The retention and disposal of the organs of children and adults by hospitals, following post mortems and without the consent of their families, is a damaging episode in the relationship between the medical profession and the general public.
It is a hugely emotional issue. And the latest controversy, concerning the supply of pituitary glands to pharmaceutical companies for use in the manufacture of growth hormones, has revisited trauma on parents who lost babies in tragic circumstances up to 30 years ago.
In opening this issue to public scrutiny and judgment, it is important to place it in the context of the unhealthy atmosphere of paternalism that existed at the time, where medical procedures and practices went unquestioned and where decisions as to the greater good of society were not entrusted to the individuals directly concerned. Hospitals and the medical profession knew best. Quite unacceptably, the question of seeking the consent of parents did not arise. Happily, a great deal has changed in recent years in doctor/patient relationships; in the rights of patients to be informed about examinations and prognoses and in the need to seek permission before any medical action is taken.
Announcing the terms of reference of the non-statutory Dunne Inquiry more than four years ago, the Minister for Health and Children, Mr Martin, charged it to ensure that previous practices, that might now be judged unacceptable, would not recur. It was to establish the facts about organ retention and examine relationships with pharmaceutical companies concerning their use. It was to restore public confidence in hospitals and in the necessity for post mortem examinations, including organ retention for further diagnosis. It was to report in six months.
The Dunne Inquiry has cost an estimated €15 million and an account concerning practices in paediatric hospitals is due in the autumn. After that, it will report on maternity and general hospitals. It has blamed a lack of co-operation by some unidentified hospitals for the delay. Nearly two years ago, the Parents for Justice organisation withdrew its co-operation and demanded an immediate statutory inquiry. Some of its members are preparing legal claims for damages. And it has alleged that the unauthorised removal of organs was financially motivated.
The Dunne Inquiry has failed to meet deadlines or satisfy parents. But it did identify the use of pituitary glands by pharmaceutical companies in its report of 2002. It must now examine the far more serious allegation that financial and commercial considerations, rather than ethical medical practice, was the driving force behind the practice of removing organs without the consent of families. That work must be completed as a matter of urgency. If hospitals fail to co-operate, they should be named and shamed. A form of statutory inquiry may eventually be required if malpractice is established but, at this stage, such a course of action would only cause further delay and heartache.