MEDICOLEGAL

From the New England Medical Journal, April 25 1990 pp 194-5

Medical Practitioners Disciplinary Committee: professional misconduct findings against Dr D W Steeper

The Medical Practitioners Disciplinary Committee (MPDC) held a three day hearing, 28, 29 June and 11 August 1989 to inquire into a charge of professional misconduct against Dr D W Steeper of Auckland by the Preliminary Proceedings Committee of the Medical Council in connection with Dr Steeper’s management of three young children. The allegations related to Dr Steeper’s use of the Vega testing machine for diagnosing and treating these three infants without carrying out a medical assessment or examination, and furthermore from the Vega test procedures Dr Steeper conveyed statements to the parents of the patients that were unjustified misleading and hurtful and fell below the proper standard of patient care. Dr Steeper in using these unproven and unorthodox techniques used his orthodox training and medical registration to convey respectability and authenticity to his practice, thus misleading his patients.

The Facts

The first patient consulted Dr Steeper on account of her 16 month old child’s sensitivity to wheat and dairy products, in the belief that Dr Steeper had special skills in the treatment of allergies and because he was a family practitioner as well as a homoeopath. Dr Steeper did not examine the infant but tested the child using the Vega machine, with the child on mother’s lap and mother holding one electrode in one hand and the other electrode probing the mother’s left middle toe. Subsequent testing of the child continued with the child running around the surgery. Dr Steeper claimed he directed questions from his own subconscious mind to the subconscious mind of the patient, with the answers being interpreted by the response of the Vega testing machine. The testing revealed allergies but also inherited chronic "miasms" from ancestors who may have had venereal or mental diseases, but that these evil "miasms" could be removed from the child by appropriate homoeopathic treatment. Dr. Steeper made predictions about diseases occurring later in life with death at 60 from carcinoma unless these "miasms" could be removed from the body by homoeopathic treatment which he prescribed. The lactose base of the homoeopathic medicine in this infant resulted in a violent gastrointestinal disturbance lasting several days.

The second patient took her 20 month old son to Dr Steeper complaining of bouts of abdominal pain. Dr Steeper without examining the child, carried out the Vega test in the same manner as in the first patient, again with the child wandering around the doctor’s surgery. There were also "miasms" resulting from a great grandmother with venereal disease and a prediction that the child would die from bowel carcinoma in his 60s, but that the treatment determined through the Vega testing could prolong his life by five years. The mother was also tested, and indicated diabetes in later life, and carcinoma of the cervix which again could be prevented by homoeopathic treatment. The infant died two months later from intestinal volvulus but this was not thought to be related to Dr Steeper’s management.

The third mother consulted Dr Steeper with her 12 month old infant who had been diagnosed as having asthma, with the expectation of allergy testing and dietary advice for that condition. Again without any preliminary assessment Dr Steeper undertook Vega testing in the manner of the two previous patients and indicated a mild selenium deficiency and allergies to caffeine, wheat and dairy products, with accumulated toxins due to previous vaccinations and "miasms" inherited from criminals in his ancestry. Dr Steeper predicted that this asthma would disappear at three years, recur in his 30s, with diabetes in his 40s and Alzheimer’s disease in his 70s, but there was a possibility of a fatal road accident at 17. The mother was given homoeopathic remedies but subsequently consulted a paediatrician who advised head-up sleeping, while allergy testing revealed no significant allergies.

Findings

The committee heard extensive evidence from Dr Steeper, from supporters of his methods of diagnosis and treatment, and from satisfied patients, as well as prominent doctors in the academic and clinical spheres of medical practice. Dr Steeper did not dispute the evidence of the three mothers, but acknowledged the foolishness of his predictions and had now ceased this practice.

