The assessor to the symphysiotomy payment scheme, Maureen Harding Clark, has reaffirmed her intention to shred applicants' unclaimed medical records. Underlying this plan appears to be a view that, collectively, they are of little significance, that they can be treated as though they were individual records of a generally accepted practice, such as Caesarean section. This is not the case.
The scheme holds documents belonging to nearly 750 women, up to 600 of whom are deemed to have undergone the controversial operation, which involved cutting the pelvic bone during childbirth. Obstetric notes specify, inter alia, the age of the patient and whether the operation was performed before, during or after labour, generally naming the doctors involved. Contemporaneous hospital records, general practitioner notes, specialist medical reports and radiological evidence, including X-rays, show the injuries caused by the surgery.
The former judge is the custodian of a vast trove of unique records that, with the consent of their owners, should be retained as well as returned. Collectively, these records are vital to establishing the truth about symphysiotomy. The documents belie the official view that symphysiotomy was done mainly as an emergency procedure and that the operation was safe. Ireland was the only country in the developed world in the mid- to late-20th century to practise symphysiotomy as a preferred or non-emergency procedure.
‘Safer’ than Caesarian
Unpublished data was excluded from the review commissioned in 2011. The inclusion of patient notes such as those held by the scheme would have made it difficult for the Walsh report to conclude symphysiotomy was “a safer intervention” than C-section.
The records the assessor proposes to destroy after March 20th constitute an overwhelming body of evidence of human rights abuses. Possible legal challenges to her decisions will also be made more difficult, as the wholesale destruction of records could frustrate future judicial review proceedings. In 2014, the UN Human Rights Committee found the practice of the surgery constituted involuntary medical experimentation involving torture, and cruel, inhuman or degrading treatment. Among its rulings (ignored by the Government) were that Ireland carry out "an independent and thorough investigation" and "prosecute and punish the perpetrators, including medical personnel".
As victims of torture and cruel, inhuman or degrading treatment, survivors are entitled, under international human rights frameworks, to an inquiry from the State. They are, by extension, entitled to the preservation of the data.
Dark chapter
The practice of symphysiotomy represents a dark chapter in the lives of Irishwomen in the last century. Irretrievable primary sources are at risk. These are of medical as well as historical interest. These obstetric notes go back about half a century.
To destroy unclaimed records is to compound the silencing of symphysiotomy survivors. The government payment scheme refused, in the main, to hear oral evidence. The scheme first proposed to destroy these records without the applicants’ consent and – often – their knowledge. The box-ticking exercise proposed is inadequate, as is the proposed depositing of records in Hawkins House for collection by elderly, infirm women.
The nature, scale and trauma of this involuntary childbirth surgery and its life- altering consequences render its practice unprecedented in the annals of human rights abuses in Ireland.
For a State scheme to deliberately destroy such uniquely valuable material is to violate survivors’ human rights and obliterate the very stuff of history. We have already seen the deliberate destruction of records in institutional schools, Magdalene laundries, psychiatric and general hospitals. Enough is enough. As well as returning all records to all applicants by post, the assessor should now seek their informed consent to archiving them so they can be made available as an integral collection for future investigators and researchers. Justice and history require no less.
Marie O’Connor is chairperson of Survivors of Symphysiotomy