Modern medicine is based on the scientific methodology of continuous experiments and logical analysis. Every medical diagnosis and principle of treatment must be supported by sufficient evidence. Baseless assumptions are not permissible.
Medical rigor is really humility in the face of fearsome ailments, because the more you know about the mysteries of the human body, the more you will be amazed by the greatness of the creator, and the more clearly you will recognize that medicine has its limits.
As a surgeon, my mission is to cure illnesses and save people. It is therefore hard to accept that after doing everything I could to fight an illness, I found myself treated as a “criminal” under the Criminal Code.
A little after 4pm on Aug. 7, 2008, our hospital’s emergency room notified me that a seriously ill patient had come in with a badly swollen lower leg, and the symptoms indicated a critical condition known as compartment syndrome.
This syndrome is often seen in traffic accidents and if it is not treated promptly it has a mortality rate of about 40 percent.
The treatment for compartment syndrome is also very special. It requires performing a fasciotomy, which involves opening an incision about 20cm long in the affected part so that blood and other fluids can drain out.
This incision is left open until the swelling is completely reduced, which takes about two weeks, after which it can be closed up with sutures. While the incision is open, the open wound is not protected by skin, so it is essential to prevent bacterial infection.
Medical statistics show that fasciotomies have a success rate of about 70 percent, while 20 percent of cases require amputation and 10 percent of patients might die.
I performed the urgent operation at 6pm that day, hoping to save the young patient’s right lower leg, but unfortunately six days later it had to be amputated.
The patient’s father thought the amputation was the doctor’s fault, so he filed criminal charges against me. I was found not guilty in the first trial, but in the second trial the verdict was changed to guilty and I was sentenced to four months in prison.
Article 376 of the Code of Criminal Procedure (刑事訴訟法) states that cases involving offenses with a maximum punishment of no more than three years imprisonment cannot be appealed to the court of third instance.
This restriction applies no matter whether the second trial results in a guilty or not-guilty verdict, and it meant that I could not appeal the verdict of the second trial.
In the second trial, the judges said they overturned the first ruling because I had not paid close attention to the patient’s blood circulation and obstructed blood vessels.
The problem with this judgement is that, in addition to the case history, the patient’s care team took photographs of the wound every day, which clearly showed that the blood circulation in the leg was satisfactory. That is why the first trial arrived at a verdict of not guilty.
However, this was not even mentioned in the second ruling, suggesting that the judges did not even notice the existence of the photographs.
Furthermore the entire judgement conflicts with pathology. It plays with words and is based on groundless assumptions, and it misinterprets the opinions expressed in the medical review committee’s appraisal of the case.
It seems that the judges were unaware of these flaws. As a result of the second verdict, I was deprived of the right to appeal and lost the opportunity to argue my case in court, all because of Article 376.
As a victim of injustice, I sought the assistance of the Judicial Reform Foundation. Over the past three years, we have made several attempts to redress this injustice.
This experience convinced me of how badly the nation’s judicial system needs to be reformed.
On July 28 last year, the Council of Grand Justices issued Constitutional Interpretation No. 752, which states that “in cases first pronounced not guilty in the court of first instance, but where the judgement is later revoked and the accused pronounced guilty in the court of second instance,” the clauses of Article 376 of the Code of Criminal Procedure that say the accused in cases involving less-serious offenses cannot appeal to the court of third instance are unconstitutional.
The foundation told me that the interpretation addresses the problem I had run into and that more than 300 people each year are denied the right to appeal on similar grounds.
The foundation asked me whether I would be willing to speak out in public and join it in calling on the legislature to amend the law to remedy past cases.
I agreed, because a guilty verdict means that a person has committed a crime and this will have a heavy impact on that person’s reputation, job prospects and life in general. It follows that anyone in this situation should at least have a chance to try and clear their name.
As legendary Tang Dynasty physician Sun Simiao (孫思邈) once said, superior medical treatment heals the nation, mediocre treatment heals the person and inferior treatment heals the illness, so hopefully I am not overstepping my role as a physician by speaking out for myself and for all the other people who find themselves in a similar predicament.
After holding a news conference with legislators, the foundation collected quite a large number of similar cases. Some people question whether there is any point in trying to amend the law, since injustices will not necessarily be set right by appealing to the Supreme Court.
As far as I am concerned, although it is important for me to clear my name, it would be still more meaningful to be able to go to the Supreme Court and argue for the legal interpretations that we call for, in the hope that this would have an influence on the judgements of all the lower courts.
I believe that anyone who has been denied that right to a third trial would like to see this happen.
Let us hope that legislators will take an in-depth look at the issue and pass proposed amendments as soon as possible, because for an innocent person, even one day in prison is a lifelong stain on their character.
Huang Hui-fu is an attending plastic surgeon at National Taiwan University Hospital.
Translated by Julian Clegg
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