Grave mistakes were made by medical experts in their advice to Roman Catholic Church authorities on dealing with paedophiles, writes Dr Patricia Casey
The dictionary definition of an expert is "a person who has extensive skill or knowledge in a particular field". The Catholic Church, when confronted with the painful fact of priests abusing children, turned to experts, including lawyers, for advice on how to handle the matter.
The recent débâcle demonstrated that, although lawyers gave expert legal advice, it was not the counsel that the church needed in order to respond pastorally to the victims of abuse by priests.
Neither was it what the church's followers in the pews wanted. Instead, the call was for sensitivity and openness and the courage to admit that the bishops dealt incorrectly with abusing priests. While lawyers gave advice, technically and legally correct, the real needs of the situation lay beyond their competence.
Other professionals also gave advice which, in retrospect, has been found wanting. Reading Alison O'Connor's book, A message from Heaven: The life and Crimes of Father Sean Fortune, it is apparent that psychologists and psychiatrists also misjudged the response to that priest. At a time when he was abusing young boys during the 1980s, he was evaluated by three psychiatrists and three psychologists and their reports varied greatly.
One psychiatrist recommended a lengthy period of hospitalisation as a matter of urgency, while a psychologist evaluating Fortune around that time is reported in O'Connor's book as being unable to decide whether he had a sexual deviation.
Another psychologist, since deceased, using a personality test, concluded that "several of the concerns expressed with regard to Father Fortune are not supported by the evidence" and believed that his sexual orientation "does appear to be heterosexual".
A psychiatrist in London's Harley Street agreed with the latter findings, while a further evaluation by a psychiatrist in Dublin led to the priest being prescribed a drug to reduce his sexual impulses.
Ivan Payne was also evaluated by psychiatrists and returned to limited pastoral duties in a Dublin parish, after which he continued to sexually abuse boys.
It cannot be said that these experts were acting in a cavalier or malicious manner. It merely points to the limitations, even of experts. Expert opinion is always based on the available scientific knowledge at the time, and it is not always safe to assume that the expert has the "extensive skill or knowledge" which is assumed.
Little was known about child sex abuse at that time, and even less about its perpetrators. Indeed, doing a literature search on the Internet of the psychiatric or psychological papers on the topic, there was a dearth of scientific as distinct from popular material written before 1967, and until 1986 there were only 13 papers on paedophiles listed in peer-reviewed psychiatric journals.
Even in 1975, a paper on the victims of child sexual abuse concluded: "Little information regarding the magnitude of the problems of medical, psychological or social sequelae of sexual abuse of children is available in the literature."
Though they were acting in good faith, grave mistakes were made by these experts. The consequence was untold suffering.
Surely this should sound a cautionary note. Yet, suddenly it seems everybody is an expert on paedophilia. Everybody is an expert on what the church should do.
However, sexual abuse is a complex problem about which very little in known, and when complex situations are given simplistic solutions people will inevitably be hurt, as they have been in the past.
Even the term "paedophilia" is used among commentators to describe all sexual abuse when the term should be reserved to describe recurrent, intense sexually arousing fantasies, urges or behaviours towards prepubescent children; as distinct from attraction to post-pubescent minors, a condition called ephebophilia.
There are also distinctions between regressed and fixated paedophiles and ephebophiles. These distinctions are of more than linguistic interest since the response of society and of therapists needs to be tailored to reflect these differences. Failure to recognise these differences is similar to regarding all cancers as the same and requiring the same intervention.
Similarly, the response of many to the present situation has been to suggest that celibacy should become optional; that homosexuals should not be ordained; or that strict psychological evaluations of aspiring seminarians should be implemented. Some, any or all of these may be true. Equally, they may be fallacious.
I am not saying that people are not entitled to hold opinions (which they are), or that the church is not in need of reform (which clearly it is), or that these matters should not be considered (which they should). Merely that opinion-formers and leaders should do so armed with scholarship and insight rather than popular conjecture; and where knowledge is scarce this should be acknowledged.
Considering the state of scientific information about sexual abuse, its causes, treatment and the identification of its perpetrators, humility rather than certainty should be the guiding principle.
Patricia Casey is professor of psychiatry at the Mater Hospital, Dublin, and at University College Dublin