Medical screening tests

Sir,– The “absolute confidence” comments by a judge would not be published as a valid comment or stricture by the Irish Journal of Medical Science because it subverts science and would never get through the reviewers or the editors. The need for a more extensive continuing professional development system for judges is starkly exposed. – Yours, etc,

Prof BILL TORMEY,

Editor in Chief,

Irish Journal of Medical

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Science,

Royal Academy of Medicine

in Ireland,

Kildare Street, Dublin 2.

Sir, – As a philosopher with an interest in the theory of knowledge in general and the standing of scientific knowledge in particular, I would strongly support Dr John Doherty’s assertion that “uncertainty is inherent in medical testing” (Letters, May 7th).

As a form of empirical or scientific knowledge, medical testing, by its very nature, operates with a standard of knowledge which, at its best, aims for a high degree of confirmation. Certainty is rarely, if ever, available in such an area, particularly where any degree of complexity is involved.

True, this provides little comfort to those whose lives have been blighted in the current Cervical Check debacle, but it would not be appropriate to respond to that debacle by demanding that testing be subject to a standard not available in the area concerned.

Thorough, careful and independent double-checking by highly trained personnel (though slow and expensive), seems to be the way forward. And, if in doubt, err in favour of the patient. – Yours, etc,

HARRY McCAULEY,

Maynooth, Co Kildare.