A friend of mine has had the misfortune to have three babies die in her womb. She and her husband were full of hope for her last pregnancy, then just weeks ago, a scan once again failed to reveal a heartbeat. She was 12 weeks pregnant, but the baby was estimated to be 11 weeks and two days gestation. Like the other times, she had to go into hospital to be induced. The baby was tiny, fitting easily into the palm of a hand, but had long delicate limbs, and clearly discernible fingers and toes, writes Breda O'Brien.
She even had what looked like a smile on her face. It was hard to imagine that someone so perfectly formed could not sustain life. My friends were happy with the nursing staff, who were sensitive and compassionate at all times. However, she and her husband were a little taken aback when they went to collect the baby a few days later for burial after a post-mortem.
The baby lay on a table, wrapped like a cylindrical roll of bandages, marked with a name tag. The room was grim and depressing. As the father said, it looked like a 1950s sitting-room, which had needed a coat of paint for years. After the other miscarriages, the baby had been returned swaddled in a little knitted square, which somehow helped. The way in which the baby was presented this time was very stark. It added to the loneliness and desolation of the experience. Small things matter at times of grief. My friends wished that there could have been some more dignified way to receive the baby they subsequently named Jane.
Yet progress has been made. One can only shudder, reading about the experience of P.J. and Josephine Cleere in 1985. Despite pleading, they were only granted five minutes with their baby after birth, even though he lived for a number of hours. The child, Patrick, had anencephaly, a condition where the skull does not form properly.
The baby had a post-mortem performed, for which the parents claim they were never asked for consent. They were not allowed to dress the baby in clothes that Josephine had knitted for him. Years later, they discovered that many of his organs had been retained, including his heart, lungs, liver, kidneys, spine and testes. The loss of a child is bad enough, but to be treated with such insensitivity compounds the grief. The thinking at the time was that it was better for the parents not to see the child, yet it is almost universally agreed today that it is better for parents to be given time with the child.
This applies no matter how severe the condition affecting the child. In anencephaly, usually just the brain stem is present, and the skull does not develop to cover it.
Yet I have seen photos of babies with anencephaly, who at first glance look no different to any newborn because they have been given back to parents wearing a little cap.
Perhaps it is because people go into medicine because they want to be of help, that many medical personnel find it so hard to deal with a situation where death is inevitable, or has already occurred. In a sense, death constitutes failure. Which of us wants to deal with failure? It is easier to switch to a scientific mindset, where the next question can be what research benefit can be gained from this death.
In medical training, human remains have to be depersonalised to some extent, or people would never manage to dissect cadavers. That necessary ability to depersonalise became distorted when a child's organs were seen only as a valuable source of research. In some cases, detachment crowded out empathy and compassion.
Discomfort with the reality of death is not confined to medical people. At other times in our history, we have probably felt more at home, or at least resigned to the reality of death.
In previous generations, this world was considered to be a "vale of tears" and death a passage to happiness, if one lived a good life. It meant that dealing with death was in some senses easier. While the dead were to be treated with respect, the body was not identified with the essence of the person.
The language used gives us a clue. The dead are referred to as "the departed". Even the word "remains" indicates that the essential part of the person is no longer present.
In a secular culture, it is more probable that we will identify the person more closely with his or her physical body, and any intrusion on that body, even after death, appears like an assault on the person.
Yet no child was harmed by the retention of organs or tissue. It was those left to mourn who were harmed, as the burden of being treated with great insensitivity was added to the weight of grief.
At any time of cultural change, practice takes some time to catch up with new insights. So while my friends who suffered a miscarriage were generally pleased with how they were treated, at the final moment, the way in which the baby was returned to them was less than it might have been. There is no doubt that medical attitudes to death and how it should be handled have a long way to go.
Simple things, like a coat of paint in a room from where a miscarried baby is collected, or a special receptacle for the body, would make a great difference. They reassure parents that their child has been treated with respect.
There is also a need to reinforce a sense of solidarity. There is renewed scandal at the retention of pituitary glands, yet it is very clear that such retention was done solely in the hope of improving quality of life, and in some cases, life expectancy for other children. In our natural solidarity with parents who have been bereaved, it is important not to undermine a wider human solidarity. Every effort should be made to improve the way in which bereaved parents are treated.
However, we are in danger of forgetting that a post-mortem, including organ retention, need not diminish the dignity of the body, but can enhance it, because it provides an opportunity to do good for others.
Last week I repeated the urban myth that Feargal Quinn does not have a Leaving Cert. He does, along with a B.Comm. Apologies.