The range of phrases indicating general culpability but no blame is impressive, writes Fintan O'Toole.
Years ago, there was an ad campaign aimed at improving safety in our homes and workplaces. The slogan, if I remember it accurately, was: "Accidents don't happen. They are caused." The aim, presumably, was to shake us out of our habit of using the passive voice to avoid responsibility. To judge from the truly dreadful report of the Lindsay inquiry into the infection of people suffering from haemophilia with AIDS and hepatitis C, the campaign was a complete failure.
The passive voice has a lot to answer for in Ireland. It is the language of avoidance, of irresponsibility, of impunity. People don't corrupt the system, the system is corrupted. White collar crooks don't commit fraud, funds are embezzled.
Politicians don't turn a blind eye, signs are missed. People with responsibility for matters of life and death don't betray the trust of those who depend on them, system failures occur. Accidents are not caused, they happen.
If there was ever going to be a set of events that might break this mentality once and for all, it must surely be the disasters at the Blood Transfusion Service Board (BTSB) in the 1970s, 1980s, and 1990s. The infection of thousands of people with potentially fatal viruses - mothers needing anti-D injections, people with haemophilia, patients receiving transfusions - ought to be the kind of catastrophe that finally wakes us up to the unacceptable human cost of a State that speaks only in the passive tense.
And yet, after 150 witnesses and 200 days of sittings, the Lindsay Tribunal comes up with a report written largely in the passive voice. It finds, in essence, that the infection of at least 104 people with HIV, at least 217 with hepatitis C and 69 people with both was not caused. It happened. So far 79 haemophiliacs have died.
This is not the place to go into the details of this scandal. The facts, however, are clear. AIDS was known about from 1981, and the first person with haemophilia in Ireland was diagnosed with the syndrome in November 1984. The existence of a third form of hepatitis (then called non A/non B) was known from 1974. By 1984 at the very latest, people dealing with blood products knew that they were handling very dangerous material.
This wasn't some kind of obscure, esoteric concern. It was public knowledge that these dangers existed and that the BTSB was not dealing with them. On June 9th, 1986, Dr David Nowlan, Medical Correspondent of The Irish Times, published a news report that commenced: "Native Irish human blood products used in the treatment of certain cases of haemophilia may still carry the virus which causes AIDS, a leading haematologist [Prof Ian Temperley\] has warned."
No one would suggest that this was an easy issue to deal with or that even the best blood bank in the world would have been able to prevent a few tragic cases of infection. The reality, though, is that the Irish system made nearly all the wrong decisions, ignored new scientific developments, didn't bother to recall products that were known to be potentially lethal, and treated the victims of these failures with mind-numbing callousness.
Both they and the rest of us who need to know we have a functioning State had a right to expect that an inquiry into such hideous failures would be clear and forthright. What we've actually got is an exquisite exercise in the uses of the passive tense.
The range of phrases in the report which indicate general culpability but no actual blame is impressive: "It might also be thought"; "An opportunity was, however, missed"; "Steps should have been taken"; "This was not done"; "A possibility which should have been explored"; "Could apparently have been attained"; "Should have been pursued with greater urgency".
One question, an example which can stand for many, is this: Why were doctors treating people with haemophilia not told that the products they were giving their patients might be lethal? It is a simple question, crying out for some assignment of personal responsibility. What the report concludes, however, is that: "In the tribunal's view steps should have been taken to draw the attention of such doctors to the risk of hepatitis attached to the use of commercial concentrates. It seems this was not done." This isn't just a matter of language. The general reluctance to assign responsibility becomes a reluctance to deal with awkward possibilities. There is, for example, considerable evidence that the cutbacks in State health spending in the late 1980s were a real factor in the disaster. Tainted products were used because they were cheap.
In 1987, the then chief executive officer of the BTSB wrote: "Finance is the board's biggest problem, particularly its cash flow." In 1989, Prof Temperley wrote: "The board should understand that in the present period of financial stringency the hospitals could not be expected to meet a doubling of the cost of concentrates in 1989. Some balance will have to be struck between cost and the infection dangers associated with blood products." The report, however, blandly dismisses the notion that financial considerations had anything to do with the disaster. If they had, of course, the crucifixion of a vulnerable community wouldn't have happened. It would have been caused.
fotoole@irish-times.ie