Cancer trials row - Interests of patients must be put first

It hardly requires a background in medicine to appreciate the possible, if not inevitable, risks to an unborn child from chemotherapy if his or her mother is engaged in cancer trials.

Consequently, it is difficult to understand why two Dublin hospitals have delayed a cancer drug trial because of the absolutely critical necessity that the women taking part use contraception for the safety of a foetus.

To the disinterested observer the reason that they are doing so on ethical grounds, because of the use of contraception, is perplexing because it appears to be the narrowest interpretations of their policy.

That policy is aimed at the protection of a foetus, and it would be totally unthinkable that the hospitals would acquiesce in women taking part in the cancer trial under conditions which would inescapably be injurious to the unborn.

The ethics committees in both the Mater and St Vincent’s University Hospital have invoked ethical grounds to take issue with the use of contraception, because of the religious ethos prevailing in both institutions. They are owned by the Sisters of Mercy and the Sisters of Charity respectively and both their ethics committees have apparently insisted that patient consent forms for the trials should not contain references to contraception.

Both are teaching hospitals, but in this instance they are, ironically, inhibiting the furtherance of knowledge of the drug Tarceva, considered to be a radical new lung cancer treatment.

Advancement in medicine requires that such trials be pursued and it is important that as wide a number of participants as medical experts warrant be involved from the point of view of accuracy in results.

Too many families in this country have been affected by the dreadful impact of the ravages of cancer, and continual research into drugs that may ameliorate it, or prove to be life-saving, cannot be ignored.

Tarceva has been approved by the Irish Medicines Board, which is the regulatory body for drugs and medicines, and trials are being conducted at Beaumont and Tallaght hospitals.

Two leading consulting oncologists, Mr John McCaffrey of the Mater and Mr John Crown of St Vincents, have been critical of the delay in the trials because of the contraception issue. Both have insisted that doctors needed to be able to offer patients the best treatments available.

The attitude of the hospitals in this case is frustrating such a possible outcome by refusing to co-operate with the trials, which are part of an international study.

Ethical policies are commendable, but when those of an institution which is funded by the State to any degree clash with the perceived common good, then it is entirely appropriate to question them.

Such is the case here, and both hospitals should balance what could be understood to be a sectarian application of their policies against the potential benefits from these trials to serve the good of the community.

According to its mission statement, the Mater continues in its healing ministry to the sick, “regardless of class, creed, or nationality”.

In other words, the community at large. Applying the letter of the law in the strictest possible sense is not in the interests of the community at large in this instance.