Madden proposals must be acted on immediately

The Madden report tells us little new but makes important suggestions, writes Eithne Donnellan

The Madden report tells us little new but makes important suggestions, writes Eithne Donnellan

The death of a loved one is probably the most difficult event any of us will experience. When it is the death of a child, the trauma and grief are increased immeasurably, whether or not death was expected.

"The death of a child is inherently against the natural order of life where the oldest die first, and it can cause lifelong heartbreak for parents, siblings, grandparents and extended families."

So states Dr Deirdre Madden in her report on the organ retention controversy published yesterday, which details how the pain of families was added to in the late 1990s when they began to discover the organs of their loved ones were retained without consent during postmortem examinations.

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Some perceived their child's body to have been "desecrated" or "mutilated". They couldn't believe their loved one could have been buried without their heart or brain for example, that these parts could have been retained, kept on a shelf or incinerated with hospital waste.

There was uproar and the Government responded by setting up the Dunne inquiry in April 2000. Chaired by senior counsel Anne Dunne, it was to examine postmortem practices at all hospitals going back to the 1970s and the retention of organs without the consent of a deceased person's next of kin.

It sat in private for several years and, after clocking up a bill of more than €20 million, the Government closed it down last March. At that stage more than 50 boxes of documents and information had been gathered.

Dr Madden, a law lecturer at UCC, was asked last May to go through the information gathered and file a report on the controversy. This she did and her work has cost just €450,000.

It is a very readable report on a practice with which, it seems, doctors saw nothing wrong. It points out that doctors, by not telling parents a child's organs might be retained at postmortem examination, felt they were saving parents from further distress. We now know the opposite has been the result.

Dr Madden says fairness demands that the doctors be judged by the standards of the time. Then, she says, the same practices were in place in other countries.

It seems, however, that doctors, hospitals and the Department of Health did nothing to change this practice until the media publicised it in 1999. This was despite the fact that, as Dr Madden puts it, anyone in the medical profession who reflected on organ retention without consent from the early 1990s on should have recognised that it was contrary to changing expectations of openness and transparency.

In general, the Madden report tells us little we did not know already, though it points out some hospitals initially gave parents wrong information when the controversy broke. However, it does make several important recommendations which must be immediately acted on.

It also says public confidence in postmortem examinations needs to be quickly restored and this will happen if, as she recommends, the area is governed by new laws.