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Name:
Dr Michael Lester Philip GROSS
Business Address:
North of Thames:
105 Nibthwaite Road,
Harrow,
Middlesex,
HA1 1 TE
Tel: 0208-861-1777
Fax: 0208-863-7124
South of Thames:
Gatwick Park Hospital,
Povey Cross Road
Horley, Surrey
RH6 0BB
Tel: 01293-771-132
Fax: 01293-771-131
Place of Birth:
Hertfordshire, England
Nationality:
English
GMC:
2310709
Defence Organisation:
Medical Protection Society
Education:
1963 - 1970 - Minchenden School, Southgate
1970 - 1973 - Sydney Sussex College, Cambridge
1973 - 1976 - The Royal London Hospital Medical School
Degrees:
1973 - BA (Hons) (Cambridge) Medical Sciences
1976 - MB, BChir (Hons) (Cambridge)
1976 - MA (Cambridge)
1978 - MRCP (UK)
1987 - MD (Cambridge)
1995 - FRCP (UK)
1998 - Founder Member Expert Witness Institute (MEWI)
Accreditation:
Accredited in neurology and neurophysiology by the Royal College of Physicians
Appraisal:
Full appraisal by consultant under jurisdiction of Clementine Churchill Hospital, 2004 - 2010
Recent Awards:
Current Position:
Consultant Neurologist and Clinical Director of Neurophysiology at the Clementine Churchill Hospital, Sudbury Hill, Harrow, Middlesex HA1 3RX
Consultant Neurologist and Director of Neurophysiology at Gatwick Park Hospital, Povey Cross Road, Horley, Surrey RH6 0BB
Neurology Adviser to Watford Football Club
Medico-legal Experience:
Preparation of medico-legal reports since 1982
At present, 150 – 300 new instructions each year.
Numerous appearances in Court (3-5/year).
Regular conferences with Counsel.
Current instructions equally split between Claimant, Defendant and joint instruction.
Work involved in personal injury and medical negligence. Also DDA, Testamentary Capacity, Employment Tribunal
Invited lecturer to Personal Injury Barristers Association Annual
Meeting 2005 entitled “Makers, Takers and Fakers” and similar
Lecture to APIL 2006 and Association of British Neurosurgeons 2007
Numerous lectures to Societies, Legal Forums and Chambers on a range of neurological topics
Medico-legal Specialist Areas:
Membership of Professional Organisations:
Fellowship of the Royal College of Physicians
Fellowship of the Royal Society of Medicine
Association of British Neurologists
World Federation of Neurology
International Headache Society
European Federation of Neurological Societies
Member of Expert Witness Institute
Membership of Advisory Bodies:
Previous Chairman, Division of Neurological Sciences, Royal Surrey
County Hospital, Guildford
Previous Chairman, South West Surrey Stroke Advisory Committee
Previous Chairman, East Surrey Stroke Advisory Committee
Member, Medical Advisory Committee, Gatwick Park Hospital (2004-2008)
Chairman Neurosciences User Group, Clementine Churchill Hospital, Harrow
Chairman Neurosciences User Group, Gatwick Park Hospital
Numerous Advisory Committees in relation to research in headache,epilepsy, multiple sclerosis and chronic fatigue
Previous Member of the Medical Advisory Committee of the Migraine Trust.
Member of the International Headache Society
Member of the World Federation of Neurologists
Member of the European Federation of Neurological Science
Previous Appointments:
February 1990 – June 2001 – Consultant Neurologist at the Royal Surrey County Hospital in Guildford
Consultant Neurologist and Director of Neurophysiology to the East Surrey Group of Hospitals, Redhill, Surrey RH1 5RH.
During the tenure of this post, Chairman of Neurosciences at the Royal Surrey County Hospital 1991 – 2001
1986 – 1990 – Senior Registrar at the National Hospital For Neurology and Neurosurgery, Queen Square, London WC1 and St Marys Hospital, Paddington, London WC2.
During the tenure of this post, eighteen months Locum Consultant position between a Hertfordshire Group of Hospitals and the Royal Free Hospital in Hampstead.
1983 – 1986 – Resident (Registrar) and Senior Resident at the National Hospital, Queen Square and Maida Vale.
1982 – 1983 – Registrar in Neurology, The Royal Free Hospital, Hampstead.
