‘Unexpected’: Sandy Bay GP says deaths of elderly patients caused concern at medical centre

A former Sandy Bay GP has told a Hobart inquest how the deaths of two of her elderly patients came as a shock. Latest from the case of Nelda and David Edwards >>

Sandy Bay couple, David and Nelda Edwards, died two days apart in 2016.

Sandy Bay doctor Elizabeth Monks knew that two of her patients, a married couple, were getting older.

But news of their deaths, just two days apart in March 2016, came as a shock.

Giving evidence at the inquest into the dual deaths of David and Nelda Edwards on Tuesday, Dr Monks said she had recently seen both husband and wife at the Long Beach Medical Centre before they passed away.

She said news of their deaths was “unexpected”, and that she shared concerns with fellow staff at the medical centre that neither had been suffering an imminently life-threatening condition.

“(Mr Edwards) was dying, he had cancer and he had problems. But dying isn’t immediate necessarily,” Dr Monks, who now works as an aged care doctor, said.

GP Elizabeth Monks

The inquest previously heard that locum doctor Jonathan Forrester had agreed to prescribe restricted schedule 8 opiates and sedatives, morphine, midazolam and clonazepam, to Mr Edwards following a phone call request from the couple’s GP son, Stephen Edwards.

Coroner Simon Cooper previously heard that David Edwards died from prostate cancer, lymphoma and dementia – with elevated levels of morphine in his blood.

On Monday, the inquest heard a forensic physician had found Mrs Edwards did not have a terminal illness, but died two days after Mr Edwards from high levels of morphine and midazolam – prescribed not to her, but to her husband.

On Tuesday, Dr Monks said she never would have prescribed schedule 8 drugs “without seeing the patient” given their potential side effects.

“No. If that was the request, for palliative drugs, I would have gone and seen the patient,” she told the coroner.

She also said there were few situations in which a person would be treated with another patient’s palliative care drugs.

Dr Monks said she had heard about doctors effecting terminal sedation when patients were in emotional distress, but doing so would be ethically and legally problematic.

On Monday, Mr Edwards gave evidence via video link – denying he’d intentionally killed his mother.

Mr Edwards, who is now ill with cancer himself, was previously charged with murdering Mrs Edwards in a mercy killing – but the charges were dropped when it became apparent he was “gravely ill”.

Mr Edwards was never charged with causing his father’s death, and the Mercury is not suggesting this was the case.

Mr Edwards admitted that after his parents’ death, he wrote a letter to the coroner that was never sent, but which was ultimately seized by police – and which he himself published in his 2022 book Evil Conjectures.

The book is subtitled “Accused of murder: a nursing home doctor argues to clear his name”.

“I didn’t imagine these drugs would build up in her system,” he told the inquest on Monday.

“I didn’t imagine it would be a terminal sedation in the morning. I simply wanted her to have a break and some sleep so we could continue our discussions about how her life would proceed after my father’s death.

“I was thinking terminal sedation down the line. If she woke up and continued pleading for death, what would we do? We’d have to contact the palliative care team. We hadn’t got to that point.”

Stephen Edwards, centre, and brother Robert Edwards, right, after a Supreme Court of Tasmania hearing in 2016. Picture: Nikki Davis-Jones

Mr Edwards also spoke about a “legal loophole” he’d believed had existed, in which an overdose could be legally justified in a palliative care situation “because of the physical or emotional distress the patient was feeling”.

He agreed his legal team had been unable to find any legal authority for the “practice of terminal sedation in cases of existential distress”.

The inquest continues.

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