A consultant gynaecologist has claimed he clipped both fallopian tubes of a patient as he felt it was in her "best interests" because he believed the only way she would become pregnant was through IVF.
Dr Declan Egan told a Fitness to Practise hearing that in this case, clipping the tubes was not a sterilisation because "infection had blocked these tubes before I got to them".
He claimed cutbacks meant he was under considerable pressure on the day he operated on patient Lorna McKeogh (36), from Mountbellew, Co Galway, with seven C-sections on his list that day, one of which involved the delivery of a baby who was inexplicably dead at 33 weeks.
Dr Egan, a consultant gynaecologist who last month retired from his practice at University Hospital Galway (UHG) and runs the private Galway Fertility Unit, said day beds had been cut from 10 to four and this had a knock-on effect on waiting lists.
He told the hearing Ms McKeogh had been referred to him by her doctor, Dr Eithne Lowe.
She had been advised that she may have a hydrosapinx or fluid-filled sac on her right fallopian tube and that this might need to be clipped.
However, Dr Egan said that when he began the operation, he believed the left tube also showed signs of disease.
He later told the hearing that tubal disease is bilateral or involves both sides in "99pc of cases".
This had left him with an "ethical dilemma", but he took the decision to clip both tubes, believing it was in Ms McKeogh's "best interests" as it would save her from undergoing subsequent tubal surgery.
He believed a line in the consent form signed by Ms McKeogh "covered" him to carry out an additional procedure if something else was found necessary. He did not ask her husband for consent because he would have found that "odd".
He said it was only when he got to the Fitness to Practise inquiry that legal experts told him he was not covered by this.
Dr Egan is before the Medical Council committee, where he faces an allegation that he clipped both tubes "in circumstances where this was not consistent with the consent form dated June 2, 2010".
He is accused of failing to meet the standards of competence that could reasonably be expected.
The hearing is due to continue on March 26.