Experts for doctors argue against censure

Experts for the three obstetricians:Experts instructed by the doctors who exonerated Dr Michael Neary in 1998 defended their actions and, in some cases, insisted that they should not be censured by the Medical Council.

An expert report by Dr Peter Lenehan, consultant obstetrician with the National Maternity Hospital in Dublin, said the conclusions reached by Prof Walter Prendiville and Dr Bernard Stuart were "reasonable and understandable".

Dr Lenehan said he disagreed with 10 of the 11 allegations of professional misconduct against the two doctors.

He said that with the benefit of hindsight there was little doubt that the conclusions of the doctors' report were wrong. However, they were understandable in the context of what they were asked to do and the time constraints involved.

It was regrettable that it was not written into their report that a solemn undertaking had been obtained from Dr Neary that he would not perform further peripartum hysterectomies on his own. It appeared this was omitted from the report, Dr Lenehan said, because it could have been "unfairly misconstrued" in the context of an industrial relations dispute.

Dr Lenehan concluded: "It is my considered opinion that, given all the circumstances, the conduct of Prof Prendiville and Dr Stuart could not be considered 'disgraceful or dishonourable' and therefore it is my opinion that they were not guilty of professional misconduct."

Dr Patricia Crowley of the Coombe Women's Hospital also acknowledged that Dr Neary had failed patients and had destroyed trust between women and obstetricians.

However, she said she believed Prof Prendiville and Dr Stuart were "good and conscientious doctors who would always do the right thing".

She said their brief examination of Dr Neary's case record and of material he provided led to a failure on their part to recognise that Dr Neary's practice was "deviant from normal obstetric practice".

Dr Crowley said she believed they took steps to safeguard the interests of patients by securing a solemn undertaking that Dr Neary would not perform another hysterectomy without a second opinion.

She concluded: "I do not believe that their failure to believe the unbelievable demonstrated by the report that they wrote on November 4th, 1998, constitutes grounds for censure by the Medical Council."

Another expert opinion from Dr BM Coughlan of the Mater and Rotunda hospitals in Dublin said it was clear that the third obstetrician, Dr John Murphy, had concerns about Dr Neary's low threshold for Caesarean hysterectomies.

He had insisted that the Drogheda-based obstetrician not proceed in future without a second opinion.

Overall, Dr Coughlan wrote that Dr Murphy "did not have time on his side" when preparing the report late at night, or have time to review it before submitting a final draft.