Homes probe - reading history backwards?

  • Niall Hunter, Editor

The planned Commission of Investigation into mother and baby homes, will, like the recent probes into child abuse, put into uncomfortable perspective societal attitudes and State policy in Ireland in the 20th century.

One of the issues it may be tasked with addressing is the events surrounding doctors carrying out vaccine trials on children in some of these homes and whether proper procedures were completely adhered to in performing these trials.

A previous Department of Health investigation into this issue, which reported in 2000, left some questions unanswered about the trials, which took place in the early 1960s and 1970s on children in mother and infant homes and other institutions and within the family home.

This report, by the Department's Chief Medical Officer James Kiely, concluded that the decision to carry out the three trials on 211 children (123 resident in homes/institutions) was justified, given the diseases the vaccines sought to prevent.

However, the report also concluded that the absence of documentation meant that it was impossible to ascertain whether consent had been obtained from the parents or guardians of the children involved and what arrangements were made with the managers of the care homes.

The report also stated that the lack of documentation meant that it could not be determined whether the provisions of the 1932 Therapeutic Substances Act, governing the importation and use of vaccines, had been complied with in the trials, although the State's drugs regulatory body had issued a letter of no objection to one of the three trials, based on a then voluntary approvals code.

A potentially more thorough investigation of the issue as part of the Laffoy Commission (later the Ryan Commission) on institutional child abuse was halted in 2004 after a successful legal challenge by one of the doctors involved in the vaccine trials. The Commission had set up a dedicated division to to look into this issue.

The High Court had upheld the challenge of the doctor, Prof Irene Hillary, who had expressed concern that the attachment of the vaccine trial issue to the work of a commission into child abuse had implications for her professional reputation.

Many reasonable people would probably agree that it was unfair to attach the vaccine trials issue to the more serious issue of institutional physical and sexual child abuse being investigation by the Laffoy/Ryan Commission.

However, that's not to say that there is not a case, in terms of natural justice, for the vaccine trials issue to be re-examined in another forum. There could, however, be legal difficulties involved with this.

In upholding Prof Irene Hillary's appeal back in 2004, the Court indicated that the machinery could exist for a separate inquiry into the vaccines issue.

The Government, however, was not overly enthusiastic about going down this road. In 2006, the then Health Minister Mary Harney decided that there should be no further examination of the question of vaccine trials involving babies and children in institutional settings.

She further stated in the Dail in 2010 that at the time of her decision in 2006,  it was 'very likely that any further investigation would experience similar difficulties to those encountered by the (Laffoy/Ryan) Commission' in trying to investigate the vaccine trials issue.

This, the Minister said, followed a detailed examination of judgements in court cases related to the vaccine trials hearings in the High Court and Supreme Court.

A key legal issue, identified by the Supreme Court in relation to one of two challenges to the Commission inquiring into vaccine trials, was that there was, it said, no indication in the Kiely report of any abuse of children having taken place within the meaning of the Commission to Inquire into Child Abuse 2000.

This, according to Minister Harney's legal advice, raised the issue of further legal challenges and it was a key factor in the Government abandoning at the time attempts to look into the vaccine trials controversy.

In addition to Prof Hillary's court action, another doctor involved in the trials, Prof Patrick Meenan, had successfully appealed a High Court order which required him to comply with the Commission's direction to give evidence about the vaccine trials.

The judge in this case had commented that the vaccine trials "appear to have only the most tenuous connection, if any, with the appalling social evil of the sexual and physical abuse of children in institutions, which was the specific area into which the commission was established to inquire".

Now, the disturbing reports about a Tuam mother and baby home and the deaths of infants there over a number of decades have led to a new State probe that is likely to include the vaccine trials issue, and may finally shed some further light on it, assuming that any possible legal obstacles are overcome.

It is highly likely that such an inquiry would unearth evidence of further medical trials carried out on institutionalised children in Ireland.

While many have welcomed the announcement that there is to be a statutory inquiry into how mothers and babies in these homes were treated, not everyone might welcome it.

Some might claim that the latest inquiry into how society dealt with the poor and the vulnerable in the 'bad old days' will achieve little, and that there is a danger of 'reading history backwards'. But they are are missing the point a little.

The logical extension of such an argument is that we should shrug our shoulders, say 'things were different then' and move on.

This essentially means we as a society should make little attempt to come to terms with our past. This would be an insult to those who have suffered to one extent or another from the consequences of the policy of official Ireland in relation to the health and welfare of children.

A 'head in the sand' attitude' on uncomfortable truths from the past will also serve us poorly in trying to formulate more sensitive and humane health and welfare policies today. This attitude might also feed in to the damaging culture of excessive secrecy and poor accountability which has bedevilled public policy since the foundation of this State and still exists to a certain extent today.

As regards the vaccine trials, there are hundreds of people around today who believe they were in these trials, about which there are still major questions about issues such as consent, adherence to regulations, the reported use of disabled children in the trials and the long-term effects, if any, of the vaccines on the children involved.

The vaccine trials, while not as serious an issue as the appalling vista uncovered by the Laffoy/Ryan and Murphy abuse inquiries, do constitute an issue about which the public deserves to know more.

Doctors involved in the child vaccine trials have defended their actions, stressing that the vaccines did no harm and the trials were in their best interests, according to an article by Brian McDonald  in the Irish Times on June 11.

The actions of the doctors involved may well have been correct by the standards of the time and were obviously done for altruistic medical motives.

However, from what has emerged to date regarding the vaccine trials, the conduct of them does smack of the overly paternalistic approach of those in the medical profession towards patients - the 'doctor knows best so don't question things' approach.

In claiming that this type of approach is shrouded in the fog of the long distant past, it should be remembered that controversial medical practices have continued in this State up until relatively recently.

The practice of retaining dead children's organs, without consent, continued until the 1990s, and the controversial practice of symphysiotomy continued until the early 1980s. The latest of the controversial vaccine trials was carried out in the early 1970s.

The argument that one should not 'read history backwards' begs the question - at which point in time should you start reading it forwards? Where's the demarcation line between attitudes and policies then and attitudes and policies now?

To what extent can what people in authority did in the past be put down to 'what was acceptable then' and to what extent were they really acceptable even then?

Certainly, in trying to explain the context of some of the recent media headlines about the homes, it can be put forward that the mortality rate among 'illegitimate' children many decades ago was much higher than in the general population, and that controls and rules on medical trials were somewhat looser in the past than they are today.

However, that doesn't mean we should simply accept this hindsight view and then ask no more questions.

The Mother and Baby Home inquiry will help shine some further light on how society stigmatised, isolated and neglected the maginalised and vulnerable until fairly recently, and the role of the State and religious orders in this.

It may also get to examine how the medical establishment, also until fairly recently, operated on the basis that 'doctors know best' when it came to practices it may have geniuinely felt were in the best interests of patients.

These dubious traditions can, as we well know, sometimes have very serious consequences for people who put their trust in the institutions of society and the State.




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