Monday, 2 September 2019

Who’s to Blame?: Inquests into Convict Deaths in Mountjoy, c.1868-1900

In this blog post, Annika Liger, a graduate of UCD's MA in History of Welfare & Medicine in Society, reveals anxieties around the medical care of prisoners in the late nineteenth century by examining newspaper coverage of inquests into convict deaths in Mountjoy prison.

“Death of a Convict in Mountjoy Prison”, Evening Telegraph
(1 October 1895). Newspaper image © The British Library Board
All rights reserved. With thanks to the British Newspaper Archive.
Following a convict’s death, nationalist journalist Alexander Sullivan wrote to the city coroner saying, ‘you cannot be unaware that Mountjoy prison lies under public suspicion as to the medical treatment of prisoners’.1 This ‘suspicion’ surrounding Mountjoy greatly influenced the inquests into convict deaths in the late 1800s. These hearings, which were widely covered in newspaper reports, reflected the public’s interest in Mountjoy and the circumstances surrounding prisoner deaths. While many of the hearings resulted in a simple death by natural causes verdict, the courses of the inquests reveal deep reservations concerning Mountjoy’s medical care. When the juries decided that someone was to blame for a prisoner’s death, it then prompted the question of who was more at fault—the prison medical officer (PMO) or the prison system?  


Inquests


In late 1800s Ireland, when someone died an investigation into their death was carried out at the coroner’s discretion. Generally, inquests only happened in cases of suspicious or unusual deaths, and the last attending medical practitioner, or any other local medical professional, was consulted. The medical community in general took these inquests quite seriously, and the ‘Principal Laws’ that governed United Kingdom medical professionals included a section on proper inquest conduct. These rules emphasized that medical officials giving evidence should be honest and accurate as their testimony was usually very influential.2

For general medical practitioners, these inquests could be stressful affairs. Depending on the outcome, the inquest could either enhance their professional reputation or destroy it. The same held true for PMOs, who had the added weight of also being responsible for protecting the prison’s reputation.3 Prior to 1877, prisoner death inquests were only called if the coroner felt one was necessary. In 1877, with the passing of the General Prison (Ireland) Act, inquests became mandatory in the event of a prisoner’s death. As a result, the number of inquests increased and PMOs ended up in front of a jury more frequently defending themselves and the prison. 


The PMOs


For information on prisoner death inquests, I mainly looked at Irish newspaper articles concerning the Dublin convict prison Mountjoy and two PMOs that worked there in the late 1800s: Dr James William Young and Dr Patrick O’Keefe. Young served at Mountjoy as a PMO from 1867-83. O’Keefe succeeded Young as head PMO at Mountjoy and served there from 1883-c.1907. Both Young and O’Keefe were highly educated individuals with multiple medical degrees who made careers out of working for the Irish prison system as medical officers.4 As PMOs, Young and O’Keefe were in charge of the general health of prisoners. They assigned diets, determined whether or not prisoners were suited for punishment or labor, and treated inmates’ specific aliments, among other duties.

Newspaper reports of the coroner’s inquests reveal that while Young and O’Keefe faced scrutiny in these hearings, Mountjoy itself received the majority of the blame in prisoner deaths. Coroner’s inquests in the late 1800s largely ended up being arenas where juries, coroners, and even the PMOs themselves, questioned and critiqued the Irish penal system’s care of prisoners in Mountjoy. 



Death by Natural Causes


In a few cases where Young and O’Keefe testified, the jury found no reason to blame either of the PMOs or the prison. They simply concluded that the prisoner had died of natural causes, as was the case when prisoner Patrick Naughton died in 1886.5 Likewise, when in 1893, Thomas Pembroke fell ill and died in prison, after testimony from multiple doctors, including O’Keefe, the jury decided that Pembroke was treated adequately and no one was at fault for his death.6

In other cases, ultimately both the prison and PMOs were cleared of blame, but during the trial there were debates over the various parties’ culpability. This is perhaps due to the general sense of skepticism when it came to Mountjoy that Sullivan mentioned in his letter at the beginning of this post. We can see evidence that others shared Sullivan’s concern over Mountjoy through the kinds of questions juries asked of the defendants, which often demanded that the PMOs explain in detail the care provided to the deceased. Some of the newspapers also reported that the juries were critical of the PMOs going into the inquests. After the death of a prisoner in 1868, for example, the jury was reportedly suspicious of Young from the outset. However, in this case they ultimately decided that he was not to blame.7

The testimonies that Young, O’Keefe, and other prison officials provided also suggest they were well aware of the public’s suspicion surrounding Mountjoy and tried to assuage any such fears. In 1883, during the inquest into Michael Watters’ death, Young, O’Keefe, and Kelly, another medical practitioner, all agreed that ‘death was not attributable to punishment or any form of ill-treatment’, thus contesting the notion that the prison’s disciplinary methods could be responsible for Watters’ death.8 In an 1886 case, the jury found that James Davies’ died of natural causes after a very laudatory testimony from the city coroner concerning the treatment of prisoners in Mountjoy. The coroner was adamant that Davies did not die as a result of neglect, saying that once a prisoner became ill ‘all his crimes appeared to be forgotten by the prison officials, who did everything for his comfort … they always have the best medical treatment’.9 Given the suspicion surrounding Mountjoy at the time, this praise was quite possibly an active attempt to combat the concern over inadequate prisoner care.