  1. The committee found as a fact that Dr. Steeper failed to carry out a medical assessment of the three patients and keep records of his findings. Despite practising alternative medicine, there remains upon a medical practitioner a duty to act as a responsible practitioner would. In this respect Dr Steeper failed to take a clinical history, conduct examinations and keep adequate records of findings, and fell below the accepted standard for a medical practitioner and this failure amounted to professional misconduct.
  2. The Vega test machine operates on the principle of a wheatstone bridge, and measures the potential differences between a small hand held electrode and a pencil probe electrode applied to the patient’s left middle toe, a recognised acupuncture point, with the meter reading the result. Organ pathology is allegedly diagnosed by inserting a specific organ/disease ampoule in a receptacle which is part of the circuit. Dr Steeper extended the usual application of the machine by "directing questions from his subconscious mind to the patient’s subconscious" and received answers through the response of the machine. Dr Steeper acknowledged that this bioenergetic system was operator dependent and not amenable to critical evaluation or examination. The hand out information sheets used by Dr Steeper gave the impression that the procedure and capabilities of the machine were established facts whereas in fact they were not. His use of the machine together with the hand out was misleading and caused the mothers considerable distress. The committee concluded that Dr Steeper’s use of the Vega machine comprised professional misconduct. The committee recognised section 58 (4) of the Medical Practitioners Act 1968 which provides that "no person shall be guilty of disgraceful conduct in a professional respect merely because he has adopted and practised any theory of medicine or surgery, if in so doing he has acted honestly and in good faith". The committee accepted that Dr Steeper acted in good faith, but it did not consider that he adopted any "theory of medicine or surgery" in the use to which he put his machine. His use of the machine was far beyond any accepted theory of medicine.
  3. It was accepted that Dr Steeper made statements to mothers of the patients which were misleading, hurtful and caused them distress and unnecessary anxiety. The advice of a medical practitioner is accepted by patients often without question and the advice as to "miasms" and predictable diseases or a potentially fatal accident in later life were given credence because they were made by a medical practitioner in whom the patients had placed their trust. Dr Steeper’s actions in this regard fell well below those of a medical practitioner, and comprised professional misconduct.
  4. The committee recognised and acknowledged that there is demand for alternative therapy from patients as well as practitioners who find that a proportion of patients do not have their expectations fulfilled through orthodox medicine. Nevertheless medical practitioners who practise alternative medicine should be conscious of the need for ensuring that their patients are fully informed as to the nature of the practices being undertaken. Where those practices depart too radically from orthodox medicine, the practitioner should question whether his role is in fact one of a medical practitioner, or some other type of practitioner. If the latter should be the case then the doctor should not operate under the guise of orthodox medicine. The fact of medical registration and holding oneself out as a medical practitioner does lead to patients accepting the treatment however radical given by the doctor, as having authenticity or credence. The patients in this case were mislead into initially accepting the reliability and authenticity of the manner in which Dr Steeper used his machine. The committee believed that this practice under the guise of orthodox medicine misled his patients and amounted to professional misconduct.
  5. In the case of the first baby with known sensitivity to dairy products, the gastrointestinal disturbance was most likely due to lactose intolerance but the committee could not be certain of this. However the response of Dr Steeper following a request for advice from the mother concerning her distressed child, was threatening and implied that if the doctor’s advice was not followed that the child would be sick throughout life and could die early. This advice was regarded by the mother as threatening and intimidating and in the view of the committee was inappropriate and comprised serious failure to provide adequate after care and amounted to professional misconduct.
  6. Unorthodox or alternative medicine was not on trial. Specific allegations were made against Dr Steeper in the methods and manner in which he treated three patients together with statements and advice he gave to them. They were frightened, distressed and misled whilst all somewhat vulnerable as mothers of young children who consulted a medical practitioner who practised homoeopathy. In the committee’s view the standing of a doctor as a registered medical practitioner enabled Dr Steeper to give credence or status to the use to which he put his machine, the predictions and diagnosis that he made. The committee had no doubt that in each of the respective cases alleged the behaviour of Dr Steeper fell substantially below the standard required of a registered medical practitioner and individually and cumulatively his actions comprised professional misconduct. While not going so far as to conclude that the actions were disgraceful conduct the committee was of the opinion that they bordered on that category of behaviour

Penalty

The Medical Practitioners Disciplinary Committee ordered that Dr Steeper be censured, that he pay a penalty of $900 to the New Zealand Medical Association, that he pay costs and expenses of $25 000 and that certain conditions be imposed upon his practice for a period of three years. Namely:

  1. That Dr Steeper should undertake an adequate medical history and clinical examination of each patient, and fully record these in the written notes.
  2. That where Dr Steeper employed alternative medical practices that the patients should be made aware of these and written consent obtained in advance.
  3. That Dr Steeper should discontinue the practice of his particular "extrapolations" and communications of these to patients.
  4. That Dr Steeper’s practice be supervised and reported upon at quarterly intervals over that period.

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