1981 – 1982 – Research Registrar at the Royal Free Hospital undertaking Doctorate project.
1980 – Renal Registrar, The Royal Free Hospital
1979 – Senior House Officer and Registrar, Hammersmith Hospital
1978 – Senior House Officer in Neurology, The National Hospital for Neurology and Neurosurgery.
1977 – Senior House Officer posts in General Medicine and Cardiology at the North Middlesex Hospital and the London Chest Hospital
1976/1977 – House Physician and House Surgical posts at the Royal London Hospital
Media Background:
Numerous articles and appearances in relation to health care, headache/analgesic overuse and its under-provision.
Invited Lecturers:
I have given more than a hundred invited lectures over the years to local, national and international groups on a number of neurological topics. I have been the organiser of numerous Neurology Study Conferences and acted as Chairman of those meetings as well as chaired numerous sessions within significant scientic meetings.
In recent years, I have been asked to lecture to the Harveian Society, the Medico-Legal Society and the Association of Personal Injury Barristers (APIB). I have also lectured at the Royal Society of Medicine on several occasions.
Personal Statement:
During my eleven years as a Consultant Neurologist at The Royal Surrey County Hospital, I was elected Chairman of the Neuroscience Department and held that position for ten years. I left the NHS in June 2001. I had stated publicly that it was unsafe to practice neurology within the NHS in Surrey and Sussex.
I continue to have a large clinical private practice (20 – 30 new patient referrals each week). I have in-patient beds at the Clementine Churchill Hospital and Gatwick Park Hospital.
Approximately 20% of my clinical time is spent in the undertaking of medico-legal work.
I employ five people in my practice with two full-time offices in Harrow and Gatwick. My team ensure a rapid response to any correspondence or telephone contact.
I am part of a Neurosciences Peer Supervision Group who meet regularly and discuss mutual matters. We are currently undertaking a research project on “The Validation of Symptoms” to be published shortly.
I am currently writing a book on “Abuse and Abusive Behaviour”.
Publications:
BRETTLE R P, GROSS M L P, LEGG N J, LOCKWOOD M C, PALLIS C
Treatment of acute polyneuropathy by plasma exchange. Lancet 11, 1100, 1978
LEGG N J, GROSS M L P, BOULOUX P M
Extent of cuts in computerised tomography of the brain. Lancet 1, 1299, 1979, Letter
GROSS M L P, BOULOUX P M, LEGG N J
Parasaggital meningioma presenting as low grade glioma on computerised tomographic scan.
Lancet 1, 821, 1979 (letter)
GROSS M L P, TEOH R, LEGG N J, PALLIS C
Ocular myopathy and Marfan’s syndrome: a family study. Journal of the Neurological Sciences. 46, 1, 105-112. 1980
GROSS M L P.
Acute dystonia as an idiosyncratic reaction to Haloperidol. Lancet 11, 479-480.
1980 (letter)
SWENY P, HOPPER J, GROSS M L P, VARGHESE Z
Nephrotoxicity of cyclosporine A. Lancet 1, 663, 1981 (letter)
SWENY P, WINNING A, GROSS M L P, MOORHEAD J F
Plasmapheresis in the haemoloytic uraemic syndrome in children. British Medical Journal 1981.
GROSS M L P, BAILLOD R, PEARSON R M, SWENY P
Plasma exchange and haemodialysis as a combined procedure. Plasma Therapy, 2, 4. 255. 1981
GROSS M L P, SWENY P, LEGG N J
Successful plasmapheresis in the Miller-Fisher syndrome. British Medical Journal 1. 282. 1981 (letter)
GROSS M L P, PEARSON R M, SWENY P, FERNANDO O, MOORHEAD J F
Rejection encephalopathy. EDTA Proceedings, 18, 461-464. 1981
GROSS M L P, THOMAS P K
The treatment of chronic progressive and chronic relapsing polyneuropathy by plasma exchange. Journal of Neurological Science. 52, 69-78, 1981
GROSS M L P, LEGG N J, LOCKWOOD M, PALLIS C
The treatment of inflammatory polyneuropathy by plasma exchange. Journal of Neurology, Neurosurgery & Psychiatry, 45, 675-679, 1982
GROSS M L P, PEARSON R M, SWENY P, KENNEDY J, FERNANDO O, MOORHEAD J F
Rejection encephalopathy; an acute neurological syndrome complicating renal transplantation. Journal of Neurological Sciences 56, 23-34, 1982
GROSS M L P, PEARSON R M, KENNEDY J, MOORHEAD J F, SWENY P.
