Margaret Puxon

Clin Risk 2008;14:104-106
doi:10.1258/cr.2008.080035
© 2008 Royal Society of Medicine

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Margaret Puxon

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Obituary


Margaret Puxon had three careers: her first was as a gynaecologist, and her second as a barrister specializing in family law, but she is best known for her third career, in medical negligence. In an extraordinarily rich, full and long life she found time to serve on ethical committees and the editorial board of Clinical Risk. She was warm, funny, hugely popular, and had a brilliantbrain. In court she was, said a colleague on the Lister Hospital’sethics committee, ‘charming, persistent and fearless’.She was smart, pretty and soft-spoken, and she could make judgeslaugh. She was, said Adrian Whitfield QC, larger than life.She did her best for plaintiffs; even on the rare occasionswhen she lost, they felt she’d given the case her best shot.

She was born in Stourbridge, Worcs; her father had a metalworkcompany. At St James’s School, Malvern she excelled in Englishliterature and turned down a place at Oxford to study Englishin order to study veterinary medicine at Birmingham. She soonswitched to medicine. She was attracted to medical science ratherthan clinical practice, and impressed her teachers with herintellectual power. She had married Ralph Weddell, an engineeringstudent, in 1937 and had a son and daughter without interruptingher studies. She graduated with honours in 1942, winning thegold medal in obstetrics and gynaecology.

After her pre-registration year she was gynaecology registrarat the Queen Elizabeth Hospital, Birmingham. She divorced RalphWeddell and married Peter Puxon, a solicitor; they moved toColchester in 1944. With two small children and a professionthat had a low glass ceiling for women, the only work she couldget initially was general practice locums. She studied for hermembership of the Royal College of Obstetricians and Gynaecologists,which she got in 1946. Birmingham University awarded her anMD in obstetrics a year later, and she was appointed consultantgynaecologist for Essex County. In 1949, after two miscarriages,she was advised to give up work when she became pregnant again.To keep her mind active she took a correspondence course inlaw, and liked the clarity of being a barrister advising solicitors,rather than the untidier task of being a solicitor advisingthe public. The clerk of her chambers told her he would notput any work her way, and was as good as his word, but solicitorssoon made their way to her door.

She separated from Peter Puxon in 1955 and moved to London becausethat was where the work was. She married another solicitor,Morris Williams, in 1957, and he was supportive of her career.Over the following 15 years she built up a distinguished reputationin family case law. After she applied to join an all-male firmand was turned down; the head of chambers told a mutual acquaintancethat ‘I don’t take niggers or women and on the whole Iprefer niggers’.

She wasn’t one to take this sort of thing lying down. She tookon legal aid divorce work for returning servicemen, which fewother barristers wanted, and eventually built up a fashionabledivorce practice. Later, in the 1970s, she was head of chamberswith offices in Colchester and Norwich, and continued to practicein London at the same time.

Her clients included rock star Bill Wyman in his divorce fromMandy Smith. She appears on the Rolling Stones’ website—calledEverybody Must Get Stoned—‘I was in London to havedinner with my barrister, a very accomplished lady called MargaretPuxon QC … [she] liked to keep in touch with what youth wasup to.’

One of her landmark cases—it went to the House of Lords—was J v C, where a mother wanted to regain custody of a child shehad given up for adoption. The case established that the welfareof the child was paramount in wardship proceedings and alwaystrumped all other considerations.

By 1970 she was a leading authority in family law when she switchedto medical negligence. Doctors were losing their apparent immunityfrom legal action. She usually represented plaintiffs. Thisfailed to endear her to her own Royal College, that of Obstetriciansand Gynaecologists. In 1979 she was elected to fellowship ofthe RCOG at the instigation of Janet Bottomly and Dame JosephineBarnes. The College largely ignored her and when they set upa medicolegal committee in the 1980s they did not invite herto join it.

It was with her encouragement that Roger Clements started onhis career as an expert witness, and many of his early caseswere with her.

Her famous cases included Krishnamurthy v Cambridge Area Health Authority. Sunil Krishnamurthy was profoundly handicapped fromnegligent management at Addenbrooke’s Hospital in the 1970s.The case came to court a decade later and may have been thefirst such case brought under the Congenital Disabilities (CivilLiability) Act 1976. Margaret Puxon was up against Ian KennedyQC—famously described in the Times, when he was prosecutingWendy Savage, as having mistaken his way. ‘He appearedto think he was at Nuremberg.’ Margaret ran rings roundKennedy and he threw in the towel around the 10th day of thetrial.

Scuriaga v Powell (1980) was the first case to deal with a failedtermination of pregnancy. The plaintiff claimed the cost ofraising the child, and the MDU defended it, hoping that theywould get a judge who would hold it contrary to public policythat a woman should be rewarded for having a baby rather thana termination. The plaintiff was a pretty girl who had beendevastatingly crippled by childhood polio. Powell, who had setup an abortion clinic shortly after the 1968 abortion act, couldhave settled the case for a pittance on the first day of thetrial, but the MDU were uninterested in his welfare. The casedestroyed his reputation and the judge—Tasker WatkinsVC, chairman of the Welsh Rugby Football Union—awardedthe plaintiff huge damages. For the record, the Court of Appealdid significantly reduce the award (from £18,750 to £4250).