PMO Blamed for Convict Death


Unfortunately for the PMOs and Mountjoy, juries did not always decide that death was simply due to natural causes. When the juries found someone at fault, it placed the PMOs and the prison in a very critical spotlight and left juries, commissioners, and journalists debating which party was more to blame  the PMO or the prison. In particular, Young faced two noteworthy inquests, one in 1868 over Matthew Lynagh and the other in 1870, concerning Johanna Hayes. Both of these cases were suspicious enough to prompt inquests in a time before inquests were mandatory. Additionally, both cases were widely covered in newspapers across Ireland.

During Lynagh’s inquest, Young explained that he was treating Lynagh, but thought he was improving. As a result, Young initially declined to send Lynagh to the prison hospital. Ultimately, the jury blamed Young for Lynagh’s death, arguing that Lynagh should have been sent to the hospital much sooner. They also specifically called out Young, saying he ‘might be more attentive to extern patients’.10

Or Was the Prison Really at Fault?


While the jury in the Lynagh case firmly held that Young was to blame, the nationalist newspaper The Nation and the official Commissioners’ Report presented slightly different takes on Lynagh’s death. Both addressed the jury’s critique of Young, but argued that Lynagh’s death was not actually Young’s fault. One month after the inquest, the Commissioners released their report exonerating Young. They recognised the jury’s verdict, but said that Lynagh’s death was inevitable and ‘that the man was not neglected during his illness by Dr Young or the other officers of the prison’.11 Notably, while defending Young, they also declined to assign any blame to the prison system.

In 1871, The Nation published a scathing review of Mountjoy prison and mentioned the Lynagh case from 1868. The writer primarily saw Young as an agentless cog in a machine, thereby absolving him of blame. They claimed that the Lynagh inquest ‘resulted in a verdict censuring the Medical Officer; a clear injustice towards him, inasmuch as he probably did his duty as far as he could [sic] under the altered systems’.12 The article continued and reiterated this point suggesting that some vague prison bureaucracy prevented Young from providing more treatment to Lynagh. Unlike the Commissioner’s report which absolved Young but did not blame the prison system, The Nation blatantly held the prison at fault for Lynagh’s death.

Conclusions like this that pardoned the PMO while simultaneously condemning the prison system were not uncommon. In an 1895 inquest over Christopher Connor’s death the coroner told the jury that ‘the evidence showed that no blame attached to Dr. O’Keefe or the governor ... they did all that the rules permitted for the man ... the rules as the nursing of sick persons in [Mountjoy] were simply abominable’.13 The jury agreed with the coroner and their verdict called out the prison’s nursing system while also clearly stating that O’Keefe was not at all responsible for Connor’s death.

The Complicated Case of Johanna Hayes


In 1870, Young was dragged back into the spotlight with the death of Johanna Hayes in Mountjoy Female prison. During the hearing, Young reportedly testified that after entering the prison Hayes’ health began declining, and he recommended that she be released from prison with respect to her failing health. However, this recommendation was not heeded, and Hayes remained in prison where she died. In contrast to the Lynagh case, here the jury lauded Young for his attempts to aid Hayes and get her released. Interestingly, the jury did not directly blame the prison system, despite the penal system’s denial of Hayes’ release on medical grounds. The jury did note, however, that Hayes died as a result of her being in prison.14 This conclusion suggests the jury found the prison partly to blame, but not wholly at fault as it had not actively contributed to Hayes’ death.

While this trial ended relatively well for Young and the prison, not everyone agreed with the jury’s take on the events. Like the jury, Sullivan, the aforementioned nationalist journalist, did not blame Young, although he was skeptical of him. Rather, Sullivan railed against the Irish penal system in a letter to the city coroner, which was eventually published in the newspaper The Warder. In this letter, Sullivan addressed his preference for Young’s predecessor, Dr Macdonnell, and basically called Young a government lackey. He also commented on the testimonies presented in the Hayes trial. In particular, Sullivan disliked the reliance on Young’s deposition, saying the jury held ‘a suspiciously laudatory protestation’ of Young, and that it was ‘very likely all true; but methought the jury did protest too much’.15

Sullivan’s issue with the jury’s praise was further illuminated during a libel trial that resulted from the publication of this letter. During that libel trial, Mr Butt, speaking for defendant Sullivan, argued that the jury’s praise was for the benefit of Young and the prison system:

Then came the [Hayes] inquest, when Dr. Younge [sic] whitewashed off the black cloud of censure passed on him at the first inquest [Lynagh’s case in 1868] … was it very strange if Mr. Sullivan should say this was an attempt to prop up a new system, in which Dr. Younge [sic] was to be praised for his exertions?16 

While Sullivan did take some shots at Young with his suggestions that he was a government stooge, he ultimately did not think Young was to blame, even if the jury’s praise in the Hayes inquest was suspicious. Instead, Sullivan complained about the penal system and how it affected prisoner health. While not directly stating that Mountjoy was responsible for prisoner deaths, Sullivan certainly found the inquests, and their non-critical outcomes, to be dubious, thinly-veiled attempts to protect the prison’s reputation following convict deaths.

