The Cartwright Papers

Book excerpt: The Cervical Cancer Inquiry and its report (known as the Cartwright Report) were momentous events in the recent history of New Zealand. Critical issues were at stake: matters of life and death; the life's work of leaders within the medical profession; professional reputations; public trust in the profession, and its own sense of self-worth. After seven months of considering evidence, Judge Silvia Cartwright, assisted by expert medical and legal teams and drawing on specialist opinion from all over the world, concluded that Associate Professor Herbert Green had been conducting unethical research at National Women's Hospital, and that many women had been affected. This book of essays recounts some of this history. Several of the contributors were participants: Clare Matheson writes as one of the patients; Professor Charlotte Paul was a medical adviser to the Inquiry; Sandra Coney (with Phillida Bunkle) wrote the article leading to the Inquiry; Dr Ron Jones was one of the three authors of the 1984 article, using data from Green's own patients, that demonstrated that carcinoma of the cervix had a significant invasive potential. Other authors are specialists in other fields: Professor Alastair Campbell and Associate Professor Joanna Manning comment from the perspective of medical ethics and medical law respectively; Ron Paterson is the Health and Disability Commissioner; Jan Crosthwaite is a philosopher with expertise in medical ethics. These essays not only review the history but also document how the Cartwright Report changed the whole landscape of medical practice and biomedical research in this country, leading to far better protections for both patients and research participants. Yet despite all the regulatory changes, the most significant change to which the Cartwright Report contributed was attitudinal - a rejection of medical paternalism and a new expectation that patients would be treated as partners in their care. The findings of the Report remain controversial and continue to be debated to this day. This book provides a perspective on the current debates and helps place them in context. As Clare Matheson (one of Green's patients) said: 'We must never forget lest it happen again'. Contributors include: Alastair Campbell, Silvia Cartwright, Sandra Coney, Jan Crosthwaite, Ron Jones, Joanna Manning, Clare Matheson, Ron Paterson, Charlotte Paul.