Focus: The Grim Reapers

Then came a telephone call that transformed her from disillusioned agitator into a reborn hunter of the truth.

At the other end of the line was Raymond Bradley, the Carlow solicitor who had made his name and considerable fortune by representing the Irish Haemophiliacs Society at the Lindsay tribunal, which investigated how Irish haemophiliacs were infected with the HIV virus after receiving contaminated blood products from the Irish Blood Transfusion Service.

Bradley’s championing of the case, and his wounding cross-examination of Ian Temperley, the former medical director of the haemophiliac treatment centre, had played a significant part in winning the day — as well as sizeable compensation payments — for the victims. Now he was offering his services to O’Reilly and Parents for Justice. He was promising retribution.

“He had us spellbound, he was like our Medusa,” said one parent, “We were in awe of him because of the blood scandal and all the compensation. He promised us documents, doctors’ heads on plates. He said he would dedicate his whole firm to getting us the truth. He said he was friends with the minister.”

This week, Bradley started to deliver on his promise.

WITH all the precision of a military campaign, Parents for Justice launched an astonishing media blitz.

What started as a trickle turned into a torrent of admissions and expressions of regret: hospital after hospital publicly acknowledged that it, too, had taken organs and glands from dead bodies without consent and pharmaceutical companies confirmed that they had received thousands of glands from Irish hospitals in the 1970s and early 1980s.

By Friday Parents for Justice could claim that body parts had been removed during almost every post-mortem examination conducted in the state and that up to 180,000 families could be affected by what was emerging as a scandal of massive proportions.

In total, 20 hospitals and two pharmaceutical companies had confirmed their involvement in the practice of “harvesting” pituitary glands; the two companies confirmed that they had received thousands of glands from 32 hospitals, while at least four more drugs companies were said to be involved.

As the media coverage intensified, so did O’Reilly’s stridency. On Friday, with a picture of her infant son by her side, she launched a blistering attack on Martin, dismissing his “cheap talk”, his “appalling” response to her organisation’s request for information and comparing his performance to the handling of the haemophiliacs’ cases by previous governments.

Martin and his department ran for cover. In a statement, the minister — who is on holiday — called for co-operation with the lumbering Dunne inquiry. He said the department knew nothing of the practice of extracting organs and glands without consent until 1999 and only discovered the following year that pituitary glands had been sold to pharmaceutical companies during the 1970s and 1980s.

It was a resounding media victory for Parents for Justice, but behind the hype some discordant voices were beginning to be heard. The taking of glands, some doctors pointed out, was a routine international practice at the time; pituitary glands in particular were essential for the production of human growth hormone, used in fertility treatments and to combat forms of dwarfism. The practice was not malign, and was not for profit: it was for the greater human good.

The parents’ grief, they argued, may be understandable, but it could not be alleviated by punishing hospitals for the actions of its pathologists in previous decades. “This looks more and more like a compensation case being built through the media rather than a focused attempt at truth building,” said one leading litigator.

“Nobody was killed, they were all dead already,” said Bill Tormey, a histopathologist and author of A Cure for the Crisis. “Where is the injustice? What are pathology specimens, including organs, only bits of people who have formerly lived? There was no malign intent on the part of pathologists and there was no cover-up.”

THE pituitary is a pea-sized gland situated near the base of the skull. Up to 100 glands a year were required to make enough growth hormone to treat a child suffering from stunted growth, so demand was intense.

“They were taken from everyone, not just kids, but everyone gets upset if it involves children,” one mortuary technician who worked in a Dublin hospital at the time said last week. “We just did what we were told by the pathologists, no questions asked.

“The glands, tiny little things the size of a pea, were placed in buckets of formaldehyde. They were all numbered, and when there was a sufficient number that the local reps from the drug company needed, they were sent off. I don’t know what all the fuss is about, its not like we were trafficking organs.”

What he and his colleagues in at least 32 of the republic’s hospitals were doing was mirrored across the world. In Britain and Australia public inquiries have confirmed that organs and glands were routinely removed from dead bodies. Suspicions that Irish hospitals had also kept organs and tissue without parental consent were confirmed shortly after Alder Hey Children’s hospital in Liverpool had kept thousands of children’s body parts without consent.

In December 1999 O’Reilly formed Parents for Justice when several mothers discovered that their deceased children’s organs had been retained without their consent.

