17 Mr Gray SC, senior counsel for the respondents had more to say in this Court than his predecessor at trial about the capacity of the jury not to be satisfied that imputation (e) was defamatory. He reminded the Court that pleaded imputations must be understood in the context of the whole matter complained of (Greek Herald Pty Ltd v Nikolopoulos (2002) 54 NSWLR 165).
18 Mr Gray pointed firstly to the structure of the article, submitting that it contrasted the doctor, Dr Gorman, with the dentist, Dr Bartrum. The latter was dealt with sardonically and portrayed in a generally poor light, with emphasis upon the orders for his removal from the register and the unfavourable findings made against him in the various South Australian courts and tribunals. By contrast, the appellant was portrayed as a doughty, unbowed fighter for a just but unorthodox cause who is still practising medicine. The article drew attention to his forensic successes.
19 In my view, this submission does less than justice to a fair reading of the article, which was uniformly critical of the appellant as regards his treatment of patients and which treated his story as supporting the opinions clearly stated in the opening paragraphs. In any event, the submission does not meet the fact that imputation (e) was found established.
20 Secondly, the headline and the opening sentences in the article were said to focus upon unproven and unconventional treatments as distinct from the demerits of the two practitioners propounding them. The submission was that it was open to the jury to construe the word "Guilty" in the heading as a reference to the treatment as distinct from the treating practitioner. I am prepared to accept the last proposition, for the sake of argument. But again it carries no weight in light of the jury's finding that the matter complained of carried imputation (e).
21 Thirdly, the respondent submitted that one can posit unsuccessful medical procedures that could be characterised as useless, dangerous and harmful but without implication of blame-worthiness, moral turpitude or even incompetence. Mr Gray instanced chemotherapy as a cancer treatment, amputation of a gangrenous limb or a heart transplant as medical procedures embarked upon as a last resort which, even if unsuccessful, would merit the same description as contained in the imputation, without suggesting that the reader should think less of the doctor involved. The imputation did not aver that the appellant had provided the treatment knowingly, consciously, deliberately or uncaringly. Rather, the appellant was portrayed as a passionate but misguided proponent of his treatment who (unlike Dr Bartrum, the dentist) is still in practice, despite the attempts of medical "establishment" to stop him. It was further submitted that one could construe imputation (e) in light of the rejected imputations (a)-(d), thereby reinforcing a possible reading of (e) in a non-defamatory sense.
22 These submissions overlap considerably and are best addressed compendiously. They lie at the heart of the respondent's defence of the verdict.
23 The suggested analogy of the doctor resorting to chemotherapy etc in a last-ditch attempt to save the patient is in my view an example of the fallacious argument rejected in cases such as Greek Herald. Such arguments seek to divorce the pleaded imputation from its textual context. The matter complained of in Greek Herald was held by the jury to impute that the plaintiff was a liar. Such an imputation was clearly defamatory in its particular context. It was quite irrelevant that an ethicist could argue that lies of an entirely different character in a different context are morally defensible. Charlwood Industries was a decision to similar effect.
24 Here the gravamen of the imputation, when read in context, is that the appellant (in his misguided zeal) provides treatment which is useless and dangerous and causes his patients harm. The present tense "provides" is significant, as is the aggregation of the three adjectives. Unlike the chemotherapy and other examples hypothesised in the respondents' submission, the appellant's treatment is portrayed as positively harmful as distinct from being an unsuccessful last-ditch attempt to avert the progression of a terminal disease.
25 The matter complained of is an uncomplimentary expose about the ongoing provision of treatment to a class of the appellant's ophthalmology patients. Two examples of ineffective and unconventional treatment are given, each of them contributing to a worse outcome (death, in the second case). The references to litigation involving the appellant take their colour from the heading and early part of the article. None of the references suggest substantive as distinct from limited or technical vindication of the appellant.
26 This material has been found to convey imputation (e) with its cumulative reference to treatment that is useless, dangerous and harmful. One then inquires about a rational explanation for the jury to have concluded that the imputation was not defamatory. I remind myself of the need for appellate restraint and of the various formulations of the standard of appellate review, discussed in Rivkin. Like Callinan J in Rivkin (at [185]), I will apply the principle that the jury's finding may only be overturned if it is one that no reasonable jury could reach.
27 In my view, the verdict cannot be justified according to this standard. The appellant is recognised in the article as a registered practitioner with an ongoing specialist practice in ophthalmology. The matter complained of is published in a magazine widely distributed to fellow practitioners some of whom would be a pool from which patient referrals might be expected. Senior counsel at trial (who correctly confined himself to the imputation in context) was unable to suggest to the jury any argument or reason why the imputation, if found, would not be defamatory.
28 Much was made about the absence of the word "knowingly" in the imputation in the written submissions in this Court
29 In similar vein, comparison was sought to be drawn between the four rejected imputations and the one that was accepted, on the basis that the former conveyed clear overtones of deliberate and blameworthy conduct.
30 I doubt that it is open to the respondent to have the imputation construed as if it excluded "knowing" conduct. The pattern of treatment adverted to could not have been anything but "knowing" in the sense of being intentional, regardless of how unorthodox or misguided it might be. But I do accept that the imputation does not necessarily carry an assertion that the appellant knew that his treatment was useless, dangerous and harmful (or even that he knew that it had any one of those effects).
31 I also doubt that it was open to the jury or that it is open to this Court to discern the defamatory impact of one imputation by reference to others that were considered and rejected by the jury. No authority was cited in support of such an approach. Each imputation put to the jury differed in substance from the others (cf Supreme Court Rules, Pt 67 r11(3)).
32 But these doubts do not matter. This imputation is directed at a practising doctor. Defamation is not limited to aspersions on an individual's private character. It also embraces disparagements of reputation in trade, business, profession or office, including those suggesting incompetence or even misguided zeal (Pratten v Labour Daily Ltd [1926] VLR 115).
33 In Drummond-Jackson v British Medical Association [1970] 1 All ER 1094 Lord Pearson said (at 1104, citations omitted):
I doubt whether the analogy sought to be drawn in the present case between a trader's goods and a professional man's technique is sound. Goods are impersonal and transient. A professional man's technique is at least relatively permanent, and it belongs to him; it may be considered to be an essential part of his professional activity and of him as a professional man. In the case of a dentist it may be said: if he uses a bad technique, he is a bad dentist and a person needing dental treatment should not go to him.
In any case, words may be defamatory of a trader or business man or professional man, although they do not impute any moral fault or defect of personal character. They be defamatory of him if they impute lack of qualification, knowledge, skill, capacity, judgment or efficiency in the conduct of his trade or business or professional activity…. It can be suggested that the article complained of in the present case impliedly imputes to the plaintiff lack of judgment and lack of efficiency in the conduct of his professional activity, inasmuch as he has adopted and practised and recommended a method of anaesthetising patients which (as the article says) is dangerous for the patients and may impede good dentistry.