In House Complaints


Critiques of the prison system were not unusual in inquests, and as we have already seen there was an established suspicion surrounding prisoner deaths and the prison system’s level of blame. Prison outsiders, such as juries, coroners, and journalists like Sullivan, used these inquests to question the prison system. Likewise, prison insiders also utilized inquests to critique the prison, and Young and O’Keefe occasionally provided testimonies that called out the prison’s operation and treatment of prisoners.

O’Keefe, albeit somewhat begrudgingly, spoke out against the prison system in his testimony during the 1895 inquest into Christopher Connor’s death. The jury began the inquest highly suspicious of the prison, with O’Keefe, the prison governor, and the penal system all being called into question. One of the coroner’s and jury’s main problems was that Connor’s family and friends had not been alerted to his illness, a matter one juror reportedly called ‘monstrous’.17 O’Keefe explained that no one was contacted because he did not believe that Connor’s condition was as serious as it ended up being. He also emphasized that the governor notified families, not the PMO, so he was not technically to blame for the lack of contact.

The other issue highlighted in the newspaper coverage was the implementation, or lack thereof, of night nursing in Mountjoy. The coroner implied that Connor would have been better cared for had there been a better nursing system in place. When the coroner asked O’Keefe for his take on the system of night nursing, O’Keefe initially refused to give an opinion. After the coroner pressed, O’Keefe relented replying ‘Well, I think it might be improved’.18

Following the death of a convict in 1878, Young testified that he had done what he could for the patient in the prison cells, but chose not to send the prisoner to the hospital. This decision was vastly unpopular with the jury who heavily questioned Young’s decision. Young claimed that the convict was not sent to the hospital because of ‘the small hospital accommodation and heat of the weather … the accommodation [in hospital] was insufficient’.19 Using the public forum of the inquest, Young aired his complaint about the prison hospital and argued its inadequacy directly contributed to the convict’s death.

While both Young and O’Keefe clearly critiqued Mountjoy and the ways in which the prison was run, these criticisms were not perhaps without ulterior motive. Going into these inquests, the juries were already suspicious of Young and O’Keefe and the care they provided. As a result, it is possible that O’Keefe and Young highlighted the poor night nursing and hospital accommodations respectively as a way to transfer the blame from them to the prison at large. In both of these cases as well, neither O’Keefe nor Young were found at fault for the prisoner’s death.

Conclusions


Coroner’s inquests into prisoner deaths were weighty affairs for the PMOs and Irish prison system. While in most cases the juries and coroners agreed that death was by natural causes, there was still an underlying suspicion concerning the prison officials and the prison. When the inquests found that the convicts’ deaths were preventable, it resulted in a debate over which party, the PMO or the prison, bore the brunt of the blame. In the end, while the juries were skeptical of the PMOs, it was the prison that was blamed most often for deaths in Mountjoy in the late 1800s. 

Annika Liger


Annika Liger completed her MA on History of Welfare & Medicine in Society at the UCD Centre for the History of Medicine in Ireland in 2018/2019.

Acknowledgements


Research completed in collaboration with Harriet Wheelock, Keeper of Collections, Royal College of Physicians of Ireland Archive Collections.




1. “Assize intelligence” The Warder 1 April 1871.
2. “Duty of medical men as witnesses”, United Kingdom Register 1889, pp. 18-9. Royal College of Physicians Ireland (RCPI) Archives.
3. Michael J Clark, “General practice and coroners’ practice: Medico-legal work and the Irish medical profession, c. 1830-c.1890” in Cultures of Care in Irish Medical History 1750-1970 eds. Catherine Cox and Maria Luddy (New York, 2010), p. 40, 50.
4. Biographical information was gathered from papers, medical registers, and the Kirkpatrick Index all held in the RCPI archive.
5. “The death of a convict” The Daily Express 18 September 1886
6. “Death of a convict”, Evening Herald 9 January 1893
7. “Mountjoy prison”, Nenagh Guardian 21 March 1868
8. “Death of a convict” The Daily Express 25 October 1883
9. “Death of a convict” The Daily Express 11 March 1886
10. “Coroner’s inquest on the body of a convict” Saunders’s Newsletter 15 February 1868
11. Report of the Commissioners appointed by Lord Lieutenant to inquire into circumstances concerning death of convict M. Lynagh in Mountjoy Prison, H.C. 1867-1868.  p. 4
12. “Secrets of the prison-house” The Nation 15 April 1871
13. “Death of a convict in Mountjoy prison: Extraordinary condition of things: Strong condemnation by the coroner and jury” Evening Telegraph 1 October 1895.
14. “Inquest at Mountjoy prison” Irish Times12 January 1870
15. “Assize intelligence” The Warder 1 April 1871
16. “Assize intelligence” The Warder 1 April 1871
17. “Death of a convict in Mountjoy prison: Extraordinary condition of things: Strong condemnation by the coroner and jury” Evening Telegraph 1 October 1895.
18. Ibid
19. “The sudden death in a convict prison” The Northern Whig 27 July 1878



