Madam, - With reference to Carl O'Brien's recent report on "malpractice claims relating to symphysiotomies performed between 1950 and 1980", there are a number of issues that need to be highlighted.
As a woman and a practising midwife I empathise with the women involved in these claims for the impaired quality of life they are now experiencing. I regret they did not receive levels of post-partum care commensurate with today's best practice. However, the care was not determined by today's guidelines and protocols but by those available to the practitioners in the 1950s. Care choices were made with reference to known mortality rates associated at the time with Caesarean sections.
In the medical profession we continually strive to deliver better and more relevant care, so that today's best practice will not be an end in itself, but rather form the basis for future care protocols.
It is not possible to use hindsight as anything more than a learning tool, nor is it possible to apply today's best practice retrospectively to the 1950s. Legal attempts to do so will undoubtedly bring some financial benefits either to the lawyers themselves or to their clients but will do little else beyond enshrining the practice of defensive medicine.
In Ireland we have witnessed an 81 per cent growth in Caesarean sections since 1991. Although some of this increase can be put down to maternal choice, the driving dynamic has been the increased practice of defensive medicine.
We are in grave danger of replacing the core ethic of putting the patient's interest first with the need to limit the legal exposure of the practising midwife or physician. - Yours, etc.,
JANET MURPHY,
RGN, RM, B.Sc. Midwifery,
Rockshire Road,
Ferrybank,
Co Waterford.