted a local solicitor, James Evans, claiming their children had been used as guinea pigs and that they had only found out about the trial when Professor Southall and his colleagues published their findings in an American journal which highlighted the dangers of the treatment. However, the hospital said the parents had been told about the trial but may have forgotten because of the stress they were under.

Mr Evans yesterday said inquiries were continuing to see whether the parents had a legal case. "The questions are whether proper informed consent was obtained and whether the ventilator was safe."

Ethical questions have also been raised about the new study, published in today'sBritish Medical Journal, which are examined in two accompanying commentaries. Despite its initial concerns, the hospital ethics committee agreed to let the study go ahead because its members were convinced it would be safe, with a paediatrician on standby, and that the parents would be properly informed and no coercion would be used. However, Julian Savulescu, of the Centre for Human Bioethics, Victoria, Australia, says there was already some evidence of risk before the study began, it had no therapeutic benefit and it is unclear whether the parents were fully aware of the danger.

The only benefit to the parents was in learning whether their child was one who responded badly to a reduction in oxygen levels in the air. They could then avoid long-haul flights or mountain holidays until their child was older.

Mr Savulescu concludes there is some value in the study but "a balance must always be struck between discouraging research which might eliminate continuing harm and making it as safe and ethical as possible."