Saturday, 15 June 2019

Irish Medical Responses to Problem Drinking from Institutionalisation to Public Health: Part I

In the first of this two-part series, Dr Alice Mauger, Wellcome Trust Postdoctoral Research Fellow at the Centre for the History of Medicine in Ireland, UCD, looks at the changing approaches of medical practitioners and psychiatrists to problem drinking in Ireland at the turn of the twentieth century.

After over 1,000 days of debate, in October 2018, the Irish government passed the Public Health (Alcohol) Bill. The Act will introduce minimum unit pricing as well as rigorous regulations surrounding advertising, sponsorship, sale and supply. Under this legislation, Ireland may become the first country in the world to attach stark health warnings to alcohol products. Billed as the first time the Irish state has legislated for alcohol as a public health issue, the Act is intended to significantly alter the culture of drinking in Ireland. While unsurprisingly the subject of extensive lobbying from the drinks industry and other stakeholders, the measures have gained overwhelming support from the Irish medical profession. The Bill’s tortuous passage is therefore a reminder of Ireland’s ambivalent and complex relationship with alcohol. This relationship is deeply embedded in Irish politics, culture and society and has a very long historical lineage. 


A ‘Disease Concept’ of Inebriety


Ephraim M. Cosgrave (1853-1928). Courtesy of the
Royal College of Physician of Ireland Heritage Centre
Like their European and American colleagues, by the 1890s many Irish doctors were describing the inability to resist alcohol as a disease. But the belief shared by many that the ‘drunkard’ was to blame for their condition, and therefore deserved punishment, was resilient. 

Perhaps the most ardent Irish medical commentator on alcohol in this period was Ephraim MacDowel Cosgrave, a physician at several Dublin hospitals who would later become president of the Royal College of Physicians (RCPI). For Cosgrave, the creation of institutions specially designed for the ‘control of inebriates’ would be the answer to Ireland’s ‘drink question’.1  

Cosgrave was not alone in promoting this approach. Inebriate homes are said to have originated in the United States in the first half of the nineteenth century and by 1870 had begun to appear in Britain. Cosgrave’s stance mirrored British developments, where under the guidance of leading inebriety expert, Dr Norman Shanks Kerr, medical practitioners were canvassing for the system’s expansion. Yet, in Ireland, many doctors continued to recommend alternatives ranging from committal of drunkards to lunatic asylums to their detention at home by physical force.2  

Despite the almost draconian nature of these suggestions, such attitudes did not apparently extend to alcohol itself. Reacting to proposals to further restrict pub opening hours at weekends, in 1895 a contributor to the Dublin Journal of Medical Science declared:


We object to the grandmotherly legislation and coercion. The liberty of the subject is sufficiently restricted already, and the patience with which millions of law-respecting citizens tolerate the curtailment of their personal liberty, lest a weak brother should offend, is a marvellous testimony to our inborn respect for law. Restrictions and pledges cannot create an Utopia.3 

Such claims diverged significantly from the now commonly accepted ‘disease view’ of inebriety, which saw alcohol as an inherently addictive substance, which put anyone who drank at serious risk of losing control over their habit. In Ireland, at least some doctors were openly contesting further restrictions, a fact which lends further weight to traditional portrayals of more permissive popular attitudes towards drunkenness in Ireland. 


Institutions for Inebriates


Painting by patient in St Patrick’s Hospital, Dublin (1905).
Source: E/137 Case Book, Males, St. Patrick’s, p.32.
Calls for inebriate reformatories in Ireland were eventually met in 1898. The Inebriates Act of that year was the first to extend to Ireland and allowed for the committal to state-funded reformatories of anyone who was tried and convicted of drunkenness at least four times in one year. But what medical reformers had been campaigning for – that is the compulsory power to detain non-criminal inebriates – never became law. In Ireland, this Act led to the creation of four specialist institutions. Of these four, only the Lodge Retreat in Belfast accepted non-criminal inmates and these were limited to relatively wealthy (fee-paying) Protestant women with no compulsory power for their detention. The remaining three institutions could only be accessed by those committed through the courts. Perhaps unsurprisingly then, this inebriate system was short-lived, catered for only a small proportion of Ireland’s ‘habitual drunkards’ and by 1920, all but the Lodge Retreat in Belfast had closed.

