Doctors ‘shocked’ at misogynistic remarks to women in cancer audit meetings

Dr Peter Boylan urges consultants to apologise to women for ‘unacceptable’ behaviour

Doctors who made misogynistic remarks to women or families in the CervicalCheck non-disclosure controversy should apologise, Institute of Obstetricians and Gynaecologists chairman Dr Peter Boylan has said.

The retired consultant said the comments made by doctors to women or families when they were belatedly told about the retrospective audit of smear tests was “completely unacceptable”.

The remarks were disclosed in this week's Government-ordered report by Dr Gabriel Scally who uncovered a "whole-system failure" over the non-disclosure of smear-test audit results.

Dr Scally describe how women were eventually told about the audit in meetings with the doctors as “damaging, hurtful and offensive”.

"It shows gross insensitivity to women who have cancer and are distressed and angry. It is not the way to deal with patients," Dr Boylan, the former National Maternity Hospital consultant, said in an interview.

‘Verging on misogynism’

Dr Scally, the Northern Irish public-health expert who investigated the years-long failure to tell women about the audits, said the family of one woman who had died from cancer was told by a consultant when he disclosed the audit: “Nuns don’t get cervical cancer.”

“It’s verging on misogynism,” he told reporters earlier this week. “If that isn’t paternalism, what is?”

The Scally report contains direct quotations from some of the 221 women affected by the controversy throughout its 170 pages, conveying their anger over how they were treated and spoken to by doctors.

“He sat back in his chair, couldn’t give two hoots,” one unnamed woman told the scoping inquiry.

Dr Boylan said the remarks were “misogynistic, ill-tempered, ill-advised and grossly insensitive”.

“The remarks were totally inappropriate and deserving of an apology to the women and anyone who was told these things in the process,” he said.

He said he only came across this behaviour on extremely rare occasions over the past decade and that these consultants were “in a minority now”, though these remarks were more common 30 years ago.

“That sort of behaviour brings the medical profession into disrepute and it damages the trust between patents and doctors: one of the pillars on which the relationship is built,” he said.

The scoping inquiry said Dr Scally was “very forthright” about doctor comments he heard from women when he engaged with clinicians and medical professional bodies as part of his investigation.

‘God complex’

The so-called "God complex" held by certain doctors, described in reaction to the Scally report, was at odds with current Irish medical school teaching, said Prof Joe Harbison, a director of medical undergraduate training at Trinity College Dublin.

“I was very disappointed to see what was written and I was a bit shocked,” he said, describing the comments as “dinosaur”. It was “very far away from how we teach”.

“It’s probably more relevant in some specialties than others. It’s perhaps more prevalent in people who haven’t trained in the last 10 or 20 years,” he said.

Prof Mary Horgan, president of the Royal College of Physicians of Ireland, said it would fully consider all 50 of Dr Scally's recommendations, "in particular those that can help to improve communications skills for doctors".

“Communicating with patients and their families with compassion and understanding must always be a priority for all healthcare professionals, even when working within a broken health system,” she said.

‘Whole-system failure’

The “whole-system failure” described by Dr Scally “included insensitive and unacceptable interactions with some doctors”, she said.

Prof Harbison, referring to the “nuns don’t get cancer” remark, said this type of viewpoint was taught “back in my day”.

“You could almost date the qualification of the person who said that,” he said. “It’s something that was taught and there was a sort of ‘so what?’ element to it. I’m really amazed it got brought up in any consultation.”

A spokeswoman for the Royal College of Surgeons in Ireland (RCSI) said the relationship between doctor and patient should be one of partnership.

"The RCSI code of practice for surgeons specifically states that surgeons should act immediately when patients have suffered harm to openly disclose what has happened and apologise where appropriate," she said.