Friday 24 May 2019

Editorial: 'Expedite cancer screening appeal'

Mr Justice Cross has been pilloried on social media and by many senior doctors. He himself has now spoken up to describe some of the criticism directed at him as ''hysterical.'' Stock photo: Depositphotos
Mr Justice Cross has been pilloried on social media and by many senior doctors. He himself has now spoken up to describe some of the criticism directed at him as ''hysterical.'' Stock photo: Depositphotos
Editorial

Editorial

Decisions made in Irish courts must be open to public scrutiny, and judges themselves cannot be exempt from criticism. Some of the opprobrium directed at Mr Justice Kevin Cross following the award of €2.1m to Ruth Morrissey and her husband Paul after she sued the HSE, Quest Diagnostics and Medlab Pathology over consecutive misreadings of her smear tests in 2009 and 2012 has, however, been excessive.

The concern which has been expressed is that, by asserting in his ruling that there must be "absolute confidence" in the cervical smear test system to rule out false negative results, he has put the entire screening programme at risk, since absolute confidence is impossible. There will always be false negatives and false positives in any cancer screening programme, and, as the Royal College of Surgeons has pointed out, enforcing an impossible standard would lead to "additional unnecessary tests and procedures on patients who do not have cancer". For all this, Mr Justice Cross has been pilloried on social media and by many senior doctors. He himself has now spoken up to describe some of the criticism directed at him as "hysterical".

Regardless of whether his ruling was wise to lay down a standard which many medical authorities regard as unattainable, he is correct about the reaction. This is an emotive issue, but it needs patient detachment to navigate a way through it, not sloganeering, and that seems to be increasingly impossible in the current political climate, where populism stokes dangerous simplicities.

This is not the fault of Irish courts. They have merely been saddled with the task of sorting out the tragic mess which has been made of these women's lives. The medical establishment must not allow itself to be seen to resist demands for higher standards of care. Ruth Morrissey's slides contained abnormalities which the High Court has found should not have been passed as negative. While 100pc accuracy is impossible, such a failure of the screening system is unacceptable. Doctors can be no more exempt from robust criticism than judges.

Similarly, while Health Minister Simon Harris is right to call for "cool heads", it is worth remembering that it is the Government which has forced women such as Ruth Morrissey to seek redress from the courts, rather than coming to generous and humane settlements with them. Squabbles about the extent of the State's liability should never have taken precedence over doing the right thing. Campaigners Vicky Phelan and the late Emma Mhic Mhathuna were both able to reach settlements with the HSE and the US labs in their cases. That should have set the template for all the women involved in this shocking saga.

What matters now is that a way is found to move on from the High Court ruling while ensuring that the cervical cancer screening programme continues to do what it is designed to do, which is catch potentially fatal disease at an early stage and save women's lives. Quest Diagnostics is to appeal the decision to the Supreme Court, and it is essential that this is expedited as soon as possible in order to find a workable legal and medical definition of "absolute confidence" which can restore faith in the cervical cancer screening programme.

Sunday Independent

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