Personal history of Dr Moore
27Before dealing with the defences raised by National Mutual, it is necessary to say something more about Dr Moore's personal history.
28Dr Moore was married in his fourth year of medical school. At about that time, he was injured in a sporting accident which required him to have a nasal operation. He was given pethidine in connection with that operation and there is some evidence (from Dr Hampshire, an expert psychiatrist called by Dr Moore) that Dr Moore continued to take that drug for non-medical purposes for a short time after his operation.
29After graduating in 1972, Dr Moore worked as an intern at Balmain Hospital in 1973 and as a Registrar in psychiatry at Sydney Hospital in 1974. He and his wife then joined the Royal Australian Army. Soon afterwards, they separated and his wife was discharged. Dr Moore then commenced a de facto relationship. Following his divorce from his first wife, he and his de facto wife were married.
30In the latter part of 1975, while stationed in the Kapooka Military Hospital, Dr Moore started injecting himself with pethidine, which he obtained either from army supplies or by making out false prescriptions, which he presented to local chemists. It is unclear precisely over what period of time Dr Moore self-administered pethidine or the precise quantity he took during that period of time. The amount, however, was substantial. His activities were discovered during routine checks of the army's store. Initially, Dr Moore denied any wrongdoing on his part. However, prompted by his wife, he saw a psychiatrist and later confessed.
31According to a report dated 9 March 1976, which was prepared by Major Owens in connection with an investigation into Dr Moore's activities, Dr Moore "admitted that he was unable to control his problem of abuse of [pethidine] and injected himself with a quarter to a third of the drugs received". In a statement prepared by Dr Moore at the time, Dr Moore said that his memory of his experience of pethidine in connection with his nasal operation "played a significant part in my voluntarily administering this and other associated drugs to myself in the latter half of 1975". He said that "why I should have done this to this day remains a mystery". Dr Moore also said that he had attempted to cease the habit of taking pethidine without assistance in the hope that he would be able to replace the missing army supplies. He said, however, that his attempts were unsuccessful.
32On 8 April 1976, Dr Moore was convicted of 6 charges relating to his use of pethidine at a general court martial. He was also found guilty by the North Sydney Court of Petty Sessions of an offence of making false representations in connection with the presentation of prescriptions to local chemists and was released on a bond. No conviction was recorded. Following his court martial, Dr Moore was assigned to the staff of Brigadier James in Melbourne. Brigadier James wrote to the Medical Council of Tasmania on 29 October 1976 in response to a request by the Council. In that letter, Brigadier James said:
Early this year I was involved in investigating the circumstances concerning an admission by Captain Moore that he had self administered pethidine during the latter part of 1975. In brief, I established that Capitan Moore took some 85 ampoules of pethidine from Army stocks and began self-administration of the drug. This action was carried out in private, but later his wife became aware of it. He then, with the help of his wife and advice of a local psychiatrist, was able to wean himself off the drug, and has not taken any since September 1975. The episode of self-administration covered a period of perhaps six weeks.
Brigadier James concluded:
Captain Moore has been a medical officer on my staff since April this year and has worked under direct supervision of my medical staff and myself. He's proving to be a competent medical staff officer and I am convinced that he is completely rehabilitated from the point of view of drug administration.
33Following his discharge from the Army in 1977, Dr Moore worked as a general practitioner first in Melbourne and then in Zeehan, Tasmania. In late 1979, Dr Moore again started using pethidine and a similar drug, Omnopon. For how long Dr Moore used the drugs is not clear from the evidence. It appears that he was caught and charged with a number of offences relating to his drug use on 31 January 1980. He admitted himself immediately to the John Edis Hospital, where he remained until 29 February 1980. Dr Moore says that he admitted himself to hospital in order to obtain leniency from the court. The charges were heard on 26 June 1980. Dr Moore pleaded guilty. Each complaint against him was discharged conditionally upon him entering into a bond to be of good behaviour for a period of two years. On 3 September 1981, Dr Moore's name was removed at his request from the medical register in Victoria, due to an "inability to practice due to his drug dependency", and subsequently from the medical register in Tasmania. At about this time, he separated from his second wife.
