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A barbaric practice

Euphemism and silence are by far and away the easier options; the frankly staggering lack of Irish data of this issue colludes with this inaction. Even the acronym — FGM — seeks to hide the sheer awfulness from the ears of the hearer and the mouth of the speaker. But talk about it we must. If we are to ever look these women in the eye, we must talk about it and name it for what it is — fetishistic barbarism.

However, the decision of the UK’s Crown Prosecution Service to bring Dr Dhanuson Dharmasena to court on a charge of perpetuating FGM has to be questioned. As the head of the Royal College of Obstetricians and Gynaecologists noted in the College’s statement following Dr Dharmasena’s acquittal, while some of his clinical decisions were questionable with hindsight, medicine is not a risk-free or perfect science. Particularly in the field of obstetrics and gynaecology.

Nothing occurs in a vacuum. Risks are weighed up against benefits, and everything is filtered through the prism of resources. Anyone working in health today knows this.

The suggestion that Dr Dharmasena’s case amounted to a ‘show trial’ is particularly worrying, although the Crown Prosecution Service vigorously defends its decision to prosecute.

Furthermore, this latest episode speaks to the growing legal dangers surrounding practising in this area of medicine.

In Ireland, increased insurance costs and the inexplicable shelving of the ‘no fault’ compensation advisory group on catastrophic birth defects all contribute to the so-called ‘chilling effect’.

As Prof John Crown told the Seanad last year, despite having one of the highest birth rates in Europe, “we have a grotesquely small number of specialists in obstetrics”.

“This cannot continue. All of the committees, bodies like HIQA, care pathways, guidelines and disciplinary hearings which occur afterwards will not fix this problem.”

While Dr Dharmasena was the first case in this law’s almost 30-year history, will it cause further concern to doctors working in this highly-litigious field on both sides of the Irish Sea? Undoubtedly, yes.

More than a place to lay your head

Congratulations to Medical Independent columnist Dr Pat Harrold, his wife Marita and their family on their appearance on RTÉ’s Room to Improve.

As well as giving viewers a glimpse into the ups and downs involved in building, it also showed a homecoming for Dr Harrold, as he and his family moved into the house he grew up in.

“It was brilliant, it was great craic,” he told the Medical Independent afterwards. “Dermot Bannon, the architect, was great, he was very easy to work with. I’d recommend him highly to anyone.”

Dr Harrold’s mother, who had been living alone in the family home, was also delighted with the transformation. The Nenagh GP also paid tribute to the professionalism and efficiency of Hackett Construction, the local firm hired for the build.

General practice, as everyone knows, is in crisis, buffeted from all sides. But the programme showed another side of a GP’s life.

A doctor at home in the community, a part of the place in which they live. This is one of the best aspects of general practice.

From everyone at the Medical Independent, we wish Dr Harrold and his family every happiness in their new home.

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