ABSTRACT
The medical model of disability has been much criticised in recent years and the traditional power of the doctor to diagnose, direct practice and provide services is now being challenged. Paediatricians have been accused of making crude assessments of potential ability in children, damaging the quality of family life in the process. Yet, the Cleveland affair admits ambiguities in the public perception of paediatricians. Are they to be advocates for their vulnerable clients or partners of parents? Can they be both? Medical attitudes arise from the political and social culture in which practitioners are learning and operating. In this paper one paediatrician shares his reflections on a 42-year career, during which period medical, social and economic changes were to radically alter his practice and perceptions.