Rejection encephalopathy. Lancet ii, 1217, 1982 (letter)
GROSS M L P
The treatment of acute polyneuropathy by plasma exchange. Journal of Neurology, Neurosurgery & Psychiatry. 46, 267, 1983
GROSS M L P, CRAGGS R, KING R H M, THOMAS P K
The modification of experimental allergic neuritis with plasma exchange. Journal of Neurological Sciences, 61, 149-160, 1983
KING R H M, CRAGGS R, GROSS M L P, TOMPKINS C, THOMAS P K
The suppression of experimental allergic neuritis by cyclosporine. Acta Neuropathologica (Berlin) 59, 262-8, 1983
MILLAR A, CLARKE S W, DAVIS S N, GROSS M L P
Prolonged ventilation in severe asthma caused by the Guillain-Barre-Strohl syndrome.
Journal of the Royal Society of Medicine, 77, 965-66, 1984
GROSS M L P, CRAGGS R
A method of plasma exchange in an experimental auto-immune disease. Apheresis 2, 1, 7-12, 1984
GROSS M L P
The treatment of inflammatory polyneuropathy with plasma exchange. Apheresis 2, 1, 7-12, 1984
GROSS M L P, PEARSON R M, SWENY P, MOORHEAD J F
Convulsions associated with cyclosporin A in renal transplant recipients. British Medical Journal 290, 555, 1985 (letter)
CRAGGS R, GROSS M L P, KING R H M, THOMAS P K
Effects of glucocorticoids on experimental allergic neuritis. Experimental Neurology 87, 9-19, 1985
GROSS M L P
Giant middle cerebral aneurysm presenting with unilateral Parkinsonism. Journal of Neurology, Neurosurgery & Psychiatry, 50, 1075, 1987
KREEGER L, GROSS M L P, NIEMAN E
MRI scanning in case of HTLV-3 associated tropical spastic paraparesis. Journal of Neurology, Neurosurgery & Psychiatry, 1988
GROSS M L P, HO R, FOWLER C, HARRISON M J, RUSSELL C
Polyneuropathy complicating severe pancreatic disease. Journal of Neurology, Neurosurgery & Psychiatry
GROSS M L P
The therapeutic modification of inflammatory polyneuropathy. M D Thesis, University of Cambridge 1987
BROWN S, GROSS M L P, HARRISON M J
Paraplegia following oral hypotensive treatment of malignant hypertension. Journal of Neurology, Neurosurgery & Psychiatry, 50, 104, 1987
GROSS M L P
A case of chronic relapsing inflammatory polyneuropathy complicating Sjorgens syndrome. Journal of Neurology, Neurosurgery & Psychiatry, 50, 939, 1987
GINSBERG L, GROSS M L P, CLLIFFORD JONES R, MORGAN HUGHES J
A case of chronic hypothermia, relapsing extrapyramidal syndrome and marrow aplasia.
