“Members of the profession would find his conduct deplorable”
File image of Bristol Royal Hospital for Children(Image: SWNS)
One of Google’s leading global experts on developing the use of Artificial Intelligence in medicine faces being struck off as a doctor after admitting he had an inappropriate relationship with a teenage patient who underwent an operation at Bristol’s Children’s Hospital.
Dr Cian Hughes will either be ‘erased’ from the medical register, or be given a suspension, when a medical tribunal panel gives its decision this morning (Wednesday) on what sanction should be applied for a series of serious breaches of guidelines.
The Irish doctor admitted having an evolving friendship with the girl, known only as ‘Patient A’, which began back in March 2011 when she was a 13-year-old patient at Bristol’s Children’s Hospital, and underwent an operation.
Dr Hughes was, at the time, a 23-year-old fourth-year medical student at the University of Bristol. He was asked to support the operation and later struck up a friendship with the girl, who was described as vulnerable.
The tribunal into the case had a lengthy hearing back in January and was reconvened on Tuesday this week to decide on the severity of the sanction the doctor must face. In January and again this week, the tribunal panel heard the relationship continued after Dr Hughes left Bristol and from December 2013, when she was 16, he was ‘aware Patient A had developed personal feelings’ for him.
The relationship progressed to the point where, when Patient A was 17 in 2014, it became a sexual one, although a raft of thousands of messages between the two revealed that Dr Hughes waited until after Patient A turned 18 in 2015 to engage in full sexual intercourse.
The relationship ended soon after, and later in 2015, Dr Hughes joined Google, where he is now, ten years on, the Google Health Informatics Lead.
In 2020, Patient A – by then in her early 20s – reported what had happened to her to the police. Police investigated and didn’t pursue a criminal case, but passed it on to the General Medical Council (GMC), who initiated disciplinary proceedings that culminated in January’s hearing. The independent tribunal panel found Dr Hughes’ fitness to practice was impaired because of his misconduct.
The Medical Practitioners Tribunal Service panel has to decide what sanction to give to Dr Hughes, and the General Medical Council’s advocate said he should be ‘erased’, or struck off from the register and banned from practising as a doctor for life.
Colette Renton, for the GMC, said that although there were mitigating factors, the case was so serious that only a full ‘erasure’ was appropriate.
“Although the misconduct occurred more than ten years ago, it was of such an unacceptable and serious nature that members of the profession and the public would be shocked and concerned,” she said.
She said there were four factors which were aggravating features in the case – Patient A’s age, her vulnerability, the power imbalance in their relationship, and the fact that Dr Hughes was aware of the risks that the relationship was in breach of the GMC guidelines, ‘but then looked for reassurance that the relationship was permissible rather than the contrary view before progressing the relationship’, she added.
“Members of the profession would find Dr Hughes’ conduct deplorable, in particular that he did not account for Patient A’s vulnerabilities,” said Ms Renton. “The tribunal further found that members of the public fully informed of the facts of the case would be shocked and concerned by Dr. Hughes’s conduct,” she added.
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Speaking for Dr Hughes, Rebecca Harris KC argued that Dr Hughes should be allowed to remain on the doctors’ register after a period of suspension. She went through a long list of glowing character references including some from Dr Hughes’ colleagues at Google, and said that there were many mitigating factors, including his remorse and work to improve himself in the years since, and the framing of the relationship as a loving one on both sides, rather than a manipulative or abusive one.
Ms Harris KC told the tribunal that one mitigating factor was that, rather than knowing what he was doing went against the GMC’s guidelines and ignoring them, he had taken time to check whether having a sexual relationship with a 17-year-old vulnerable former patient would be a breach of the guidelines, and persuaded himself that it wouldn’t be.
“Whilst it’s right to say that the tribunal was concerned as to the way Dr Hughes approached the guidance, we submit that the tribunal absolutely did not determine that Dr Hughes had ignored the guidance, but that he paid regard to it and persuaded himself.
“The distinction between deliberate flouting and being at least aware of a risk, and then, of course, going on to persuade oneself, is a very important distinction, indeed in the context of this case, we submit,” she added.
The tribunal hearing was adjourned on Tuesday afternoon to allow the independent panel to come to a decision on the sanction Dr Hughes should receive.