Wednesday 21 August 2019

Medics told 'take a breath and reflect' on Morrissey judgment

Call for calm: Dr Asam Ishtiaq wants medics to reflect
Call for calm: Dr Asam Ishtiaq wants medics to reflect
Maeve Sheehan

Maeve Sheehan

A former president of the Irish Medical Organisation has accused his profession of "groupthink" in its "knee-jerk reaction" to a High Court judgment that sets a new medical standard of "absolute confidence" for reading cervical smear slides.

Dr Asam Ishtiaq, a consultant surgeon, said the profession needs to "take a breath to pause and to reflect" on the judgment in the Ruth Morrissey case which convulsed the medical profession last week.

Mrs Morrissey, who is terminally ill, was awarded €2.1m after she sued the HSE, Quest Diagnostics and Medlab Pathology over the misreading of her cervical smear tests.

Mr Justice Kevin Cross's landmark judgment said screeners must have "absolute confidence" rather than judge slides on the "balance of probabilities" - a standard which has applied in the UK since 1999 - and if in doubt on whether a slide could be classed as normal it should be sent for further checks.

Doctors last week rushed to question the implications of his judgment with statements issued by the Institute of Obstetricians and Gynaecologists, the Royal College of Physicians in Ireland and the Royal College of Surgeons in Ireland.

Doctors warned that uncertainty is inherent in screening but the judgment could lead to increased litigation which could jeopardise cancer screening programmes.

Senior HSE staff discussed halting the State's screening programmes at a meeting in the wake of the judgment. Mr Justice Cross criticised some of the commentary in the media as "hysterical".

Dr Ishtiaq criticised "this total knee-jerk reaction that all our screening programmes will come to a halt".

He said: "It's called groupthink. It is called staying in their comfort zone. There is a cultural problem we have here and I am calling it out."

He said Mr Justice Cross's judgment does not call for certainty in detecting cancer on slides but for confidence that a slide is normal. It requires cyto-technicians who read slides to be "absolutely confident" when deciding whether a cell "looks normal". He said: "Finding something cancerous is not their job, their training or their responsibility."

"Mr Justice Cross's judgment is a timely reminder for the medical profession that we can no longer indulge ourselves in delusions of delivering quality screening services while not objectively measuring it and striving to improve it constantly," he said.

Mairead Enright, a senior lecturer at Birmingham Law School, suggested the judgment does not mean screeners must be 100pc certain on every call or that false negative results equate to negligence.

Quest Diagnostics is appealing the judgment to the Supreme Court, while the two other defendants are considering doing so.

Meanwhile, the 221 women impacted by the CervicalCheck scandal received invitations last week to apply for ex-gratia payments in line with settlements for "nervous infliction of emotional suffering" and psychological injury. The payment will be the same for all women who qualify and legal sources say it is likely to mirror the €10,000 awarded to Mrs Morrissey.

Sunday Independent

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