Thursday 23 October 2014

True loyalty put to the test with cancer vaccine vote

Dr Jim McDaid made an honourable choice to put patients before the party line, writes John Crown

Published 16/11/2008 | 00:00

Two doctors made me very proud of my profession last week. There are very few medical researchers whose work saves thousands of lives. Harold zur Hausen, the man who discovered that most cases of cervical cancer are caused by a virus, is one of them. His work, originally treated with scepticism, challenged prevailing assumptions about the disease, but is now universally accepted within the biomedical community. He was awarded the 2008 Nobel Prize in Medicine or Physiology (jointly with one of the discoverers of the HIV/AIDS virus).

This quiet, extraordinary gentleman was interviewed by Aine Lawlor on Morning Ireland this week. He calmly and authoritatively demolished the spurious arguments that were being advanced in defence of the indefensible decision by our Government to cancel the proposed life-saving cervical cancer vaccination programme for young girls. The minister, and the official in charge of the new cervical cancer screening programme, suggested that somehow cancer screening obviated the necessity for vaccination. This is incorrect.

Screening is critically important, it picks up pre-cancers and many early curable cancers. Screened lesions require surgical treatment -- treatment which while it is, in the great majority of cases, effective in preventing cancer -- doesn't always work, and can cause occasional serious side effects. Even countries with well-established screening have cervical cancer deaths. We already have cervical cancer screening -- done competently if not comprehensively -- for many years in Ireland. We still have cervix cancer. Many of my cervical cancer patients developed the disease despite diligent and competent screening.

The technology used in cervical screening -- the papanicolau smear -- was developed in the Forties. How much credit should our Government and our society take for rolling out a technique that was discovered when Truman was president, and our Republic was still a free state?

The vaccine prevents the great majority of these cancers and pre-cancers. It also prevents treatment and treatment side effects. That any serious authority could suggest that early detection is better than prevention is simply absurd. I say this after some consideration, but the fact that the minister and the head of the Screening Service raised this wholly spurious argument casts serious doubt on either their competence, their bona fides or the quality of the advice available to them.

A GP/TD also defended this decision -- a decision which I believe is the worst I have ever seen made by a democratic government, He raised worries regarding side effects. Prof zur Hausen again rode to the rescue, pointing out the extraordinary safety profile of the vaccine, and told Ms Lawlor's listeners that his granddaughter (like my daughters) was vaccinated.

The other medical hero of the week was Dr Jim McDaid, a FF TD who has had his ups downs, his supporters and detractors, over the years. He had his finest hour last week when he broke party ranks and abstained on the Fine Gael motion. He will be accused of disloyalty, but to whom should our politicians owe their loyalty? Should it be to their parties, or to the citizenry at large?

What is Irish political loyalty all about anyway? It certainly is not loyalty to ideals, or to political principals. The two big parties are completely indistinguishable ideologically, slaloming past each other on the right and left at each election like demented downhill skiers.

No, the loyalty is of the type Dermot Ahern exhibited during the former Taoiseach's travails, when he said: "He was loyal to me, so I'll be loyal to him", or of the type that had the then future Taoiseach Brian Cowen famously chanting "Fianna Fail, good -- Gael, bad" when he was a six-year-old in the back of his dad's car.

If there was a song about Irish politics, it wouldn't be the 'Internationale", 'The Red Flag' or 'We Shall Overcome', but 'Stand by Your Man'.

So who in Fianna Fail showed true loyalty last week? Dr Jim McDaid, who stood up for patients, or those who voted against cervical cancer vaccination.

You judge.

Professor John Crown is a consultant oncologist

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