02.27.07

Loyalty and Neary

Posted in Feminism at 11:43 am by Sarah

sigh..still no ST “regional” edition online so you are stuck with the version that has not had the benefit of the diligent and elegant work of the ST editorial staff

also apologies for delay. I had a severe dose of PMT and couldn’t muster the focus to write anything or even post this yesterday. But all better now

Speaking as someone who is frequently wrong, I have some sympathy with Dr. John Murphy who resigned this week as President of the Royal College of Physicians. I’ve been ignorant of all the facts. I’ve placed my trust in the wrong people. I’ve rushed decisions under pressure and made the wrong call. I’ve made the most horrendous errors of judgement with totally unforeseen consequences when instead of absolute right and wrong, I let loyalty muddy the waters. The only comfort is that it’s a common mistake.

It’s exactly where Dr. Murphy and his colleagues Dr. Bernard Stuart and Dr. Walter Prendiville went wrong. These are the three doctors who have been declared guilty of professional misconduct by the Irish Medical Council. They aren’t a bit happy about this verdict. The way they see it, anyone else in the same position would have acted as they did. That might be true, and indeed several of their colleagues have testified to this very fact. Unfortunately it doesn’t matter. Their colleagues aren’t the ones in trouble.

In 1998, at the request of Finbarr Fitzpatrick, head of the Irish Hospital Consultant’s Association, the three eminent obstetricians reluctantly agreed to perform a review of Dr. Michael Neary’s practice. He was facing suspension because the North Eastern Health Board, who had recently taken over the management of Our Lady of Lourdes hospital in Drogheda, were deeply concerned about the high level of caesarean hysterectomies being carried out by him. They wrote glowing reports in which Murphy for example, claimed that the mothers of the North East were fortunate to have Dr. Neary. We found out later this was not the case – that the unfortunate mothers of the North East who went home without wombs were the victims of malpractice.

Defending themselves, they have given many reasons for their behaviour. They were under pressure from Finbarr FitzPatrick though he himself has managed to escape trouble. They didn’t have time. It was a preliminary report. They believed Neary’s difficulties were part of an industrial relations row with the NEHB. The Catholic ethos prevailing at Our Lady of Lourdes banned sterilisation so hysterectomies protected women’s health by preventing potentially dangerous pregnancies. The hospital was under resourced and didn’t have the capacity to carry out certain procedures which would have saved the mothers and the wombs. They trusted Neary as he personally guided them through each case. The women refused blood transfusions. Oh, these doctors offer many reasons for not being wrong.

There’s just one problem. They sought and kept secret an undertaking from Neary that he would not perform any more caesarean hysterectomies without a second opinion. The only possible reason for extracting this commitment was that they knew there was a problem. They just decided not to tell anyone. Dr. Murphy’s solicitor told the Medical Council the undertaking “could not be put in the report because . . . the ground would have been taken from underneath Finbarr Fitzpatrick and the IHCA.”

It’s just one little line in hundreds of pages of transcripts from the Medical Council hearings which exposes how loyalty, the supreme virtue in the view of some philosophers, can have appalling consequences. Murphy, Stuart and Prendiville acted out of loyalty to the IHCA, to Mr. Fitzpatrick and to Dr. Neary. What they fail to comprehend is that while loyalty is indeed a virtue, in their case it was entirely misplaced. Murphy in particular had concerns about Neary’s practice but faced with the competing demands of a colleague and his patients, he thought he could cover both by praising Neary in public and privately asking him to stop the hysterectomies. He was wrong and now it’s come back to bite him.

I wonder how much harm has been done in the world in the name of loyalty. It has obvious practical benefits and no friendship, alliance, organisation, community or political party can progress unless its members show loyalty. Yet, look at the misery inflicted upon thousands of children when those who considered themselves loyal to the church covered up for abusive priests. Their loyalty has destroyed the church. The war in Iraq has killed more than three quarters of a million people, yet political leaders don’t hesitate to morally blackmail the opposition by demanding loyalty to the troops. No member of the Lenihan family will say a word against Charlie Haughey even though he took money from Brian Lenihan’s liver transplant fund. How many bad teachers, corrupt Gardai or other errant professionals have been protected by the bonds of loyalty?

At a certain point, loyalty stops being good and becomes enormously damaging. For the ordinary person who is foolishly loyal they can feel stupid or cause unintended pain. For the professional, they can find themselves in criminal territory. EM Forster declared in a famously flawed defence of personal loyalty: “If I had to choose between betraying my country and betraying my friend, I hope I should have the guts to betray my country.” Few of us will be faced with the opportunity to betray our country, but like those doctors betraying the women of the North East, there will be other smaller though no less important tests. When you find yourself in a moral quandary how do you know what to do?

There is one simple test. Is the loyalty voluntary? If someone asks that you behave a certain way out of loyalty then watch out. Dr. Murphy never wanted to do the Neary review in the first place but Finbarr FitzPatrick pressed him to help out a colleague in trouble. When Tony Blair was facing a House of Commons vote when he wanted to invade Iraq, Cherie Blair begged women MPs to vote in favour saying “If not for Tony, then do it for me”. If ever there was an indication that an argument is without any moral foundation, it’s an insistence of loyalty.

You can also be sure of this, where a demand for loyalty fails, the use of fear is rarely far away. How many potential whistleblowers have been silenced when threatened with demotion, dismissal or isolation when arguments for fidelity failed to do the job? Once you hear “Do it for the Sisters” or your colleague, or the company or respect for our history as friends or as nations, its time to run. Don’t be fooled, claims of loyalty are the last resort of the morally bankrupt. Don’t listen to Forster. When you have to choose between betraying your friend or your best instincts, have the guts to betray your friend. If Murphy had done this, he’d still be President today.

Permalink