The Vasectomy Doctor
Page 14
Soon after these celebrations my father had to have a leg amputated due to gangrene that in turn was brought on by narrowing of the artery supplying blood to his leg. A life-long habit of over twenty cigarettes a day had eventually caught up with him in his seventy-ninth year. I went to visit him in the Richmond Hospital the day after the amputation and, while he may have lost a leg, he clearly had not lost his sense of humour. ‘I suppose they’d say that this operation was a great success,’ he said to me with an impish grin on his face. He died the next day but I think that he had suffered enough and that it was time to go.
Being the doctor in the family certain tasks seemed to fall on me ‘naturally’ and it was left to me to impart the bad news to my mother who was, by then, confined to a nursing home. When she saw the look on my face as I came into her room she instinctively knew and anticipated my sad message. This made my task a little easier and she took the news with great calm and poise. She died herself six months later. She too had had enough.
CHAPTER 9
A Storm in a Condom
Contraceptives were totally outlawed in Ireland under section 17 of the Criminal Law Amendment Act 1935. This act makes it quite clear that it is ‘unlawful to sell, or expose, offer, advertise or keep for sale or to import or attempt to import into Saorstat Éireann any contraceptive’. Since neither the birth control pill nor the intra-uterine contraceptive device (IUCD) had yet been invented the term ‘contraceptive’ in section 17 is taken to mean condoms exclusively. How such a clearly sectarian statute could find its way into the legislature of a so-called republic is very difficult to understand. Other European countries that once had similar legislation had long since scrapped it. Fortunately for me vasectomy had not been invented in 1935. Otherwise I have little doubt but that it too would have been squeezed in under the terms of this act.
It may be tempting to suspect that the Catholic hierarchy had a lean on the government to keep this legislation in the statute books. But in fact they did not need to overly interfere because they had a laity who were more than capable of doing the infiltrating for them. Deeply conservative groups like the Legion of Mary, the Catholic League of Decency, the Irish Family League and most particularly the all-male and secretive Knights of Columbanus were well represented on government benches and within the medical and legal professions. These were the self-appointed custodians of the common morality and the occupiers of the high moral ground.
Protestantism is a minority religion in the Republic of Ireland. Protestants do not share with Catholics a moral veto on contraception or birth control. So why did Irish Protestants not protest against this blatantly sectarian piece of legislation? I wish I knew.
I suppose one must try to understand the concerns of people at the time even if one did not always share them. Reading the letter columns of our national newspapers around 1972 and 1973, it seems many people expressed their opposition to contraceptives in terms of the perceived disastrous consequences of ‘introducing that kind of filth’ into Ireland. To further justify these fears they would point to other countries, usually to the UK and say: ‘look at what happened over there’. The principles that one was being asked to take on board were: (a) that Irish sexual morality was superior to elsewhere in the world and (b) one of the reasons why that was so was because there were no contraceptives. The fact that there was not a shred of evidence to support either proposition did not seem to matter.
It was left to a Catholic mother of four, Mrs Mary McGee, then aged only twenty-seven, to take a High Court and later a Supreme Court action against the government in 1973. Mary’s contraceptives had been seized in the post by customs. She had a history of toxaemia of pregnancy (a potentially fatal complication that tends to get worse with each ensuing pregnancy) and was advised not to have any more children. She claimed before the Supreme Court that by seizing her contraceptives the state was denying her her constitutional right to privacy including marital privacy. A very brave young woman, Mary McGee won her case and this precedent put an enormous dent in the efficacy of the 1935 act to keep contraceptives out of Holy Ireland.
Following this ruling the clause dealing with ‘import or attempt to import’ was no longer sustainable. Anticipating this outcome Senator Mary Robinson attempted to introduce a Private Members bill to legislate for the new post-McGee situation but the government refused to even discuss it. It seemed that they were happier to have a deeply flawed prohibition on contraception than to actually face up to introducing laws that squared with the Irish Supreme Court ruling.
The exact same scenario repeated itself many years later when the Supreme Court ruled on a constitutional amendment to do with abortion. This ruling allows for abortion in Ireland where the mother’s life is at serious risk but to date no matching legislation has been put in place and I very much doubt if it ever will be, at least not in my lifetime.
So there we were in the Irish Family Planning Association importing condoms to beat the band. The fractured Criminal Law Amendment Act 1935 still prohibited us from selling them so we gave them away for nothing instead and accepted a ‘donation’. Strangely this donation always covered our costs with a decent profit thrown in for good measure. In those days it was all to do with language. The contraceptive pill likewise in theory was prohibited by the 1935 act but we got around this by calling it a ‘cycle regulator’ which was very handy.
