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Victims Partly To Blame For Nurse’s 20 Year Pattern Of Sexual Abuse?

Marcella Chester

From the BBC:

David Britten, 54, a former manager at the Peter Dally Clinic in Pimlico, central London, preyed on patients over a 20-year period.

Claims by patients of sexual misconduct emerged after his dismissal from the clinic in 2002 over unrelated issues.

The NHS launched an inquiry in 2006 into how he escaped detection.[…]

The investigators blamed poor management, missed opportunities and the reluctance of his victims to come forward as the reasons for Mr Britten “grooming vulnerable patients”.

The report described Mr Britten as a “manipulative predator who represented a clear danger to women”.

Alison McKenna, who led the inquiry, said: “The effect of David Britten’s abuse of these vulnerable women cannot be overestimated.

What I find striking is the contradiction between the idea that the effect of this man’s abuse cannot be overestimated and how the blame for this man’s serial abuses included the reluctance of his patients to come forward.

Britten was an eating disorder specialist and there are no criminal charges pending due to insufficient evidence in this case which involves 23 patients. Some jurisdictions have criminal statutes which specifically address this type of violation by health professionals so that consent cannot be used as a defense, but I don’t know if England has any such laws.

Since the first official complaint came after Britten was dismissed for other reasons, it looks like there was a pervasive sense that until that happened these complaints would not have been taken seriously or complaints would put the complainant’s health at risk because that health center would likely become hostile territory.

This blaming of victims wrongly makes victims equally responsible for what was done to all subsequent patients. This habit of making victims scapegoats when they don’t report immediately helps mask or excuse systemic problems. The most obvious systemic problem is having other employees fail to take note of any behavior which crossed or neared an ethical line. If abused patients had the sense that the clinic accepted Britten’s sexualization of them why would they believe that their complaints would be welcome?

These systemic problems unfortunately create a predator-friendly environment where abuse can easily flourish and patients are protected by luck alone.

I can’t imagine an inquiry into a serial practitioner of a blatantly unsafe medical practice — which was done in front of the patients harmed — which would list those patients failure to report that unsafe practice as one of the factors to blame for the continuation of that unsafe medical practice.

It’s definitely worth noting that patients didn’t speak up, but that notation shouldn’t be under the category of blame.

This silence on the part of patients only shows that patient outreach is important to give patients tools which they can use before, during or after something happened which harmed them. Any outreach program would be putting patients in danger the minute the medical facility started depending on patient reports to keep the staff from committing unsafe medical practices.

Most members of the public would be outraged at the idea that they could be blamed after a family member died because of an intentional lethal drug injection administered in their presence. A nurse who was a master manipulator would work to convince the family member that the lethal action was appropriate. If the medical system didn’t recognize the true cause of death that family member might naturally say nothing until they learned that nurse was fired.

We need to see inquiries into sexual misconduct which blame the victims with this same outrage.

A family member’s silence is not complicity with the crime and it does not prove that no crime occurred. The same is true of victims of sexual abuse within medical settings.

11 thoughts on Victims Partly To Blame For Nurse’s 20 Year Pattern Of Sexual Abuse?

  1. “It’s definitely worth noting that patients didn’t speak up, but that notation shouldn’t be under the category of blame.”

    – Exactly. The responsibility of care lies with NHS London not with the patients anyway, aside from anything else. Blaming women who were very vulnerable to start with is as you say outrageous. I hope this is down to a distortion on the BBC’s part and not the actual conclusion of the enquiry.

  2. I think there’s a little semantic ambiguity here that caused you to overplay this. “Blame” has more than one sense – I don’t think the management was using “blame” in the sense of moral culpability or negligence or anything of that sort. I think they were using “blame” in the sense people use that word to mean “cause” in a context where something bad happens. E.g. – “scientists blamed the satellite failures on increased solar output.” There is no sense of moral blame in that use of the word – and I think that’s what’s going on here. I didn’t get the sense that anybody thought the patients were morally culpable. But surely it would do much good if patients were encouraged to come forward with complaints if things like this happen, or to raise awareness so they knew there would be a ready support network if they do come forward with complaints.

    Furthermore, it’s not clear whether the investigators used “blame” or whether the BBC interjected that word to summarize the “causes” the management gave.

    Also note that the other things they list – poor management and missed opportunities – address several of the things you raised concern about.

