Noakes case: 'Where is even-handedness?'

By Renee Moodie Time of article published Feb 9, 2016

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Cape Town - When does the relationship between a doctor and a patient begin?

That was the question at the centre of the afternoon session of the hearing into the professional conduct of Professor Tim Noakes on Tuesday.

Earlier University of Stellenbosch psychiatrist and bioethics lecturer Willem Pienaar told the Health Professions Council of SA committee that he thought Noakes had erred when he said on Twitter that a mother should wean her baby on to a low carb high fat (LCHF) diet.

He said felt that Noakes had been guilty of improper conduct and insufficient care for his patient, and that he believed a doctor-patient relationship had been established between them. That relationship was formed when a doctor makes an “affirmative action” in relation to a lay patient, he said.

In the afternoon session, Van der Nest put to him that affirmative action by a doctor comprised examining, diagnosing and treating or agreeing to do so. Pienaar remained firm in his contention that the giving of advice constituted caring for a patient, and that this is where the relationship began.

Van der Nest asked about the status of a general medical question asked at a public meeting, which he said was the same as a question asked on Twitter. Pienaar replied that this was a “value question” - it was up to the clinician to assess this and decide whether a consultation was needed.

Van der Nest pointed out that in the 2014 Twitter exchange mother Pippa Leenstra had been advised by a dietician not to wean on to LCHF, and that another dietitician had disparaged Noakes on Twitter, which was also unprofessional. Yet only Noakes was being charged.

“Where is even-handedness here?” he asked.

Pienaar replied that three wrongs do not make a right.

Van der Nest put it to Pienaar that he was a “social media dinosaur” in that he did not understand the nature of Twitter.

Pienaar replied that professionals needed to think about the messages they broadcast on social media.

The hearing resumes on Wednesday at 11.15am with Pienaar still under cross-examination.


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