Brisbane, June 17 (IANS) Two terminally ill cancer patients allegedly killed by Indian-origin doctor Jayant Patel had consented to the risky surgeries because it was their ‘only hope’ for a cure, an Australian court heard Thursday.

The hearing Thursday began with accusations from prosecutors that Patel had a ‘toxic ego’ and made ‘astonishingly bad’ decisions, while his defence counsel told the Queensland Supreme Court that patients’ consent was a ‘huge factor’ in the trial, The Australian reported.

Patel, 60, has pleaded not guilty to the manslaughter of three of his patients – James Phillips, Mervyn Morris and Gerry Kemps – and not guilty to causing grievous bodily harm to Ian Vowles, during his time as director of surgery at the Bundaberg Hospital between 2003 and 2005.

All four patients consented to the operations performed by Patel, Barrister Michael Byrne QC, defence counsel for Patel, said.

He launched an attack on the media and said it whipped up a ‘frenzied storm’.

Byrne said the jurors needed to properly consider the evidence of experts who dissected Patel’s decision-making ability and behaviour.

He spoke about the cases of Kemps and Phillips, both of whom had been diagnosed with terminal oesophageal cancer.

Patel performed the complex oesophagectomy procedure, which involves the removal of part of the patient’s oesophagus, on both men. The prosecution, however, says the surgeries should not have been performed at all.

Both men had consented to the procedure, knowing it was risky, because it was their only hope of a cure, Byrne said.

Patel had undertaken the procedures based on the material and test results then available to him, he said.

Earlier, prosecutor Ross Martin said Patel had a ‘toxic ego’ and had been disciplined in 2000 in Oregon in the US for ‘gross and repeated acts of negligence’.

Patel had been forbidden from performing certain surgeries without first seeking a second opinion, and as a result, did not operate for two years before arriving in Bundaberg, he said.

‘It’s easy to see, when you know all the evidence, how ambition, ego and a lack of insight might lead a man stung by the order of Oregon to prove himself, redeem himself in his own eyes,’ Martin said.