Sunday 26 May 2019

Eilis O'Hanlon: Our godlike 'butchers' must be cut down to size

Blaming religion for the brutal practice of symphysiotomy is too simplistic, writes Eilis O'Hanlon

LIAM Neeson once appeared on a chat show with Clive James and admitted that reading Men Are From Mars, Women Are From Venus had revolutionised his understanding of male/female relationships.

What he chiefly learned is that a woman will say something is bothering her, and a man will immediately leap in to offer possible solutions. The woman will listen, but still feel dissatisfied, because what she was looking for at that moment was not logic but empathy and reassurance. When it comes to the Walsh report on symphysiotomy, the Government's problem is that it is acting like a man.

Here is a group of women who, as young mothers from the Forties onwards, were subjected to a brutal practice, whereby the pelvis was surgically enlarged in order to facilitate normal childbirth -- a procedure carried out in preference to Caesarian section, many believe, on purely religious reasons, because a woman could have multiple symphysiotomies whereas there was a recommended limit of four Caesarians. As a result, up to 1,500 women have suffered a lifetime of physical discomfort, including chronic back pain and incontinence, the cause of which some did not even realise until late in life.

It was in response to their plight that Professor Oonagh Walsh of UCC was appointed to conduct a report into the practice -- but now that the first draft has been published, ministers seem to have forgotten why they commissioned it at all. Instead of listening, they have simply used its release to deliver a dispassionate lecture on medical history, complete with statistics and little historical factlets about common practice at the time, as if the issue was academic rather than a continuing trauma in the lives of hundreds of women.

The last few weeks have been the political equivalent of giving someone who was grievously injured in a bomb a tutorial on how the explosives were manufactured.

No wonder then that the Survivors of Symphysiotomy (SOS) decided last week at a meeting in Wynn's Hotel in Dublin to "repudiate" the Government-commissioned report, describing it as a "deeply defective and distorted piece of work", as well as opting, possibly more significantly, not to co-operate with the Department of Health's ongoing consultation process. Both sides are now further apart than before, and the mystery of how and why they were brutalised by a procedure chillingly described by SOS spokesperson Dr Marie O'Connor as having been "resurrected from the graveyard of obstetric surgery" is as far from being satisfactorily answered as ever.

Many advocates for the survivors think they know the answer to that one already. Mutilating Mothers in the Name of God goes the title of one educational video produced a few years ago by supporters. But whilst symphysiotomies may have been the preferred method of certain doctors in Ireland who also happened to be Catholics, blaming religion for what happened is too simplistic. Such a serious charge needs more than anecdote to back it up. As Iona Institute director David Quinn has pointed out, there is not the slightest scrap of documentary evidence that the church had any position on symphysiotomy, much less an iron will to enforce it in Irish hospitals.

There is also the matter of the high rate of hysterectomies on women in many of the same hospitals during the same period. The wholesale removal of healthy wombs which has been uncovered hardly conforms to the image of a Catholic medical establishment desperate to preserve women's fertility at any cost.

Even if it was, rabid Catholicism in no way represents the position of the present-day State, so why the apparent eagerness to brush off the concerns of victims of symphysiotomy? It cannot be, surely, that they're afraid of the cost involved if they admit that a terrible injustice was done to so many women and thereby open the door to a flood of claims for compensation?

A Co Louth woman who was subjected to the procedure without her knowledge or consent, at the age of 18, in 1969 in Our Lady of Lourdes hospital in Drogheda, received €450,000 in compensation for medical negligence in March. Another 120 cases are pending. The only thing stopping hundreds more victims taking action is that the statute of limitations has passed in their cases, they having discovered too late what had been done to them decades before. It would be no surprise if the State was thinking here with its chequebook rather than its heart.

The malaise, though, feels deeper than that. Marie O'Connor possibly came closest to an answer when writing a couple of years ago in response to the hysterectomy scandal also in Our Lady of Lourdes hospital. The removal of wombs from healthy women continued until 1998, despite repeated warnings; the hospital was cleared many times by its peers, despite having a rate of womb removal 20 times greater than normal. What Dr O'Connor observed at the time remains as pertinent now as then: "Decades of State lethargy gave the nod to medical power, consultant hubris, midwifery subservience and an obstetrical culture that objectified and demeaned women."

Doctor knows best: it's a servile attitude which continues to hold back serious discussion and reform of the medical establishment to this day. The official response to the Walsh report simply confirms that nothing much has changed. A timid Government has chosen to rely entirely on the opinion of professional bodies such as the Institute of Obstetricians and Gynaecologists, who, in a classic rallying-round manouevre, continue to argue that symphysiotomy was "considered valid practice at the time".

Doctors are the real God-like figures in this story, not priests. They're the ones who need to be cut down to size. The survivors are an embarrassment because they demand that the medical majordomos who butchered them be censured and held to account.

At least there are some public representatives who understand what's needed right now. Independent TD Stephen Donnelly has called for the report to be "binned" and the statute of limitations to be lifted so that these women have the same right to seek redress through the courts as every other citizen. "The strengths or weaknesses of the content of the report do not matter at this point," he explained last week. "What matters is that the report has further alienated the very women for whom it is meant to be seeking justice."

The Minister for Health and his officials should listen and take note. They need to stop talking Martian and learn to speak Venusian.

Sunday Independent

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