Journal of Neurology, Neurosurgery & Psychiatry
VAN DE POEL H, GROSS M L P
Pink visioin – report of four cases
KENNEDY A, GROSS M L P
The sphenoid sinus revisited – a report of two cases. Paper completed
GROSS M L P, MUTHTHUSWAMY S, EARL C J
The clinical syndrome of spinal cord compression by tumour – 92 cases reviewed
LLEWELYN G, BRADLEY C, GROSS M L P
Acute aphasia as the presenting feature in a case with HIV infection, 1989
GROSS M L P, KAY J, TURNER A M, HALLETT K, CLEAL A L, HASSANI N
Sumatriptan in acute migraine using a novel cartridge system self-injector. Headache 1994:
34: 559-563
GROSS M L P, KAY J, TURNER A M, JEWSBURY J, CLEAL A L
Long-term efficacy of subcutaneous Sumatriptan using a novel self-injector. Headache 1995:
35: 601-606
GROSS M L P
The use of Sumatriptan in the treatment of migraine. British Journal of Clinical Practice 1993:
47, 4 205-7
STEINER T J, DELLAPORTAS C I, JESTICO J, FINDLEY L J, GROSS M L P et al
Lamotrigine monotherapy in newly diagnosed untreated epilepsy; A double-blind comparison with Phenytoin. Epilepsy 1996
CULL R E, GROSS M L P, DOWSON A, PRICE W H, BATES D, GIBSON J
Evaluation of a new migraine diagnostic questionnaire. Cephalalgia 1996
GROSS M L P
Pizotifen in hemifacial spasm. Journal of Neurology, Neurosurgery & Psychiatry 1996
GROSS M L P
Current and future therapies for migraine. Exp Opin Invest Drugs 1995, 4 (4): 283-290
LIPTON E B, AMATNIEK J, FERRARI M D, GROSS M L P
Migraine: Identifying and removing barriers to care. Neurology 1994, 4 (Suppl 4): 563-68
GROSS M L P et al
Migraine Management Guidelines. Synergy 1993
GROSS M L P
Stroke: The intrusive platelet, 1993, 5: 1-3
GROSS M L P, DOWSON A, DEAVEY L, DUTHIE T
Impact of oral Sumatriptan 50 mg. on work productivity quality of life. British Journal of Medical Economics, 1996 (In Press)
MAIN A, DOWSON A, GROSS M L P
Photophobia and phonophobia in migraineurs between attacks. Headache 1997 37, 8, 492-496
CULL R E, GROSS M L P, DOWSON A, PRICE W H, BATES D, GIBSON J
Evaluation of a new diagnostic questionnaire. Headache 1997
GROSS M L P, BARRIE M, BATES D, DOWSON A, ELRINGTON E
The efficacy of oral Sumatriptan in menstrual migraine – a prospective study.
Cephalalgia 1998
TEALL J, TUCKMAN M, CUTLER N, GROSS M L P et al
Rizatriptan (Maxalt) for the acute treatment of migraine and migraine recurrence.
A placebo controlled out-patient study. Headache 1998, 38: 281-287
STEINER T J, DELLAPORTAS C I, FINDLEY L J, GROSS M L P et al
Lamotrigine monotherapy in newly diagnosed untreated epilepsy. A double-blind comparison with Phenytoin. Epilepsia 1999
Vigabatrin European Monotherapy Study Group
A multi-centre randomised double-blind study comparing the safety and efficacy of Vigabatrin and Carbamazepine in newly diagnosed epilepsy. Epilepsia 1999
BRODIE M et al
A multi-centre double-blind randomised comparison trial of Lamotrigine and Carbamazepine in elderly patients with newly diagnosed epilepsy. The Lancet 1999
Presentations at Meetings & Abstracts:
GROSS M L P, LEGG N J
The treatment of chronic relapsing polyneuropathy by plasma exchange
Meeting of the Royal Society of Medicine, 1979
GROSS M L P, THOMAS P K
The treatment of chronic progressive and chronic relapsing polyneuropathy by plasma exchange. Association of British Neurologists meeting York, 1981
GROSS M L P, PEARSON R M, SWENY P, MOOREHEAD J M
Rejection encephalopathy. European dialysis and transplant association meeting, Paris 1981
GROSS M L P, THOMAS P K
The treatment of experimental allergic neuritis by plasma exchange. Association of British Neurologists meeting, Brighton 1982
GROSS M L P, THOMAS P K
The treatment of experimental allergic neuritis by cyclosporin A. First International Congress of Neuroimmunology, Strese 1981
GROSS M L P, CRAGGS R
The treatment of experimental allergic neuritis by plasma exchange. 4th International Congress of Neuromuscular Diseases, Marseilles 1982
GROSS M L P, THOMAS P
Chronic polyneuropathies treated with plasma exchange. European Society for Clinical Investigation, Travemunde 1983
GROSS M L P
Controlled trial of plasma exchange in experimental allergic neuritis. European Society for Clinical Investigation, Travemunde 1983
GROSS M L P
Is demyelinating neuropathy a treatable disease? Queen Square Research Society, February 1984
GROSS M L P, GAUTIER SMITH P
The anatomical basis of hemidystonia.. Meeting of the Royal Society of Medicine (neurology section). December 1985
GROSS M L P
The role of plasma exchange in chronic relapsing and chronic progressive polyneuropathy.