Instead, lunatic asylums became the principal treatment centres for problem drinkers. By 1900, 1 in 10 people admitted to Irish asylums were sent there due to ‘intemperance in drink’. This trend gained increasing attention among psychiatrists, not least because of mounting uncertainty as to whether excessive drinking could actually cause mental illness. Some asylum doctors recognised intemperance as a manifestation of an existing mental disorder, others cited adulterated alcohol as a cause and still more believed that the habitual drunkard produced offspring liable to insanity. This latter claim was to be expected, given that alcohol and degeneration were now strongly linked in discussions of the alleged increase of insanity both in Ireland and overseas.

Given the influx of these cases, the Irish psychiatric community were soon called upon to respond. In 1904, delegates at a conference of the British Medico-Psychological Association in Dublin were confronted with evidence of the ‘disastrous effects everywhere observed’ of drink. Reporting on this event in the association’s official journal, the writer proclaimed:


It may cause some searching of conscience to ask whether our profession as a whole, and particularly our speciality, have up to the present taken a sufficient leading part in the holy war against alcohol. It is high time for our Irish colleagues to make themselves heard upon this subject, when in at least one asylum, one third of the male admissions are attributed chiefly to this cause.4 

This battle cry reverberated with the temperance rhetoric of the day, a movement which boasted strong support from some Irish asylum doctors. Meanwhile, members of the wider medical community showed signs of absorbing, and even propagating, the Nationalist-toned temperance claim that sobriety held the key to Irish independence. In 1904 a reviewer for the Dublin Journal of Medical Science decreed:


One of the heaviest blows which a patriotic Ireland could possibly inflict on its neighbouring British rulers would be given by taking the pledge all round – old and young – and keeping it! Why, we often say to ourselves, do not patriotic politicians utilise this fact?5 

In spite of calls to engage in the ‘holy war against alcohol’, Irish psychiatrists made little comment in the ensuing decades. Soon after, discussion of the links between alcoholism and degeneration became seriously compromised by new scientific studies which found no evidence that alcoholism in a parent gave rise to mental defects in their children.

As will be discussed in the next instalment of this series, after the First World War, there was a shift in focus towards alcohol and later, problem drinkers, with the eventual acceptance of a new ‘disease view’. 


Alice Mauger


Dr Alice Mauger
Dr Alice Mauger is a Postdoctoral Research Fellow at the UCD Centre for the History of Medicine in Ireland in the School of History, University College Dublin. Her research project 'Alcohol Medicine and Irish Society, c. 1890-1970' is funded by the Wellcome Trust. The project explores the evolution of medicine's role in framing and treating alcoholism in Ireland. It aims to make a significant contribution to the medical humanities, exploring historical sources to better understand and contextualise Irish society's relationship with alcohol. Alice was awarded a PhD by UCD in 2014 for her thesis which examined public, voluntary and private asylum care in nineteenth-century Ireland. Prior to this she completed the MA programme on the Social and Cultural History of Medicine at the UCD Centre for the History of Medicine in Ireland, UCD. Both her MA and PhD were funded by the Wellcome Trust. 

Alice has published on the history of psychiatry in Ireland including a full-length monograph: The Cost of Insanity in Nineteenth-Century Ireland: Public, Voluntary and Private Asylum Care (Palgrave Macmillan: 2017), which is available via open access and in hardcopy.




1 Ephraim MacDowel Cosgrave, ‘The Control of Inebriates’, Dublin Journal of Medical Science, Vol. XCIII (Jan-Jun 1892), pp.178-85.

2 ‘Section of State Medicine’, Dublin Journal of Medical Science, Vol. XCIII (Jan-Jun 1892), pp.327-328.

3 ‘Review of Norman Kerr, Inebriety: its Etiology, Pathology, Treatment, and Jurisprudence, 3rd edition’, Dublin Journal of Medical Science, Vol. XCIX (Jan-Jun 1895), p.50.

4 ‘Intemperance’, Journal of Mental Science, 50, no. 208 (Jan 1904), pp.117-118, p.117.

5 ‘The Medical Temperance Review’, Dublin Journal of Medical Science, Vol CXVIII (Jul-Dec 1904), p.140.


Monday, 3 June 2019

Abortion and Symphysiotomy in Ireland


In this month's blog post Dr Lynsey Black, Lecturer in Criminology, Department of Law, Maynooth University, considers the legal and historical context of abortion and symphysiotomy in Ireland.


Law and Gender in Modern Ireland

Lynsey Black and Peter Dunne (eds.),
Law and Gender in Modern Ireland: Critique
 and Reform
(Hart Publishing, 2019

We are currently in the midst of a ‘Decade of Centenaries’ in Ireland. For anyone working broadly in the field of gender, it is also clear that we have lived through a decade of reckoning. As editors of the recently published Law and Gender inModern Ireland: Critique and Reform (Hart, 2019), one of the key challenges has been to present the current legal regime in its historical context. As the book started to take shape, it became clear that the intersection of medicine, gender and the law was an essential part of this story. Within the collection, chapters by James Gallen (Dublin City University) and Máiréad Enright (University of Birmingham), which deal with symphysiotomy and abortion respectively, have provided insight into the role that gender ideologies played in medical practice in post-independence Ireland. Their chapters outline the prevailing historical context in which these medical procedures became emblematic of Catholic conservative Ireland, and the contemporary redress and reform which have attempted to resolve these wrongs.