In the early 1980s Bourn Hall, the private fertility clinic,consulted Margaret on the wording of the consent form for spermand egg donors. The Family Planning Association (FPA) consultedher when threatened with legal action for ‘aiding andabetting a miscarriage’ when prescribing the morning-afterpill. It was her opinion that ‘if there was no carriagethere can have been no miscarriage’: if the pill was takenwithin 72 hours the ovum had not embedded in the womb and thereforethere was not an abortion within the meaning of the Act. Theday after she advised the FPA, Sir Michael Havers, the AttorneyGeneral, gave the same opinion in the House of Lords.

In Biles v Barking and Havering and Brentwood Health Authority(1988) she won substantial damages for a young woman who hadbeen sterilized after being told, wrongly and with crass insensitivity,that she was unfit to bear children and would die young of kidneydisease. Mrs Biles had suffered a kidney infection as a teenager.When another doctor asked her when she was going to start afamily she questioned whether she has been properly advisedand subsequently underwent repeated fertility treatment andsuffered an ectopic pregnancy. It was the first case on damagesfor sterility for 30 years. Damages (£45,000) were awardedfor probable permanent infertility, the pain and suffering ofthe procedures she underwent, scarring, impairment of sexualfunction, future expenses and special damages, and pain andsuffering and loss of amenity.

In the early 1990s she was the first woman in the Society of Doctors in Law, a dining club, and she became its chairman. She edited Medical Law Reports (now called Lloyd’s Reports, Medical) was appointed by the Privy Council to the council ofthe Pharmaceutical Society, and was a deputy circuit judge from1970 to 1978 and a recorder from 1986 to 1993, when she reached78. She served on several ethics committees including that ofthe Lister Hospital and the Royal College of General Practitioners.

She wrote or contributed to The Family and the Law (1963, 1971), Progress in Obstetrics and Gynaecology (1983), In Vitro Fertilisation: Past, Present and Future (1986), Gynaecoloogy (1991, Shar, Souter and Stanton, eds.), Safe Practice in Obstetrics and Gynaecology(1995, Clements, ed.), and wrote many papers for medical andlegal journals. In the same year she and Morris set off on around the world trip, and Morris died suddenly in India.

She took a pot-shot at Cherie Booth QC in 1996 when the latter took to the appeal court, Goodwill v BPAS, where a mother had sued the British Pregnancy Advisory Service because her partner’s vasectomy—performed three years before they met— had been unsuccessful. She had become pregnant and decided against an abortion. The case was struck out but Mrs Blair took it to the Appeal Court, using legal aid. Lord Justice Gibson described the case as ‘unsubstantial’ and ‘manifestly unsustainable’. Lord Justice Thorpe described it as ‘far fetched’. In her comment in Medical Law Reports MargaretPuxon held the case up as a prime example of ‘hopelesscases being brought to trial with the help of legal aid’,adding that such cases are often settled on poor terms thatdo not reflect the underlying merits of the case but were ‘legalaid blackmail’. ‘If the legal aid system is to bepreserved for cases where justice would otherwise be denied.’She added, ‘Some protection for the fund must be devised.’

In old age she lost much of her sight and hearing and she neededa wheelchair to get around art galleries, but her memory andintellect remained as sharp as ever. So, also, did her enjoymentof opera, food and drink. She was a superb home-maker. Her interestin people, especially the young, was also undiminished. ‘Sheknew more about my children’s career aspirations than I did,’said Lizanne Gumbel QC.

Her funeral was conducted by the reverend Richard Collier who,like her, had more than one career; he had at one time beenher instructing solicitor. He spoke of ‘the vitality andbreadth of this extraordinary woman… [she was] audacious,courageous, demanding, difficult, flirtatious, formidable, funny,impossible, intelligent, naughty, single minded and unreasonable.’He said that she may have appeared the epitome of an establishmentfigure but had a deeply rebellious streak, was bothered thatthe establishment was bureaucratic and small-minded, and caredpassionately about justice end equity.

Her two sons—a musician and a solicitor—and daughter survive her. Caroline Richmond


Personal note

‘I met Margaret in 1987 when she led me in my first clinical negligence case, thereafter she became not only a colleague but a close friend. The last case she led me in was X v Bedfordshire County Council [1995] 2 AC 633. Margaret was instructed by the Official Solicitor for the five children in this case; she saw their plight as a shocking injustice and was determined to pursue the case. She retired (nearly in her 80s) soon after the first application but followed the case with interest as it made its way to the House of Lords and then to Strasbourg where the children finally recovered damages. The result came as no surprise to her. Nobody who knew Margaret well could fail to be inspired by her, she combined fierce competitiveness and determination, with a flirtatious gentle femininity and genuine concern for others – a truly rare combination.’ Lizanne Gumbel QC

 



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Margaret Puxon




Footnotes


Christine Margaret Puxon QC FRCOG, born 25 July 1915, died 1April 2008




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Margaret Puxon
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