Madam, - As the consultant medical oncologists at the Mater Misericordiae Hospital, we do not share the views attributed to the special advisers to the hospital's executive management committee with regard to pregnancy and cancer chemotherapy.
With more than 40 years' combined experience in managing cancer, in Ireland and abroad, we strongly believe that no one should become pregnant while on chemotherapy. We have always counselled our patients to avoid pregnancy. This discussion - with patients and their partners - is a private matter between doctor and patient, and may involve a discussion of different methods of birth control, including abstinence.
We believe that no church (except that desired by the patient) or administrator has any role in this exchange and we continue to believe and practise this. This is all the more relevant in our increasingly multicultural society.
Physical risk to the health and viability of the foetus, or treatment refusal by a pregnant woman who might die from cancer, leaving a motherless child, are two potential, albeit extreme, results of failing to counsel patients appropriately before chemotherapy.
In the routine management of patients, we use educational materials which are explicit in this information. These are widely available from the Irish Cancer Society and are distributed to patients within the hospital. This information has been posted on the Mater Misericordiae Hospital website for over two years.
The clinical trials research environment has not changed the fact that this discussion occurs but rather reinforces the need for informed patient consent and clear documentation of this process. Being on a clinical trial and placing in writing the fact that this discussion has taken place should not to our minds offend the hospital ethos.
We take great pride in our oncology unit, including the Institute for Cancer Research, where we practice state-of-the-art, evidence-based cancer care. We have been pleased to participate in the investigation of new tools in the quest to control or cure cancer. We are proud of our patients who have agreed to join studies not only for the potential benefit to themselves, but for future generations of cancer patients who may bless them for assisting in its cure.
We are making this statement now because we feel mature reflection and common sense will allow us collectively to refocus on the most important elements in this issue - our patients and the eradication of this indiscriminate disease. - Yours, etc,
Dr JOHN A McCAFFREY, Prof DESMOND N CARNEY, Mater Misericordiae Hospital, Eccles Street, Dublin 7.