Catholic society


The march of the Archbishops - Bishops etc.,
outside Pro Cathedral, Congress 1932, Dublin City.
Eason Collection, National Library of Ireland.
Law and policy on abortion and symphysiotomy took shape in the decades after independence, years in which the Catholic Church emerged as an imposing character. In this era of nation-building, Catholic social teaching informed the views of many in government, while members of the Catholic hierarchy offered policy contributions on matters integral to the creation of a Catholic society. Such input disproportionately affected the lives of women and girls, as morality, sexuality, and maternity became focal points for concern. These concerns were fundamental to the histories of both abortion and symphysiotomy. Measures enacted conspired to circumscribe women’s role to a narrow template of womanhood that revolved around the idea of woman as ‘child-bearer’.


Symphysiotomy


As Gallen notes, crucial to the project of nation-building was the valorisation of the family based on marriage, and the corresponding demonisation of women who became pregnant outside marriage. Gallen’s exposition of gendered historical abuse underlines the primacy of marital fertility in this abuse. Such ideologies had tangible consequences, in the preference for symphysiotomy over Caesarean sections to preserve female fertility. Symphysiotomy was often preferred as an alternative to Caesarean sections, considered a risk to potential future pregnancies. Symphysiotomy was a surgical procedure, requiring the partial cutting of fibres joining the pubic bone to the pelvis. Gallen outlines figures from the 2012 State-commissioned Walsh Report, which estimated that 1,500 women had undergone the procedure unknowingly from the 1940s to the 1960s. Its revived use in these decades ‘arose from a confluence of legal and religious gendered restrictions on women’s bodily autonomy’ (page 265). The procedure itself exposed women to the risk of health problems, and in many cases was carried out where it was entirely unnecessary, and against the standards of best practice.


Abortion


The primacy of fertility further influenced the intersection between medicine and the law with regard to the status of abortion, culminating in the insertion into the Constitution of Article 40.3.3in 1983, which created a near-total prohibition on abortion. Through the decades of Ireland’s independence, the legal position on abortion had created the context of unwanted pregnancy and forced birth. As with symphysiotomy, the case of abortion is illustrative of a wider historical failure in Irish law and society to prioritise women’s agency. As Gallen writes in relation to consent for medical procedures, there have often been priorities more highly valued by the Irish state than women’s consent and agency, namely, the preservation of women as child-bearers. Similarly, Enright notes that the Catholic template of motherhood had been one of self-sacrifice, and for decades ‘Irish abortion law has emphasised the protection of prenatal life in ways which efface women’s personhood’ (Enright, page 58).


Historical abuse


Gallen and Enright also elucidate the painstaking efforts to have historical abuse acknowledged and redressed, and to ameliorate and transform the ongoing harm caused by Ireland’s restrictive laws on abortion.


Survivors of symphsiotomy


In the case of symphysiotomy, on foot of the 2012 Walsh Report, in 2014 the Surgical Symphysiotomy Ex Gratia PaymentScheme was established, administered by Judge Maureen Harding Clark. Gallen highlights the efforts of the various groups that brought historical gendered abuse into the political foreground. Organisations such as Survivors of Symphysiotomy compiled victim-survivor testimony, often carrying out their own research where no such efforts were forthcoming from successive Irish governments.


Repeal of the 8th Amendment


A mural outside the Bernard Shaw pub in Portobello Dublin
depicting Savita Halappanavar and calling for a yes vote
in Ireland's referendum to remove the 8th Amendment.
Photo by Zcbeaton, Creative Commons Licence.
Enright too overviews the legal twists and turns which, in May 2018, finally led to the removal of Article 40.3.3 from the Constitution, replaced with the 36th Amendment. The 36th Amendment removes the constitutional ban on abortion and replaces it with a statement of the government’s capacity to pass legislation on abortion. As Enright notes, the legislation proposed in the wake of the May referendum has caused a dramatic change to constitutional law on pregnancy in Ireland. Like the recognition grudgingly given to victim-survivors of symphysiotomy, Enright discusses the necessary and transformative effect of activism in the reform of abortion law, overviewing the grass-roots campaign to remove the 8th Amendment. Crucially, State recognition builds slowly from public awareness, and public disquiet.


Continuing concerns


As the authors note, gains made in this area are hard-won, and achieved against official obfuscation and denials of harm or responsibility. Crucially, any gains achieved cannot be taken-for-granted. In his chapter, Gallen emphasises how the State was, and remains, resistant to many of the arguments made by victim-survivors. Gallen outlines how the redress schemes falls short of international best practice in many regards, and is highly critical of the judgemental tone of many of its reports. Similarly, as the debate on the Regulation of Termination of Bill makes its way through the Oireachtas, the danger that the hopes of real reform could be stifled are very evident. Crucially, the intersections between legal and medical regimes remain a point of vulnerability felt particularly by women. Indeed, as recent developments regarding CervicalCheck have shown, the dangers of gendered medical mistreatment continue to be a real concern in Ireland. Although Law and Gender in Modern Ireland outlines many of the positive reforms in recent years, it does so with a note of caution.


