Tuesday, February 17, 2009

Record Keeping - A Supposition

Normally I try and keep suppositions and conjecture out of this blog, however, recent conversations with politicians who were enquiring in regard to the record keeping of the time here in South Australia has led me to the point where we have to suppose what the intent was.

What do we know as fact? That record keeping and making in the early seventies in the hospitals were excellent. Everything that could be recorded was recorded and the records were kept. This is clinical best practice that allows for medicine to be practiced with the greatest care on the day and also in the future as we are to track down causation and effect events to improve subsequent treatment. An example of this is the post-natal treatment records for most children and mothers of the day which are large enough to fill their own small book. In regard to donor conception records, the only documents that have been provided are those contained on small pieces of paper with a paucity of information and the volume of which wouldn’t even be enough to fill up your back pocket.

What we don’t know. Are these poor DC treatment records the only records in existence? The clinics and practitioners of the time have been constantly changing their story in regard to these records, they were destroyed, they are lost, records weren’t kept or we do not have anything to link the treatment records to the donor records. Numerous doctors that I have spoken to who have been involved in the hospitals at the time find it hard to believe that either poor records were kept or that they have been destroyed as it does not follow the practice of the day. For argument’s sake we will assume that the clinics are being honest to an extent and that these small pieces of paper are the only records that have ever existed (provided that they haven’t been destroyed or lost) and that they are unable to link these to any donor records that may or may not exist. Why would the clinic go strictly against best clinical practices in not creating and keeping appropriate detailed records? It goes directly against everything doctors and nurses are taught from day one of their training.

While these clinics were operating in a hospital environment and in a clinical setting, the early seventies represent donor conception in its infancy here in SA and we could perhaps assume that they were operating more as a research facility undertaking experiments in medical and social science. As a scientist myself, I know for a fact that any research that is conducted now and in the past must be appropriately documented so that experiments can be verified and repeated as required. So what we have is a scenario in which the documentation that was being made within donor conception falling outside the accepted norm within either the medical or scientific fields. For something that was so important and supposedly ground breaking it is mind boggling to think that inappropriate documentation occurred.

If these practitioners and clinics were so lazy as to not create appropriate documentation then it is difficult to see how they could have gotten into those positions in the first place or how they were then able to carry on in the field for such a long time thereafter all the while receiving accolades after accolades. This is where we fall into the realm of conjecture. If we do not wish to follow the practices of the day and do not want to be able to go back over what was done, how, when and why to improve things in the future, we either have to be completely incompetent or we have to be hiding something. As mentioned previously, these practitioners and clinics either already were or they went on to be very successful, so they are definitely not incompetent. Is it possible to assume that it was intentionally done, to reinforce anonymity? That if there are incomplete or poor records then there is no way that the identity of the donor/vendor can ever be found out. And if they were worried about anonymity then they knew that it may become an issue for offspring in the future who would then seek out this information.

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