Sixth International Congress of Neuromuscular Diseases, Los Angeles 1986
GROSS M L P, GAUTIER SMITH P
A case of Wegener’s disease. Meeting of the Royal Society of Medicine (neurology section) 1987
GROSS M L P
The treatment of chronic relapsing inflammatory polyneuropathy by plasma exchange
Association of British Neurologists Meeting, London 1987
GROSS M L P, MUTHTHUSWAMY C, EARL C J
The clinical syndrome of spinal cord compression by tumour. Queen Square Research Society, 1988
GROSS M L P, MUTHTHUSWAMY C, EARL C J
The clinical syndrome of spinal cord compression by tumour. European Neurological Society, Nice 1988
GROSS M L P, MUTHTHUSWAMY C, EARL C J
The clinical syndrome of spinal cord compression by tumour. Association of British Neurologists Meeting, Hammersmith 1988
GROSS M L P
Spinal cord compression S.E.N.A. 1992
GROSS M L P
Representing Sumatriptan auto-injector study group. Sumatriptan is effective in acute migraine by new auto-injector device. Migraine Trust 1994
MAIN A, DOWSON A, GROSS M L P
A case controlled study of photophobia and phonophobia in migraine patients between attacks.
Cephalalgia 1995, 15 (14) 284. 7th International Headache Congress, Toronto 1995
DOWSON A, STEVENS C, SENDER J, GROSS M L P
The Royal and East Surrey Neurology Research Unit. Does establishment of a Migraine Research Unit alter clinical referral patterns? Cephalalgia 1995, 15 (14) 42. 7th International Headache Congress, Toronto 1995
STEVENS C, DOWSON A, GROSS M L P
The Royal and East Surrey Neurology Research Unit. A retrospective study of migraine patients participating in drug research programmes. Cephalalgia 15 (14) 281. 7th International Headache Congress, Toronto 1995
GROSS M L P, BARRIE M, BATES D, DOWSON A, ELRINGTON E
The efficacy of oral Sumatriptan in menstrual migraine – a prospective study. Cephalalgia 1995, 15 (14) 227. 7th International Headache Congress, Toronto 1995
CULL R, GROSS M L P, DOWSON A, PRICE W, BATES D
An investigation into the validation of a new migraine diagnostic questionnaire. Cephalalgia 1995, 15 (14) 27. 7th International Headache Congress, Toronto 1995
GRUFFYDD-JONES K, HOOD C, PRICE D, DOWSON A
Patient preference for subcutaneous and oral Sumatriptan in acute treatment of migraine.
Cephalalgia 1995 15 (14) 173, 7th International Headache Congress, Toronto 1995
DOWSON A, RAMPHUL-GOKULSING S, KLEIN K, COX R, WILKINSON M, GROSS M L P
Can oral 311C90 , a novel 5HT1D agonist prevent migrainous headache when taken in aura?
Cephalalgia 1995 15 (14) 173. 7th International Headache Congress, Toronto 1995
DOWSON A, RAMPHUL-GOKULSING S, KLEIN K, COX R, WILKINSON M, GROSS M L P
A pilot study to investigate whether Zolmitriptan (311C90), a novel 5HT1D agonist can be used as acute prophylaxis to prevent a migraine headache. 6th International Headache Research Seminar, Copenhagen 1995
FLETCHER P, LOWY M T
On behalf of the 311C90 long term study group. Evaluation of the long term safety and efficacy of Zolmitriptan (311C90) in the treatment of migraine. 6th International Headache Research Seminar, Copenhagen 1995
ROTHWELL K, DOWSON A
Patient evaluation of acute migraine treatments. 6th International Headache Research Seminar, Copenhagen 1995
CULL R, GROSS M L P, DOWSON A, PRICE W, BATES D, GIBSON J
An investigation into the validation of a new migraine diagnostic questionnaire. European Federation of Neurological Science, Marseilles 1995
DOWSON A, GROSS M L P et al
The efficacy of oral Sumatriptan in menstrual migraine – a prospective study. European Federation of Neurological Science, Marseilles 1995
DOWSON A, GROSS M L P
The value of Sumatriptan as an acute treatment for migraine. European Federation of Neurological Science, Marseilles 1995
DOWSON A, GROSS M L P
The value of Sumatriptan as an acute treatment for migraine. 3rd European Headache Federation, Sardinia 1996