Lynsey Black


Dr Lynsey Black

Dr Lynsey Black is a Lecturer in Criminology, Department of Law, Maynooth University. Lynsey researches in the areas of gender and punishment, the death penalty, and historical criminology. She completed her PhD in the School of Law at Trinity College Dublin in 2016. Her doctoral work examined the cases of women sentenced to death in independent Ireland. From 2016 to 2018, Lynsey was an Irish Research Council Government of Ireland Postdoctoral Fellow at the Sutherland School of Law, University College Dublin.


Her IRC-funded project took a comparative approach to capital punishment in Ireland and Scotland from 1864 to 1914. Recent collaborations include a public engagement and knowledge exchange project undertaken with Dr Lizzie Seal (University of Sussex) and Dr Florence Seemungal (University of the West Indies/University of Oxford) along with the United Nations Development Programme in Barbados. This ongoing collaboration is focused on reform of the death penalty regimes in Barbados, and Trinidad and Tobago.

Lynsey has published recently in Law and History Review and the Social History of Medicine, and is editor of the collection, Law and Gender in Modern Ireland: Critique and Reform (Hart Publishing, 2019).


Tuesday, 10 April 2018

Lecturer/Assistant Professor in the History of Medicine

Lecturer/Assistant Professor in the History of Medicine (Modern)


University College Dublin - UCD College of Arts & Humanities


School: UCD School of History
UCD School of History seeks to appoint a Lecturer/Assistant Professor in the History of Medicine (Modern). Any research specialization will be considered, but the School has a preference for candidates with a research area that stretches beyond Irish history.
You will have a PhD in a relevant area, a track-record of high-quality research, demonstrated by publications. A proven ability to attract external funding and undergraduate/postgrduate teaching experience. Preference may be given to candidates with research and teaching interests that complement and reinforce existing strengths within the School.
The appointment is a two-stage process, with UCD nominating the preferred candidate for consideration by the Wellcome Trust for a University Award. This candidate, on nomination to the Wellcome Trust, will produce a funding application, outlining a major research project with high quality outputs to be conducted within the University Award period. No appointment will be made without a successful application for a Wellcome Trust University award.
95 Lecturer/Assistant Professor (above the bar) Salary Scale: €52,325 - €82,267 per annum
Appointment will be made on scale and in accordance with the Department of Finance guidelines
Closing Date: 17:00hrs (local Irish Time) on 20 April 2018
Applications must be submitted by the closing date and time specified. Any applications which are still in progress at the closing time of 17:00hrs (Local Irish Time) on the specified closing date will be cancelled automatically by the system. UCD do not accept late applications.
Prior to application, further information (including application procedure) should be obtained from the UCD Job Vacancies website: www.ucd.ie/workatucd
Note: Hours of work for academic staff are those as prescribed under Public Service Agreements. For further information please follow link below: www.ucd.ie/hr/t4cms/Academic%20Contract.pdf

Monday, 6 November 2017

When Does The Air Matter? by Janet Greenlees

Air Quality and the Working Environment


In this month's blog post Dr Janet Greenlees, Senior Lecturer at Glasgow Caledonian University, looks at  the history of industrial air quality and considers how it has variously been considered a worker's health, community health, and economic concern.


When Does Air Matter?


Men and women weaving at the White Oak Mill in Greensboro, NC, 1909.
Courtesy of the National Museum of American History.
When do people think about the air quality inside buildings? Similar to other health issues, the honest answer probably would be when either they or someone they care about is affected by the poor air they breathe on a regular basis. That being the case, the air quality in working environments could only then be of concern to a relatively small number of people with any improvements sought by labour and their representatives or employers seeking to increase productivity. However, sometimes public health concerns about air quality can apply to both the community and the working environment. How then, is the public health discourse negotiated when the needs of industry can be affected? And, why do certain health issues attract public or political interest and intervention, while others do not? A simple answer might be that the only health issues to attract widespread public interest are those which can affect large numbers of people, such as contagious diseases. However, a closer look suggests regional and national variations regarding responses to public health concerns, even when the same issues and industries cross special boundaries.

An Air Laden with Dust and Dirt


During the nineteenth and early twentieth centuries, cotton cloth manufacturing grew rapidly in New England, America and Lancashire, Great Britain. Both industries subsequently declined, albeit at different rates. Cotton manufacturing was also an industry where men and women worked alongside each other, performing the same tasks for the same rates of pay and experiencing the same workplace health hazards. The air these men, women and sometimes children breathed was laden with dust and dirt, factory ventilation was poor and concerns were raised about the spread of contagious diseases in such environments, particularly tuberculosis. In addition, the noise from the machines was horrendous, particularly in the weaving rooms, and could cause hearing loss and in some cases, deafness. While since the earliest cotton factories, workers had been aware that inhaling dust and dirt made them feel unwell and the noise was uncomfortably loud, it was the late nineteenth century before the workplace became entwined with public health reform, starting with fears about tuberculosis contagion. Public and much scientific belief held that the tubercle bacilli attached itself to dust and quickly spread disease throughout the mill. In the progressive state of Massachusetts, the leading cotton cloth manufacturing state, these fears about TB contagion secured both a legislative ban of a particular technology, the suction shuttle, and selective employer cooperation at improving ventilation. In contrast, and despite widespread belief that England led the way with factory regulation, the tuberculosis risk in the Lancashire mills was debated, but economic concerns prevented both regulation and industrial reform.