And that’s how things stood from 1973 until 1 November 1980 when the then minister for Health, Mr C. J. Haughey, introduced his inspired Health (Family Planning) Act 1979, the infamous ‘Irish solution to an Irish problem’ that made us the laughing stock of Europe if not indeed the whole world. In a nutshell this ludicrous piece of legislation made condoms a matter for a doctor’s prescription and they could then only be dispensed by a community pharmacist. Note that under this arrangement, a person seeking contraceptives could not just go in and buy them from a GP or a pharmacist. No, a responsible adult, seeking to exercise his constitutional right to limit his family size, had to make two separate trips to two separate professionals and pay professional fees at each stop.
I felt from the beginning that this piece of legislation was grossly iniquitous, unworkable and a violation of human rights. As a doctor I felt a deep sense of disgust that my chosen profession had agreed to co-operate with this kind of hypocrisy. Also the political cowardliness and the craven way that the proposed legislation seemed to pander to a particular view of morality was, I found, deeply depressing. I strongly felt that if this were the best that Mr Haughey could come up with he would have been better off leaving the thing alone.
A doctor’s prescription, or so I was always led to believe, was for serious medicines like antibiotics, addictive sedatives and analgesics like opiates and morphine and things that, in the public interest, need to be controlled. But condoms are not medicines or drugs, they are made from inert latex so what are they doing on a doctor’s prescription? It was clear from the very beginning that this proposed new legislation was being foisted onto us in an awkward attempt to ‘medicalise’ our national neurosis about things sexual and to let the government off the hook. But we accepted it.
But it was even worse than that. The responsible adult seeking a package of condoms so as to prevent his wife from becoming pregnant could only get a prescription for them from the doctor for ‘bona fide family planning purposes or for adequate medical reasons’. So here now was a brand new role for doctors to play. We were now being asked to make a judgement about our patient’s morality when heretofore all that used to concern us was our patient’s health. One implication of Mr Haughey’s Health (Family Planning) Act was that if doctors suspected that their patients were going to use condoms for some purpose other than ‘bona fide family planning’ then that doctor was duty bound to refuse that patient a prescription. Doctors had to exercise great care in making this moral judgement about their patients because any laxity in this regard could result in the doctor facing a fine of £500 or six months imprisonment.
As if to underline this notion that money would assuage us all I had a chance encounter with Mr Haughey after the press reception to launch his new Family Planning bill. Ann and I were at a reception given by the Irish Medical Times when in walked the minister. A small man, he walked with great economy of effort. He came into the room as if he was being pulled along on wheels for he took short but rapid steps, his arms held motionless by his side. Ann and I went right up to him and told him what we thought of his new bill. To this Mr Haughey replied that if I did not like it, then, as the bill stipulated, there was no obligation on me to participate, I could just opt out. This response was delivered with a backwards wave of his right hand as if he was trying to get rid of a housefly that had landed on the sugar bowl. It was a dismissive answer from an arrogant little man and it showed how the minister failed to grasp or perhaps did not want to grasp the serious flaws in his new legislation.
After this rather terse exchange Mr Haughey then addressed the assembled doctors. His opening words were: ‘I will make money for you doctors yet’. It was difficult to decide which was the more painful, the tastelessness and insensitivity of a minister for Health who would make such a remark or the vulgarity and crassness of the assembled doctors who thought that this was funny. It hardly matters. I left that gathering feeling like a complete outsider, ashamed to be a doctor and very alone, sick to the pit of my stomach at the whole lot of them. It was then that I vowed to do whatever I could to bring this piece of legislation down and to expose it for the hypocrisy that it surely was.
The new laws surrounding the sale and distribution of condoms threw the Irish Family Planning Association into something of a backspin. As its newly-elected chairman I had to tread an impartial path. The sale of condoms, or should I say the giving away of condoms for nothing and the accepting of a ‘donation’, had been the organisation’s main source of income and now all that was seriously threatened. There were two schools of thought as to what we should do. One was that we should simply ignore the law, carry on and see what would happen. This would have been my favoured approach because I saw the IFPA as a trail-blazing and pioneering organisation and had absolutely no respect for this new legislation. The association may have been pioneering at one time but by now, over a decade since its foundation, many of the people working in it were becoming institutionalised in their thinking and were fearful that if we broke the law we could be closed down and then they would all lose their jobs.
In the end it was these people who won out and the Irish Family Planning Association became fully compliant, or at least as compliant as possible, with the provisions of the Health (Family Planning) Act 1979. I had little choice but to accede to the majority view. A pharmacy division was established within the organisation and a full-time pharmacist was employed to oversee it. In this way the doctors could ‘write’ prescriptions for condoms and our pharmacist could ‘dispense’ them. In practice however prescriptions were written in bulk and the condoms were dispensed by whoever happened to be around at the time. But in theory at least we were compliant and it looked well and in any case there was never any attempt to enforce this law as the government did not need any embarrassing prosecutions.
