In keeping with this ethos, Michael Neary told the Clark inquiry he would never carry out a hysterectomy as a primary contraceptive procedure but a hysterectomy for a medical reason was not a problem.

The inquiry report notes that "hysterectomy was carried out in the Lourdes maternity unit where in other hospitals tubal ligation or safe methods of contraception would be advised."

But the inquiry rejects Neary's contention that 75% of hysterectomies were attributable to the Catholic ethos at the hospital.

The report concludes that "Dr Neary's air of competence and con"dence in the theatre masked any further apperception of his fear of haemorrhage from his colleagues.

Dr Neary's competence in other areas of obstetrics and gynaecology concealed his defective practices in carrying out hysterectomy when faced with a particular type of bleeding."

Kevin Rafter