DIENER H C, KLEIN K B, GROSS M L P
For the Multinational Oral 311C90 and Sumatriptan comparative study group. The first comparison of the efficacy and safety of 311C90 and Sulmatriptan in the treatment of migraine. 3rd European Headache Federation, Sardinia 1996. Functional Neurology (1996) (11) 2/3, 153
FLETCHER P E, McDONALD S, LOWY M T, GROSS M L P
For the Multinational 311C90 long term study group. Long term safety and efficacy and pattern of usage of 311C90 in the acute oral treatment of migraine. 3rd European Headache Federation, Sardinia 1996
RYAN jnr R E, ELKIND A H, GOLDSTEIN J, GROSS M L P
For CN115-020 BMS study group. 24 hour response rate and incidence of recurrence of BMS 180048 in the acute treatment of migraine headaches. 3rd European Headache Federation, Sardinia 1996. Functional Neurology (1996) (11) 2/3, 148
HANSEN P, FLETCHER P E, LOWY M T, GROSS M L P
On behalf of the international 311C90 long term study group. Evaluation of the long term safety and efficacy of 311 C90 in the treatment of migraine. 3rd European Headache Federation, Sardinia 1996
DOWSON A, GROSS M L P, MATTHEW N T, COUCH J
Functional improvement and patient acceptability of BMS 180048 in the treatment of patients with acute migraine. 3rd European Headache Federation, Sardinia 1996. Functional Neurology (1996) (11) 2/3, 147.
RYAN jnr R E, ELKIND A, GOLDSTEIN J, MONDELL B, MATTHEW B, COUCH jnr J, KUDROW D, DUBOFF E, THEIN jnr S, BROWN W, LEGG N, GROSS M L P
Twenty-four hour effectiveness of BMS 180048 in the acute treatment of migraine. Functional Neurology (1996) (11) 2/3, 148. 3rd European Headache Federation, Sardinia 1996
ELKIND A H, GOLDSTEIN J, RYAN jnr R E, GROSS M L P
For the CN 115-020 study group. Use of a test dose for determining safety of a 5HT1 like agonist BMS 180048 in 216 subjects. European Headache Federation, Sardinia 1996
Functional Neurology (1996) (11) 2/3, 147
GOLDSTEIN J, RYAN R E, ELKIND A H, GROSS M L P
For the CN 115-020 BMS Study group. A double blind trial of BMS 180048 at 75 mg, 150 mg. and 200 mg. in the acute treatment of migraine headaches. European Headache Federation, Sardinia 1996. Functional Neurology (1996) (11) 2/3, 147
DOWSON A, GROSS M L P, DEAVEY L, DUTHIE T
An assessment of the economic and quality of life impact of oral Sumatriptan (50 mg).
European Journal of Neurology Vol. 3 Supplement 5, p 148. European Federation of Neurological Science, Rome 1996
LOWY M T, KYNOCH D, HOWARD D, FLETCHER P E, GROSS M L P
On behalf of the International 311C90 long term study group. An interim analysis of the long term safety, efficacy and pattern of usage of 311C90 in the acute oral treatment of migraine.
America Academy of Neurology, April 1996
DOWSON A (GROSS M L P)
An open dose titration study evaluating 25 mg, 50 mg. and 100 mg. doses of oral Sumatriptan in the acute treatment of migraine. Cephalalgia 17 (3) 419 8th International Headache Congress, Amsterdam 1997
DOWSON A (GROSS M L P)
An open dose titration study of three doses of Sumatriptan tablets in the acute treatment of migraine over a six month period. American Association for the Study of Headache.
New York 1997
DOWSON A, (GROSS M L P)
An open dose titration study of 25 mg. 50 mg. and 100 mg. doses of oral Sumatriptan in the acute treatment of migraine. JNSCAG 150 (Suppl) S170, 3-21-15
TUCHMAN M M, DOWSON A, MILLSON D S, FLETCHER P E (GROSS M L P)
Maximising migraine relief with Zolmitriptan: Star final data from an open label study with > 49,000 treated attacks. 50th American Acadamy of Neurology, Minneapolis 25 April - 2 May 1998
MAIN A, DOWSON A (GROSS M L P)
Report of the effect of wave length on photophobia in headache-free migraineurs.
XII Migraine Trust, London Sept 1998
GROSS M L P
“Who goes there? The medical profession, government and judiciary – friends or foe?
Journal of the Medico-legal Society. 2008