Madam, - In 1982, recently returned to Ireland and to hospital practice, I became concerned about the custom of burial without appropriate medical certification. When post-mortem was not mandatory, it appeared routine to release a body from hospital to claimant undertakers. Urgency and convenience were invariably cited. I enquired from management about the legality of this practice. The authorities seemed quite unconcerned.
Very aware that cremation without stringent documentation is not permissible, I was and am bothered about this still extant practice. Certification after hospital death continues to be long delayed.
I had worked in jurisdictions in which a body is considered to be in the ownership of the State, not the family or relative. I attempted to ascertain the official position in this State. Numerous lawyers appeared not to know.
I wrote to the Attorney-General, to be eventually informed that this matter was not in his remit. I set a protocol for my personal practice and that of my junior colleagues - not without administrative difficulties.
The ownership, State or otherwise, of a body and perhaps body tissues may be central to the current cries of "scandal" and I believe should be the opening defining statement in a long-awaited Dunne report.
Would the lawyers please address this issue? Does anyone know? - Yours, etc.,
GERARD J. BURKE, FRCP,
Castleconnell,
Co Limerick.
Madam, - Thank God for some sensible discussion at last on this controversy - in particular the letter from T.P. O'Connor (August 24th), who lost two children, one of whom underwent a post-mortem examination. Until now people have been reluctant to criticise the campaign by Parents for Justice, for fear of seeming uncaring or downright heartless. The fact is, however, that the practice of retaining organs was the norm in pathology departments all over the world.
The reasons for this were in no way sinister. Organs were retained to understand disease processes and because full pathological evaluation would have taken days or weeks, delaying burial. Such delays would have caused distress and would have lead to widespread refusal of post-mortem examination. But it is vital to understand why patients die to have any chance of improving medical care.
Of course it was wrong that parents were not fully informed and that proper consent was not sought. That was fairly typical of the attitudes that prevailed in medicine until relatively recently, where doctors did what they thought was best for patients and their families, not always involving them in decisions which were rightly theirs. Fortunately, things have changed.
Highlighting the practice was correct and it has contributed to increased sensitivity in dealing with this most difficult situation in medical practice. But what use is a witch-hunt for pathologists, mostly now retired or deceased? How will it help? They were not criminals or heartless, cavalier scientists, but professionals working with limited resources, who simply operated in the way their colleagues all over the world operated at the time.
Already €15 million has been spent in an attempt to answer the anger and hurt of parents who have lost much loved children. Now there is an increasingly strident call to escalate the inquiry into a statutory review. And what will that achieve? I would like to hear more voices of common sense such as that of Mr O'Connor. - Yours, etc.,
Dr MICHELLE McNICHOLAS,
Park Avenue,
Sandymount,
Dublin 4.