Noakes witness inaccurate, hearing told

Published Feb 10, 2016

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Cape Town - A witness in the Tim Noakes hearing was told on Wednesday that his evidence was artificial and unfair.

Bioethics lecturer Professor Willem Pienaar is giving evidence in the Health Professions Council of SA disciplinary committee into the professional conduct of the sports scientist.

The hearing arises from a Twitter exchange in February 2014 in which the low carb high fat (LCHF) diet was discussed in relation to breastfeeding mothers and weaning babies. Noakes told Pippa Leenstra: “Baby doesn’t eat the dairy and cauliflower. Just very healthy high-fat breast milk. Key is to ween (sic) into a LCHF.”

The then-president of the Association of Dietetics SA, Claire Julsing-Strydom, lodged a complaint with the HPCSA after this social media exchange.

Under cross-examination by Michael van der Nest for Noakes, the question of what constitutes a doctor-patient relationship was raised.

Van der Nest contends that there should be an agreement to treat and be treated in this relationship.

Van der Nest took Pienaar though tweets from Noakes and Leenstra, various dieticians and members of the public. The debate raged for several days, and ultimately Leenstra decided to take the advice of the dieticians rather than Noakes.

He put to Pienaar that it was “artificial and unfair and inaccurate to say one tweet creates a doctor patient relationship”. Instead, Leenstra was seeking information on a public forum in order to make a decision. “If a person asked for advice and made an informed decision - what is wrong with that?” he asked.

“That is precisely the problem,” Pienaar replied. “Many other people could have decided otherwise {Ie differently from Leenstra]. We cannot allow this on open social media.”

Van der Nest took the professor through an article in which Leenstra was interviewed, in which she said it had been an innocent question and had made up her own mind.

Pienaar countered that this was hindsight, which did not have bearing on his opinion about the Twitter exchange.

Van der Nest repeated that there was no evidence there has been an agreement to treat and be treated between Noakes and Leenstra.

Pienaar opposed this. “Noakes gave advice on social media - we should not do this as doctors.”

Van der Nest noted that Noakes had not practiced as a general practitioner for several years. He was a highly-rated scientist who was advocating LCHF as a matter of science. “If he says on social media that is ok for breastfeeding moms to wean to LCHF, the world can get this and act or not,” he said.

Pienaar disagreed: “It is not the science, it is giving advice on social media.”

The hearing has adjourned for lunch, and is set to run until February 17.

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