An NHS doctor has told an inquest she was concerned that a former nurse-turned-conspiracy theorist influenced her daughter’s refusal of cancer treatment.
Paloma Shemirani died on July 24, 2024, after refusing treatment for non-Hodgkin lymphoma.
The 23-year-old was the daughter of Kay “Kate” Shemirani, a nurse who rose to prominence on social media while sharing Covid-19 conspiracy theories, and was eventually struck off for spreading misinformation about the disease.
Paloma’s twin brother, Gabriel, and her second brother, Sebastian, later claimed in a television documentary that it was their mother’s extreme conspiracy views that led Paloma to refuse medical treatment and so caused her death.
A Cambridge graduate and former beauty queen, Paloma was diagnosed with cancer at Maidstone Hospital in December 2023, but declined to undergo the chemotherapy treatment that was prescribed, despite being told it would give her an 80% chance of survival.
She died seven months later.
Her brothers attended the inquest at Oakwood House in Maidstone today (Friday) while her mother watched proceedings via a remote link.
Arunodaya Mohan, a consultant haematologist at Maidstone Hospital, confirmed from medical records that Paloma had first reported to Maidstone Hospital in October 2023 with right-sided chest pain and shortness of breath.
She presented again on December 3 with similar symptoms and was given a CT scan, which revealed a “significantly large mass,” measuring 6cm by 5cm, by 7cm on the right side of her chest.
Close to her heart, the mass was displacing the aortic arch.
A biopsy was carried out, which revealed the mass to be a Non-Hodgkin Lymphoma, a cancer of the lymph nodes.
The diagnosis was by other doctors, but Dr Mohan said she had reviewed the notes when Paloma was transferred to her care and had no problem with the diagnosis.
She told the inquest that non-Hodgkin lymphoma was a common condition seen every day in her clinic, but it was less common in someone as young as Paloma.
Paloma’s case had been discussed by a team of doctors from various specialties, and all agreed there was only one course of action, which involved immediate treatment with steroids and a course of high-dose chemotherapy.
“There is a standard protocol, and only one treatment option”
Asked by Mrs Hewitt what would happen in the absence of treatment, Dr Mohan replied: “Not treating her even for a day could have a major impact on the outcome.”
She added: “There is a standard protocol, and only one treatment option.”
That would involve six cycles of chemotherapy, running consecutively, of 14 days each, with some drugs being taken orally and some intravenously.
She recalled meeting Paloma on December 23 and said it was a busy time at the hospital because of the impending Christmas break and because it was in the middle of a strike by junior doctors.
She recalled telling Paloma of the diagnosis, the treatment and also the possible side effects, which could include nausea, vomiting, hair loss, but also sometimes damage to heart and kidney functions and to fertility.
She told Paloma she could be offered “fertility preservation” or the freezing of her eggs, and said Paloma had been happy to take up that offer.
Dr Mohan said the 23-year-old raised no concerns.
The consultant haematologist told the inquest the treatment offered Paloma a 80% chance of survival, but without it she would die.
Under questioning, she confirmed that the figure was not just some statistical average, but “a specific calculation based on Paloma’s personal factors.”
She expected to keep Paloma in hospital for the first course of chemotherapy, but said: “Things did not go the way we planned.”
The next morning, when Dr Mohan visited Paloma again, the patient said she hadn’t made up her mind to have the treatment and that she wanted to investigate alternative treatments.
Asked whether Paloma had explained her reluctance to undergo treatment, Dr Mohan said: “I asked, but she didn’t want to discuss it.”
Asked if Paloma was scared of the possible side effects, Dr Moham said: “She did not make any mention of the side effects.”
Mrs Hewitt asked what contact the doctor had had with Mrs Shemirani and was told that there had been a telephone conversation between the two.
Dr Mohan said: “The mother had concerns and said Paloma should not start the treatment. She was also unhappy that we were arranging for Paloma to have a PET scan.
Dr Mohan told her she would discuss the issues again with Paloma, but as Paloma “had full capacity” to make her own decisions, she didn’t feel she needed any other person’s consent.
Two days later, Paloma discharged herself from the hospital without treatment.
The inquest continues on July 28.
Paloma was educated at the prestigious Roedean School in Brighton and later at Cambridge University, where she took a degree in modern languages.
At 18, she had been a finalist in the Miss Brighton beauty pageant.