This was so typically Irish but madly frustrating for all of that. We had an unworkable piece of legislation that shamelessly exploited people seeking to be responsible about family planning; everyone was breaking the law in all but spirit and nobody did anything to change it.
Outside of the IFPA it was difficult to know what we could do to challenge this wretched legislation. Dr Sheila Jones and I organised a petition with the signatures of some 260 doctors across Ireland saying that they were strongly opposed to this new law and that they would not cooperate. We drummed up as much publicity as we could and on 11 March 1982 delivered our letter to Dáil Éireann to Dr Michael Woods’ secretary. Woods was minister for Health at this stage and Haughey, prime minister. It may not seem like much now but to get 260 doctors in Ireland to agree to anything was quite an achievement. But the thing got very little media attention and of course I am still waiting to hear back from Dr Woods.
As time went on it began to dawn on me that the only way to bring embarrassing outside attention to this miserable legislation and thus have it changed was to go out and deliberately break the law. Since there was no effort being made to enforce it in the first place breaking it would have to be done in a very formal and documented way. The situation required some bottle. In July 1982 I asked a friend of mine, Robert Sheridan, to play a cameo role for me in this charade. He would come into my surgery at half past six in the evening and ask me for a package of ten condoms. I was then to sell him these directly and contrary to the provisions of Mr Haughey’s Health (Family Planning) Act 1979. My ‘excuse’ for doing it this way was that the local pharmacy closed at 6 p.m. and I did not want my client to risk causing an unwanted pregnancy. I was to issue Mr Sheridan with a receipt for the money he paid me and this, along with a covering letter, would be sent off to the DPP for his consideration. This forced the government to act through its own DPP. Much as they may have wanted to do otherwise they simply could not ignore me.
We then sat back wondering what would happen next. After about two weeks the gardaí phoned me and asked if it would be all right if they ‘raided’ my surgery sometime as there had been a complaint made against me. I said that there would be no need for that, that they could come down here anytime they liked and that I would give them whatever they wanted. Such compliance among the criminal classes must be rare. A day or so later two burly gardaí arrived and I gave them a few packets of condoms and a receipt book showing that I had indeed been selling condoms directly to people contrary to the provisions of you know what. Then it was just a question of waiting another week or so for the summons to arrive.
* * *
During these years a group of four of us – James Egan, James O’Dwyer, Peter Cunningham and myself – used to take land for rough shooting down in Carlow, halfway between Rathvilly and Hackettstown. This land was for the most part poor for farming but ideal for snipe and released pheasants shooting. Two men used to look after things down there for us. We called them the ‘Two Billys’. These men reared a few pheasants for us and came out with us, with their dogs, to keep the farmers sweet and, as best they could, to keep poachers away. The system worked very well for a good few years but the farmers were constantly improving their lands through drainage. This, while no doubt improving the land, left it unsuitable for snipe-shooting. As well as that it was becoming increasingly difficult to keep the farmers on our side and a time came when the thing became untenable.
But when it was working well we would go down to Carlow maybe four or five times during the shooting season, arriving at an appointed gateway at around 9.30 a.m. having stopped off for breakfast on the way down. We would then shoot until 12.30 or so, at which stage someone would deem it time for lunch which was, often as not, partaken of in a local hostelry called the Tobanstown Inn. In those days most country pubs did not serve any food at all so we would bring our own. By the time we’d get back to the Two Billys we would, as they say, be feeling very little pain.
After one such excellent lunch I remember we were taken onto a large field of sugar beet not yet harvested. This kind of a crop is great for holding pheasants parti
cularly if it is a bit weedy. The pointer was sent out in front of the guns and the Two Billys followed behind. The pointer ranged right to left and left to right across the guns, her nose held close to the ground all the while trying to pick up a scent on this winter’s day. Suddenly the dog stops dead in her tracks as if struck by lightning. She is petrified and statuesque. Her head is cocked slightly to one side, her front left paw is held off the ground, her tail is held out behind her as straight as a die. All the guns know that there is a cock pheasant somewhere about ten feet in front of the dog’s nose and ready themselves accordingly. Dog and bird are going through their ancient ritualistic stand off.
Then the pointer begins to wag her tail in the horizontal plane, the tip moving two inches each way. This is a sure sign that the pheasant is about to move which is exactly what happens. The dog now breaks her set and moves slowly forward, crouched down. This is where you need a good steady dog. It is vital that the pointer keeps her distance behind the running pheasant otherwise he will break out of range of the guns and that is no good. The chase is on. The pointer moves on up the field in pursuit of the unseen bird. Peter Cunningham, who happens to be nearest to the action, takes off up the field after the running pheasant and crouched down pointer. This trio move forward from the rest of us by some 200 yards.