Worker Fatigue and Factory Ventilation


The Boott Cotton Mill of Lowells, Massachusetts.
Courtesy of the Lowell Museum Collection.
During the early twentieth century new health concerns arose, firstly surrounding the importance ventilation and following the Great War, fatigue. Fatigue was not simply related to long hours of labour but also to working in poorly ventilated factories. In Massachusetts cotton towns, ventilation became a public health campaign with improvements introduced in many public buildings, including schools and government buildings and extending into workplaces. Some (but not all) employers accepted the notion that a healthy worker was a more productive worker. Ventilation attracted considerable British debate and scientific interest, but while some communities sought to improve factory ventilation and legislation imposed air quality standards on the cotton mills, in reality, employers remained able to operate as they saw fit. Factory air quality was secondary to the needs of industry. The Great War turned scientific, political and medical interest to fatigue research, particularly in Britain. Textile workers were included in the research; however, industrial decline meant political and scientific interest in operative fatigue quickly faded. The same was true in New England. During the 1920s, most of the cotton manufacturing industry shifted to the southern states. Remaining northern firms were more concerned about economic survival than the air quality in the mill. Worker and community concern about mill air quality also declined as jobs took priority. Indeed, wider economic concerns were increasingly influencing the public health agendas of both countries.

Cotton Dust Inhalation


Nevertheless, scientific and medical interest about occupationally specific health concerns was growing, particularly surrounding cotton dust inhalation. However, the physical symptoms of respiratory damage caused by dust inhalation mirrored those of respiratory diseases common to many textile towns, including bronchitis and pneumonia, namely, tightness of the chest, dyspnea and coughing. Therefore, doctors found it very difficult to identify cases of byssinosis, the respiratory disease caused by prolonged cotton or flax dust inhalation. While public concern grew surrounding the widespread dust found in urban environments, such concerns were not transferred to factory dust. There, dust remained an occupationally specific hazard about which middle class social and political reformers had little interest. This was only reinforced by the ambiguity surrounding diagnosis. For workers, dust was an everyday reality that was simply part of the job and unions sought compensation rather than reform. Britain was first to introduce byssinosis compensation for selected male workers in 1941, although it was the 1970s before compensation was extended to all affected workers. By this time, cotton manufacturing had virtually disappeared from the country. Despite individual American doctors and scientists recognizing byssinosis cases, it was 1969 before the federal government introduced compensation for byssinosis sufferers. Instead, public health concerns about dust remained confined to the urban living environment and, when combined with the ambiguity surrounding diagnosis, many workers were left to suffer on their own.

Interior of a Lancashire Cotton Mill with Mill
Workers at their Machines, Lancashire, c. 1890.

Managing the Health Impact of the Working Environment 


Lastly, noise, but not internal industrial noise, briefly became a public concern. Community concerns about specific urban noises increased as the twentieth century progressed. Societies were formed to tackle ‘unnecessary noise.’ However, the continuous crashing of metal-tipped shuttles against metal loom frames in the mills which caused hearing loss in many workers was ignored. Instead, communities, medics and even operatives accepted that hearing loss was a risk attributable to certain jobs, including weaving. Weavers adopted coping strategies to manage the noise, including sign language and lip reading. Indeed, despite the fact that other air quality issues had attracted public interest and industrial reform, operatives regularly found themselves needing to adopt coping strategies to manage the health consequences caused by working in confined spaces with poor air quality. Other strategies included taking unpaid time off, patent medicines, cooperative strategies, switching firms to where conditions were better and exiting the industry. Air quality at work was important to workers, but managing the health impact from the working environment comprised only one part of their decision-making surrounding work, health and community. Similarly, at different times, certain aspects of air quality became community health concerns. Only at certain times did the two environments entwine.

Janet Greenlees


Dr Janet Greenlees
Janet Greenlees is a Senior Lecturer in History at Glasgow Caledonian University, based in the Centre for the Social History of Health andHealthcare. Her research interests include women and work, public health and the working environment and maternal health and she has published on all these topics. The intersection of health in the community and work environment described above is explored in greater detail in her book: When the Air became Important: A Social History of the Working Environment in New England and Lancashire, 1860-1960 (Rutgers: Rutgers University Press, forthcoming 2018). For more on gender and workers’ responses to poor air quality at work, see ‘Workplace Health and Gender among CottonWorkers in America and Britain, c. 1880s-1940s’, International Review of Social History, 61, 3 (2016), 459-83.