Doctor faces tough task restoring his reputation

The former medical director of the National Haemophilia Treatment Centre, Prof Ian Temperley, will have his work cut out next…

The former medical director of the National Haemophilia Treatment Centre, Prof Ian Temperley, will have his work cut out next week to repair a somewhat dented reputation.

He has undoubtedly fared worst from the latest round of testimony from victims of HIV and hepatitis C infection, which was completed yesterday.

Some 43 people - surviving haemophiliacs, parents of infected children, and next-of-kin of those deceased - have given evidence and, perhaps not surprisingly, given that he treated more haemophiliacs than most, Prof Temperley's name was cited in evidence more than any other medical practitioner.

Yesterday he was accused of advising a haemophiliac that it was safe to start a family on the same day that a blood sample was taken from him - without his knowledge or consent - to test for HIV.

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The patient's wife, giving evidence under the pseudonym "Deirdre", said she would have thought the very least Prof Temperley should have done was wait for the result of the test before telling them to start a family. Her husband, Declan, tested positive for HIV and subsequently died of AIDS. Fortunately, the virus was not passed on to her.

A more general allegation made by a number of witnesses was that Prof Temperley failed to inform patients of the risks regarding commercial concentrates, or give patients a choice about which product they could use.

Last Friday the mother of a haemophiliac who died from HIV after contracting the virus through such concentrates said she "only wanted an excuse" not to use them.

She said "we had managed for nine years on cryo" (a safer, locally-made product) and would have continued using it had she been told about the risk of HIV infection from concentrates. She said she was never told about such a risk, however, despite having discussions with Prof Temperley in May and August 1983.

Prof Temperley's first chance to reply to such criticism will come on Tuesday when the third phase of the tribunal - that centring on the role of doctors - begins. Along with specific allegations, he faces the more general charge of being "cold", "arrogant" and "dismissive", descriptions provided by a variety of witnesses.

By no means, however, is he the only treater who faces tough questions.

A recurring theme in testimony has been the lack of counselling services provided to victims and their families in the aftermath of a positive test for HIV or hepatitis C.

St James's Hospital, Dublin, where Prof Temperley practised and where most haemophiliacs were treated, is expected to challenge such claims. So, too, individual treaters such as Dr Helena Daly, whose counsel has already indicated that she will contest evidence to the effect that she did not provide sufficient counselling.

It was interesting to note that, with the third phase approaching, lawyers representing treating doctors were more eager to cross-examine witnesses giving personal testimony.

And, in a departure yesterday, Mr Brian McGovern SC, representing both Prof Temperley and Dr Daly, as well as Dr Fred Jackson, accused witnesses of making "gratuitous" and "unwarranted" references to practitioners.

As a result of such objections, a number of witnesses were stopped from straying from prepared statements and making allegations which had not been notified to all parties.

One such witness, Ms Linda Dowling, who gave evidence last week, criticised the tribunal for cutting her evidence short. Mr John Finlay SC, for the tribunal, had submitted that she had been shown "considerable indulgence" and was making "in effect, a speech" at the end of her evidence.

Such tension, however, is inevitable as the stakes are raised at the inquiry. With reputations now on the line, the 15 to 20 other victims and relatives who are due to give evidence in a third round of personal testimony can expect a more difficult ride when they come to give evidence next year.