34From 1980 to 1982, Dr Moore worked as a lecturer in anatomy at the University of Tasmania and then from January 1983 to January 1984 as a registrar in histopathology at Flinders Medical Centre in Adelaide. He met his third wife there, who was also a medical practitioner.
35In March 1983 Dr Moore's registration was reinstated, at his request, on the condition that he was prohibited from possessing or prescribing schedule 8 drugs - that is, drugs of addiction, including pethidine.
36At some time after March 1983, Dr Moore moved overseas for a period time. It is not clear from the evidence for how long he was away, precisely what he did and whether he made one trip or two. However, there is evidence that he lived in London for a time and worked in the hospitality industry while he was there.
37Dr Moore returned to Australia in June 1984. He worked for a time as a general practitioner. However, in August 1984 he relinquished some of his renewed prescribing rights due to his dissatisfaction with the practice of medicine and, in late 1984, he took up a non-clinical position with the Department of Veterans' Affairs in Hobart. Despite that, in December 1984, Dr Moore contemplated a return to medical practice, and he requested that his prescribing rights once again be reinstated. That request was granted in June 1985.
38In about August 1985, while working full time for the Department of Veterans' Affairs, Dr Moore began some weekend work at an after hours medical service in Hobart. Once again, he started using pethidine, which he obtained from a doctor's bag supply. The authorities soon discovered that he was doing so and, on 14 October 1985, Hobart police attempted to interview him at his workplace, only to find that Dr Moore had already left the state. Shortly before leaving, on 9 October 1985, Dr Moore wrote to the Minister for Health in Tasmania. In that letter he said that he wished to surrender his rights to prescribe schedule 4 and schedule 8 drugs. 1In his letter, Dr Moore pointed out that Dr Ian Martin, a specialist psychiatrist, had said to him that his basic problem was that "I like the stuff [that is, pethidine]". The letter went on:
To my horror I have found the Dr Martin's contention is correct. Placed in a clinical environment (and, as mentioned without any concomitant personal problems) I experienced a rekindling of the most powerful yearning for narcotics imaginable: I virtually found myself salivating at the thought. Such an experience had been totally absent for the five years that I had been away from clinical medicine.
...
The critical factor is to ensure that never ever again have I anything to do with clinical medicine.
39Dr Moore was charged with a number of offences in connection with his use of pethidine in late 1985. He pleaded guilty to those offences on 5 May 1986. A conviction was recorded and the court imposed a sentence of four months imprisonment, which was wholly suspended on condition that Dr Moore be of good behaviour for three years.
40During 1986, Dr Moore's name was removed from the register of medical practitioners in Tasmania, as well as Victoria, South Australia and New South Wales. Dr Moore then wrote a lengthy letter to the Medical Council of Tasmania in which he sought to explain his conduct and requested again to be restored to the Medical Register. In that letter, he said that he had been forced to live apart from his third wife, who had remained in Adelaide while he moved to Tasmania to obtain work. He went on to say:
This, coupled with the stress of separation from my wife, which had become progressively more difficult to cope with, saw me slip insidiously into a depressive illness which, in retrospect was much more serious than I had realised, and played a significant role in what was to follow.
The letter went on:
Being, as I now recognise, seriously depressed by virtue of the long separation by my wife, plus a midlife career crisis, the return to clinical work further deepened my depression.
And later:
I was not able to overcome the overpowering urge to seek relief from my problems by the self administration of pethidine.
And later still:
The self administration of pethidine occurred in the depths of a brief but severe psychiatric illness...
Dr Moore requested that his registration be conditional on his prescribing rights being permanently revoked and on condition that he not be involved in clinical medicine, as his "inability to handle the prescription pad is a permanent fact". It appears that Dr Moore's submission was accepted and his suspension from the medical registers of Tasmania, New South Wales and Victoria were conditionally revoked, although there is a question whether that revocation was effective.
