Welfare board to investigate baby's death

The Swedish National Board of Health and Welfare (Socialstyrelsen) is to open its own investigation into the death of a newborn baby at Astrid Lindgren's Children's Hospital in Solna.

• Court orders doc held over baby's death (6 Mar 09)
• Doctor accused of murdering child (4 Mar 09)

Meanwhile senior physicians have condemned the arrest of a paediatrician at the hospital on suspicion of manslaughter and warn of the potential damage to child healthcare in Sweden.

The doctor is suspected of euthanasia by injecting the then three-month-old baby with deadly doses of morphine and a tranquillizer before turning off the respirator keeping the brain-damaged baby alive.

"I don't want to speculate on the motive. But it's possible that this is a case of a mercy killing," prosecutor Elisabeth Brandt told Sveriges Radio on Friday.

Although euthanasia is illegal in Sweden it is unusual that legal procedures against doctors occur, cases of malpractice usually go before the National Board of Health and Welfare.

The board has now announced that it will look into the case and has requested all documents associated with the case from the department at the hospital where the doctor works.

The board's director-general Lars-Erik Holm and the chairperson of the doctor's union, Läkareförbundet, Eva Nilsson Bågenholm, have expressed surprise that the case has been passed on to the justice system.

"I am surprise that this has gone over the heads of the health and welfare board," Holm said to news agency TT on Friday.

Bågenholm argued that only the health and welfare board had the scope to decide such cases.

Suspicions against the doctor are primarily based on an autopsy conducted after the baby's death in September 2008.

There is nothing strange about administering an excessively high dose of morphine when a respirator is to be turned off, Lars-Erik Holm argued.

Stefan Enqvist, a senior physician at Karolinska University Hospital, agrees. Engvist points out that the baby's life could not be saved and a decision had been taken, in concert with the baby's parents, to terminate life support.

"In this instance medicine is administered to make death as comfortable as possible. That was what has occurred here," Enqvist told TT.

Sometimes the doses are very high, according to Enqvist, who has studied the medical journals without finding anything of note.

The case has been met with controversy in Sweden.

In a full page opinion article in Dagens Nyheter on Saturday, leading paediatrician at Astrid Lingren's Children Hospital, Hugo Lagercrantz, has accused the prosecutor, Elisabeth Brandt, of "seriously damaging" child healthcare in Sweden.

Lagercrantz argues that the case will force doctors to continue to treat patients with no hope of recovery and underlines the lack of clear guidelines in the area.

"We are therefore faced with a a future of congested hospital departments and an increasing number of relatives who drag doctors before the courts and prosecutors who serve remand notices," Lagercrantz writes.

The doctor will now be held in a detention centre while prosecutors continue to interview witnesses as a part of the investigation.

If prosecutors decide to bring formal charges, they are to be filed by 11am on March 13th, at which time the doctor's detention will be reviewed.