Just after my first son was born, I was standing, dazed, in the hospital corridor, my mind still struggling to catch up with the events of the previous hours. A friendly nurse who had assisted at the birth came out of the delivery ward and beckoned me over to a deep freeze. She had the placenta and was putting it with the others. When she opened the door of the freezer there were rows and rows of frozen placentas winking out at me.
They kept them, she said, for a pharmaceutical company.
In the circumstances, it didn't occur to me to ask any questions. Only recently did I ask my wife whether she had been asked for permission to dispose of her tissue in this way. She hadn't, of course.
What prompted the question, naturally, were the much more significant and disturbing revelations of the widespread hospital practice of keeping the organs of dead children and adults without seeking the permission of their next-of-kin. It is already clear that this has been going on for a long time and has involved very large numbers of people. The Parents for Justice group has so far received more than 2,000 complaints about the practice.
It is clear, too, that this was not an accidental or occasional occurrence but a systematic routine. At least two hospitals, Limerick Regional and Our Lady's in Dublin, sent pituitary glands to a commercial pharmaceutical company, Pharmacia and Upjohn.
It is also clear that the practice had little medical justification. This week, for example, the Coombe maternity hospital in Dublin announced that it carried out perfectly rigorous post-mortems without having to take whole organs. If the Coombe could manage by taking biopsy samples from organs, there is no obvious reason why other hospitals could not have done likewise.
And as all of this unfolds, to the immense distress of many parents, another question arises. Where were the ethics committees of these hospitals? Many of the hospitals involved are voluntary Catholic hospitals. All of them have powerful ethics committees. So how could something so obviously at odds with basic ethical standards have gone on for so long?
Let me stress that I am not suggesting that the abuse of human tissue is somehow a product of the Catholic nature of much of the Irish hospital system. This story, on the contrary, started in England with the revelation of what had been going on in state-owned hospitals that have no Catholic ownership or tradition. Far worse breaches of medical ethics have emerged from the "progressive" culture of Sweden, where the state ran a hideous programme of eugenic sterilisation.
There remains, nevertheless, a need to understand how, in Ireland, medical institutions dominated by a Catholic ethos and policed by ethics committees could have treated human remains with such a fundamentally irreligious lack of any sense of the sacred. How could a religious culture have displayed such a callous disregard for the rituals of mourning and the burial of the dead?
THE answer lies, surely, in the way a religious and ethical tradition has been distorted into an obsession with a few specific issues of reproductive morality to the exclusion of almost everything else. If the ethics committees didn't see the organ scandal in front of their eyes, it was almost certainly because that wasn't where they were looking.
The action was elsewhere - abortion, contraception, sterilisation. Huge medical scandals, such as the infection of thousands of women with hepatitis C, could unfold with virtual impunity, but a mother with a heart condition could be denied a sterilisation operation by an ethics committee because that would be unethical.
It's not just that a concern with one set of issues blinded the system to everything else, but that it could actually foster the most unethical kind of behaviour. One of the things that is slowly emerging from the medical undergrowth is the degree to which the conservative obsession with those very issues could actually encourage the most grotesque practices.
Recent research by Jacqueline Morrissey, for example, has begun to lay bare the hair-raising practices at the National Maternity Hospital in Dublin in the period between the late 1940s and the mid-1960s.
Catholic obstetricians, concerned that women who had babies delivered by Caesarean section might feel the need to use contraception or be sterilised, tried to establish as an alternative a violent and dangerous operation called symphysiotomy in which the pelvis is opened like a hinge. This resulted, in some cases, in injury to the mother and in the death of healthy babies. But risking the life of a real baby was more ethical than risking the possible failure to conceive some putative future baby.
Equally, as recently as last year, there was the case of an obstetrician in Our Lady of Lourdes Hospital in Co Louth, who performed an extraordinary number of hysterectomies in conditions where they seemed medically unnecessary.
He told a medical review group investigating this: "Our Lady of Lourdes Hospital was run by a religious order. . . and sterilisation would not have been allowed." He felt his job would have been in jeopardy if he had carried out tubal ligations rather than a hysterectomy for the purposes of sterilisation.
Taking out women's wombs, in other words, was, in his mind, more "ethical" than tying up their tubes.
These are extreme examples, and it would be foolish to suggest that this kind of behaviour has been prevalent in the Irish hospital system. But they are extreme manifestations of a mentality that has been all too deeply rooted. By turning a few issues into the essential markers of ethical medical behaviour, the church created a culture in which doctors could do the most extraordinary things and still be considered ethically sound.
It's important now that the promised public inquiry into the taking of human organs be used as an opportunity to reflect on all of this. It should, of course, give parents the answers they deserve to the haunting questions of what happened and why. But it should also try to explain what went wrong with an ethical tradition that seemed blind to the sacrilege under its nose.
fotoole@irish-times.ie