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Doctors in revolt over the effect of Catholic 'ethics'

Added on October 9, 2005


By Dearbhail McDonald and Jan Battles

Should a hospital be allowed to boycott cancer drug trials over contraception, ask our correspondents
Janette Byrne almost choked on her cornflakes. Reading her newspaper over breakfast last Monday, she spied a story that the Mater hospital in Dublin was objecting to trials of a new cancer drug because it involved the use of contraceptives.

Byrne was astonished because the hospital had not shown such reservations when they treated her. Quite the reverse. Before they began chemotherapy to treat her non-Hodgkin?s lymphoma, doctors at the Mater told her she could not get pregnant. So under medical orders she had a contraceptive coil inserted at the hospital and was prescribed the pill throughout her treatment. ?They told me that under no circumstances was I allowed to get pregnant,? said Byrne, who is now in remission.

So how could it be, she wondered, that the Catholic directors of the Mater were now objecting to a trial of a drug for lung cancer victims because the patient leaflet accompanying the drug said any women taking part must first agree ? to use an effective method of birth control to prevent pregnancy?? The drug, called Tarceva, might have extended the lives of women at the hospital suffering from lung cancer by several months and has been given to patients at Beaumont and Tallaght hospitals, which are not controlled by religious orders. Although the requirement spelt out in the leaflet could have been overcome by a simple agreement to abstain from sex, the Mater blocked the trial.

Byrne, who runs the lobby group Patients Together, said last week?s disclosure that the rigid ethos of those running the Mater was affecting medical care at the hospital was ?total hypocrisy?.

?No one mentioned the Catholic position to me then, I don?t know why it is being raised now.?

Byrne?s account is not unique: on the wards of the Mater and other Catholic hospitals such as St Vincent?s, doctors openly discuss birth control with women undergoing chemotherapy, to the point of discussing the different methods available. But, while senior management has been turning a blind eye to this practice in its wards, when it sees this spelt out in writing, as in the Tarceva leaflets, it draws the line.

This apparent lack of compassion for seriously ill patients has finally prompted doctors, thwarted by the boards of Catholic hospitals many times, to break ranks.

They spoke out last week to reveal how other clinical trials were postponed because of the Catholic ethos at leading institutions.

The disclosure that medical care at state-funded hospitals was sometimes influenced by the religious views of board members came as news to liberals who thought Ireland?s secularisation took place some time in the 1980s. So to what extent are modern Ireland?s hospitals still run according to Catholic mores?

LIKE the education system, the Irish health service was largely run by religious orders in the past. The nuns set up many of Ireland?s hospitals in the 19th and 20th centuries. In 2001, when the Sisters of Mercy sold the Mater to the state for ?22m, it insisted that its Catholic ethos, first espoused by the order?s founder Catherine McAuley, be retained. Several nuns still sit on the board of directors, including Sr Margherita Rock, the hospital?s director of mission effectiveness. Rock is also one of the members of the ethics committee, as is Sr Eugene Nolan. Before doctors start to work at the hospital, they have to sign contracts containing a stipulation dubbed ?the bishop?s clause? that requires them to adhere to the ethos of the hospital. The Mater prohibits female sterilisation, a standard procedure in non-Catholic-run institutions, and some fertility treatments.

When Roche, the pharmaceutical giant, laid down in its patient leaflet for Tarceva submitted to the Mater that women had to use contraception during treatment, the hospital cried foul.

?The situation is crystal clear,? said Mark Rogers, managing director of Roche Ireland, who intervened in the row after being accused of ?bullying and trampling on the Catholic ethos? by the hospital in a radio interview.



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