  3. This blaming of victims wrongly makes victims equally responsible for what was done to all subsequent patients. This habit of making victims scapegoats when they don’t report immediately helps mask or excuse systemic problems.

    Yes, this. There are any number of reasons why patients choose not to report inappropriate actions by medical professionals – not the least of which is self doubt about the inappropriate behavior. There have been at least two doctors who I, in retrospect, think I should have reported, but when the events happened, I could not even process that something inappropriate took place, it seemed so impossible in the context of having a trusted relationship with a medical professional, and not wanting to put myself through an exhausting inquiry that might be more emotionally wraught than the events themselves.

    The culture of victim blaming is part of the reason people decide not to come forward.

  4. Acta non verba, either way the word “blame” is used assigning blame to victims for not reporting is incorrect. Victims not reporting Britten did not cause him to continue offending nor did their silence allow him to continue.

    Britten caused himself to continue and a lack of proper oversight and missed opportunities by staff at the facility allowed him to continue.

  5. Acta non Verba has it right. The word blame is not used assigning blame to the victims. Rather it’s used in place of “explain”. It may be an unfortunate choice of words, but I didn’t get the sense that anyone was blaming the victims.

  6. The investigators blamed poor management, missed opportunities and the reluctance of his victims to come forward as the reasons for Mr Britten “grooming vulnerable patients”.

    Regardless of what word was used, the point is that this is a laundry list of things that management is using to “explain” their lack of knowledge:
    1. Poor management
    2. Missed opportunities
    3. Reluctance of victims to report

    It doesn’t matter what semantics we parse, or even if that’s not how it was meant to sound by the original speaker. The larger point is that it holds victims at least partially responsible for the victimization of others – i.e., blames them.

    Personally, I see two problems here – a) like in a lot of discussion of sexual assault and abuse, the focus is on the victims’ agency rather than the agency of the person who chose committed the assault in the first place; and b) the fact that the system makes it substantially easier not to report sexual crime than to report it on multiple levels.

  7. I think that if he had assualted people for twenty years someone did talk out, and the report was quashed.

    There are reasons why assaults are reported, and why they are not, and one of the reasons WHY is to stop the abuser from abusing someone else. I cannot believe he was able to abuse his position of trust without someone coming forward…

  8. Marcella:

    You wrote “nor did their silence allow him to continue.” I think it did – there were multiple necessary causes to his actions. It was the confluence of their silence, poor management, his depravity, etc. etc. ad infinitum. Any one of them being negated would have stopped him. There is nothing problematic in pointing this out.

    Em:

    It wasn’t the managers using victim silence to explain his actions. It was the investigators from NHS.

    I just don’t see anyone as “blaming” the victims here as that phrase is usually used. The investigators merely pointed out that there is a problem (in the neutral causal sense of “problem”) with victims not reporting these things . This does not imply they are morally blameworthy.

  9. “It was the confluence of their silence, poor management, his depravity, etc. etc. ad infinitum. Any one of them being negated would have stopped him. There is nothing problematic in pointing this out.”

    The assumption that a report by one or more of his victims would have stopped this man is incorrect in this situation. Victims are unfortunately regularly dismissed as liars or delusional when the person they accuse is viewed as respectable.

  10. It was the confluence of their silence, poor management, his depravity, etc. etc. ad infinitum. Any one of them being negated would have stopped him. There is nothing problematic in pointing this out.

    That’s not true though. If you read the article, it points out that the staff was aware of the abuse, and facilitated it. I think this happens a lot in institutional settings – and certainly mental health patients are particularly vulnerable because PEOPLE DON’T LISTEN TO THEM OR CARE WHEN THEY DO SPEAK OUT.

    So why should his patients have “spoken out” when they certainly would have observed his actions being condoned by other staff members?

  11. and certainly mental health patients are particularly vulnerable because PEOPLE DON’T LISTEN TO THEM OR CARE WHEN THEY DO SPEAK OUT.

    Absolutely. I read “eating disorder specialist” and that’s a rather specialised and extremely vulnerable group of people. We have a room of (mostly) young women and girls, physically weak from malnutrition, heads buzzing from lack of food and anxiety medication, each believing that they are the worst person in the history of the world. Their self esteem couldn’t be lower. And they’re supposed to go to an authority and report something bad that happened to them? 10 or 20 years ago, when eating disorders were even more stigmatised and misunderstood than now?

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