Doctor operated on brains of involuntary patients

The Guardian, January 1 1981

A leading surgeon performed irreversible brain operations on four female patients at Rampton Hospital. This is the first known case of moden psychosurgery in a special hospital where patients are detained involuntarily.

Two of the women were subsequently discharged, apparently recovered. One, who had a young child, committed suicide. The fourth is still detained under the 1959 Mental Health Act, despite undergoing further brain surgery.

The operations were performed without the knowledge or consent of the Department of Health which manages the hospital.

The surgeon, Mr David Price, a consultant neurosurgeon at Leeds Infirmary and senior lecturer at Leeds University, said yesterday that he thought he had informed the department but now believed he had mistakenly told a different government department.

The surgery, which was performed between 1974 and 1976, has been unearthed by Mr Larry Gostin of MIND, the National Association for Mental Health. He said: “I find it quite amazing that this sort of surgery is being performed on patients who cannot possibly give effective consent. It is remarkable and lamentable that the Department of Health seems not to have been consulted either.”

The revelation comes in the wake of a series of unrelated allegations made in a Yorkshire Television programme about brutality at Rampton. The Director of Public Prosecutions is considering bringing charges over 38 incidents at the hospital.

All four women were given pre-frontal rostral leucotomies by Mr Price. The operation involves drilling through the top of the skull to remove parts of the brain with a suction tool.

The first leucotomy was performed on March 12 1974 on a young woman who was recognised as one of the most difficult patients in the hospital. She had a history of arson, self-injury, destructiveness and violence towards staff and other patients.

Case notes which are in the hands of the Guardian, record that in the days after the operation, “she seems to lapse into day-dreaming, staring into space, and is obsessed with cleaning the centre of her ashtry. Her fingers constantly crease the sheets into neat pleats.”

But then, as the case notes say, she made a remarkable recovery. She seemed calm, placid, and no longer tried to attack those around her. She was discharged eventually to resume her life at home.

Mr Price later told a symposium at the hospital: “I think I made a decision within a minute or two of seeing her that I would like to do a leucotomy. On the other hand, I couldn’t really say that the operation was going to help her.

“All I knew was that there was perhaps and 80 or 90 per cent chance that we could help her but there was also a small chance that we might make her even worse. Nevertheless I thought it was worth taking this small chance.”

In the next 18 months, Mr Price performed similar operations on three other women from Rampton. He told the same symposium: “I know what I did in the sense that I know the operation that I did, but what I actually did to the brain, I don’t know.”

Mr Gostin and MIND are critical of the operations because they are unpredictable and irreversible. They believe it is hard for mentally ill patients to give effective consent, particularly if they are involuntary patients and their release may depend upon their co-operation.

They want psychosurgical operations to be submitted to a review board of doctors, lawyers, and social workers for approval. Many doctors are firmly opposed to the idea of such boards, which they see as an infringement of their professional independence.

But Mr Price said yesterday: “I totally agree with very careful scrutiny of every patient that has this type of surgery. I think it is quite reasonable that decisions about involuntary patients should be reviewed by a board, just as an extra safeguard.”

He added: “Getting consent is always a problem. These patients knew that this operation was their only hope. They had tried every drug and ECT and they had got to the end of the road, which is where you put psycho-surgery.

“I’m absolutely satisfied that these patients gave a logical, thoughtful answer. We knew that we were entering a precarious area and we were particularly careful that fair amount of discussion took place.”