Fears Ruth Morrissey judgment could have a negative impact
Concerns have been raised in medical and legal circles that a High Court judgment in the case of a terminally ill woman could ultimately have a negative impact on patient care and in the delivery of screening programmes.
If screeners are required to have “absolute confidence” in their finding before giving the all-clear when reading a test slide, it could lead in the long term to patients being over-investigated and overtreated, and ultimately harmed, according to Professor Donal Brennan.
Prof Brennan, UCD professor of gynaecological oncology, was speaking on RTÉ’s This Week programme in relation to the case of 37-year-old Limerick woman Ruth Morrissey who successfully sued the HSE and two laboratories for misread smears and failure to tell her about it.
The judge in the case, Kevin Cross, set the threshold for giving the all-clear at “absolute confidence” ie that the screener must be absolutely confident the test result is negative.
Prof Brennan said there was “very little if anything that is absolute in medicine, not only in screening, but across the whole of medicine”.
“If it’s a case that we must be absolutely confident that all tests are negative that’s going to have a major impact on how we deliver the screening programme,” Prof Brennan said.
He said he could envisage a situation where “a woman who has an entirely normal cervix ends up having a hysterectomy for no apparent reason other than nobody was willing to call the sample normal”.
Prof Brennan said the ruling could also pose problems for those working in diagnostics.
Barrister Paul Anthony McDermott said the Cross judgement was “probably the most important judgment delivered in the area of medical law for decades”.
He said a requirement for “absolute confidence” was “an incredibly high bar but Judge Cross felt if you are going to engage in the national screening programme, that’s as high as it has to be”.
Ms Morrissey, who, with her husband Paul, was awarded €2.1m in damages on Friday after they sued the Health Service Executive and two laboratories said screeners needed to be certain when calling a result.
If you are unsure of what you are looking at, then you can’t pass it.
“It’s not like you are looking at a sheet or a slide that has no impact on someone’s life,” Ms Morrissey told Miriam O’Callaghan in an interview on RTÉ radio.
“If there is any doubt then it should not be passed, it’s very simple.
“It’s not going to clog any system, it’s just going to give more assurance to people that they are going to have a proper screening programme, that people are more vigilant doing it, that we are going to have more competent screeners.”