Within weeks, the group had received more than 2,000 phone calls from parents and other next-of-kin who expressed similar concerns.

The controversy soon reached fever pitch. Parents mounted “black flag” protests, picketing government buildings and waving pictures of their dead children.

The backlash led to the establishment in 2001 of the Dunne inquiry, a private, non-statutory tribunal, which has has cost ¤15m, but produced no report.

Six months after the inquiry began, Parents for Justice withdrew its co-operation because they could not agree with the confidentiality demands and more than 100 sets of parents lodged High Court actions seeking compensation.

The outcome of their cases is uncertain but the momentum has not been halted by adverse judgments. Last month, a High Court judge dismissed an action for damages by a Dublin couple over the retention by the National Maternity hospital of organs belonging to their stillborn daughter.

O’Reilly insists the legal action is a last resort. “Money won’t bring our kids or our dignity back,” she said. “The truth will, and heartfelt apologies from the hospitals and pathologists who plundered our babies’ bodies.

“A little humility, and an adequate explanation coupled with a sincere apology would be enough.”

But it isn’t. In the wake of last week’s revelations, the parents have called for individual consultants, pathologists, mortuary technicians and pharmaceutical representatives to be named and shamed.

They want a full statutory public inquiry, and some of its members have handed files to gardai in the hope that individual doctors can be jailed for breaches of the coroners’ acts.

ELDERLY paediatricians and pathologists fear that they are becoming the victims of a witch-hunt. Before it agreed to co-operate with the Dunne inquiry, Our Lady’s hospital in Crumlin sought legal indemnity from all claims as a “prudent matter of course”.

Until the scandal broke, the medical profession did not give, nor was required to give, any legal consideration to arrangements for dealing with human tissue and organs.

Doctors claim the retention of organs without consent accorded with what was considered best national and international post-mortem practice at the time. Sean Daly, the master of the Coombe maternity hospital, which admitted removing pituitary glands, said he regretted the practice had occurred without parental consent, but said it was carried out “in good faith and not for monetary gain”.

Others agree. “What these poor parents need is a hug, not lawyers,” said Maurice Gueret, a GP and editor of the Irish Medical Directory.

“Doctors in the past treated dead bodies like old washing machines — useful for old parts. But it was carried out with a benevolent intent. The important thing now is to ensure that it never happens again,” he said.

However, some leading pathologists and coroners of the day who were unaware of the practice say their colleagues’ behaviour was deplorable.

“Under no circumstances should organs be removed without consent,” said Dermot Holland, 89, a retired pathologist who worked at the Richmond hospital, Dublin, which has been embroiled in the scandal. “I would never have approved of that practice.” Mick Loftus, the former GAA president and coroner for Mayo, said the parents deserved every sympathy. Loftus, a 75-year-old GP who still runs his own practice, said: “It horrifies me and the scale is distressing. Pathologists were well aware of the strict rules coroners operated under, so they knew where they stood ethically. We were not allowed to remove organs at will. “Given the scale of this practice, we must now look at the possibility that some in-house pathologists interfered in coroners’ post-mortems.”

UNTIL the Dunne inquiry delivers its conclusions at the end of this year Parents for Justice will maintain its pressure for full disclosure as well as their pursuit of compensation. The tone was set at an early meeting between Bradley, Parents for Justice, Micheal Martin and representatives of the Department of Health. Martin knew what the parents were going through — his own infant son died in 1999 — and he appealed to them to be patient with the inquiry. But as the meeting progressed witnesses say “an outrageous altercation” broke out between Martin and Bradley when the solicitor started to lecture the minister on the parents’ grief. “There was huge animosity, the tone had changed,” said an official who was present at the meeting. Martin, who has never spoken publicly of his own loss, needed no lectures on grief. “Suddenly everything was hostile and legalistic. From then on, it got very personal. Everything changed after that meeting,” said one parent. The acrimony will intensify as Parents for Justice ratchet up their demands. O’Reilly admits it could be “endless” but says that it “has the potential to affect every single family wherever a post-mortem has taken place in the last 30 years”. Unless Martin can broker a deal and close off the claims for compensation “the prospect of mass litigation is real and nauseating,” said one senior counsel. “It really does beg the question of who is benefiting, the lawyers or their clients?”