The dispute that has blown up around the Mater Hospital and cancer drug Tarceva trials is a real blast from the past. In the 1970s we used to discuss the ethics of contraception and Charlie Haughey came up with an "Irish solution to an Irish problem".
Then we appeared to have moved on to the far more difficult issues surrounding abortion, reaching a national compromise that has legalised abortion when the health or the life of the mother is threatened.
Now we are engaged in a debate about the ethics of stem cell research, the definition of the unborn and other issues arising from the report of the Commission on Assisted Human Reproduction.
In each of these debates an evolving public opinion and the body politic have wrestled with approaches based on what might be termed "pure" Catholic teaching and more permissive positions that sought to set limits on the use of new technologies like IVF or genetic research but also recognised their positive life-affirming potential and/or their sad necessity in the face of human tragedy. We have moved from the black and white to a more nuanced and humane position on the so-called right to life. There is less dogmatism than before.
Yet the issue of the Catholic Church's opposition to contraception, not shared by huge numbers of Catholics, has not disappeared, most notably in hampering the struggle against Aids in Africa. And now in the Mater, access to drug trials by a small number of critically ill patients with lung cancer has been denied in the name of the Catholic ethos of the hospital.
The issue has been muddied by a number of complications. Not least of these is an outright contradiction between the hospital's insistence that the drug company had an absolute requirement that patients on the trial take contraceptives, and the company's assurance that its guidelines allowed for abstinence as an alternative. Did the hospital simply disregard that alternative, or did it decide that abstinence was not a viable option?
And there is confusion about who took the decision to put off the trial, the hospital board or a subcommittee, and the apparent simultaneous existence of two parallel systems for approving trials. Approval for the trials to start had been given by the Irish Medicines Board and the ethics committee of Tallaght hospital by the beginning of July.
That should be sufficient. That a wholly publicly-funded hospital should decide to second-guess that decision in the name must raise real questions for the future about the need for broader accountability of medical ethics and its decision-making process.