41Dr Moore says that many of the statements in the letters to the Minister and to the Medical Council were not true. He denied that he suffered from an addiction to pethidine or that he suffered from a psychiatric illness before 1995. He says that he wrote what he did because that is what his audience expected him to say.
42Following his convictions in 1986, Dr Moore held or claims to have held a number of non-clinical positions around the country. He moved to Perth and worked as a resident counsellor with the Australian Institute of Sport between 1986 and 1987. He was at one stage enrolled in the Faculty of Education at the University of Western Australia, and says he was also a senior tutor in Anatomy at the Faculty of Science at that institution. He claims to have worked as the manager of a Drug and Alcohol Crisis and Rehabilitation Centre in Perth, with the Jesus People Welfare Services in 1987. He worked with the Red Cross Blood Transfusion Service in 1988. In 1990, he moved to Queensland and became Master of Capricornia College in the University of Central Queensland until March 1993, when he applied for the position of psychiatry registrar at Launceston General Hospital. Although Dr Moore undoubtedly held a number of the positions he said he did, it is difficult to be confident about precisely what positions he did hold. On his own admission, a number of resums that he prepared contained false information about the jobs that he had held.
43In connection with his application for the position of psychiatry registrar, Dr Moore reapplied for registration in Tasmania. He was held to be medically fit to practice, and registration was granted subject to a condition that he not possess nor prescribe schedule 8 drugs and that he not practise in clinical medicine except with the approval of the Medical Council of Tasmania. A request by Dr Moore that these restrictions be varied was denied, but the Council indicated that it was prepared to consider a variation to the restrictions after 12 months.
44As I have said, Dr Moore developed symptoms of depression and anxiety in late 1994. He also started using pethidine again at that time. I have already described the events that immediately followed, including his claim under the policy.
45I should add, however, that, in May 1996, Dr Moore applied to be a civilian medical officer with the army in Bonegilla, Victoria. At that time, he was unregistered to practice in Victoria. Nonetheless, he worked in that position briefly in July. His time in that position was punctuated by a number of incidents, including requesting pethidine from the Emergency Department at Albury Base Hospital and allegations that he had stolen the qualifications of a neurologist. In my opinion, this attempt to return to work was a symptom of his illness rather than evidence of a recovery.
46Dr Moore then remained out of work for an extended time, living off his income protection insurance until it ceased in November 2002. He then obtained Centrelink benefits. Originally, he received Newstart benefits but subsequently he received a disability pension, which he continues to receive. He completed his Bachelor of Nursing in 2003. He came top of that course. His Centrelink benefits ceased for periods of time while he was employed, although those periods of employment were not extensive. ln 2004, he commenced a casual teaching role at the University of Tasmania, and was employed by the university for different periods until 2006. In December 2004, Dr Moore also applied to the Department of Health and Human Services for the position of a mental health registered nurse . He worked in that position (full time) from March 2005 to June 2005. He completed a Masters Degree in Counselling Studies in August 2005. In May 2010, he was briefly employed in the Customer Care group of a travel insurer as a registered nurse.
47From 2003 onwards, Dr Moore suffered from a number of different physical, neurological and psychological complaints. These included abdominal pain and bowel problems, recurring lower back pain, cycles of depression and anxiety and mental confusion and distorted perception, among other things. He was treated by numerous medical practitioners over that period of time and was admitted to hospital on a number of occasions. He was prescribed pethidine as part of a pain management regime in late 2004 until April 2005. Some of Dr Moore's complaints are likely to have had an organic basis. However, as Dr Hilton Francis observed, it is likely that many of them did not, and that his complaints were part of an elaborate attempt (sometimes successful) to obtain pethidine. As Dr Francis observed in a letter dated 6 July 2005 to Dr Smith:
I am not as convinced [about] how genuine he is with his complaints. I have no doubt he has pain. I have equally no doubt that he is addicted to narcotic analgesia and certainly has a need for pethidine. ... His behaviour was fairly classical of a narcotic abuser turning up late at night at the end of the day.