Dr. Tony Holohan:

A key consideration for us was whether the HSE open disclosure policy was being complied with in this regard. The HSE open disclosure policy does not mention disclosure in every circumstance, irrespective of every consideration. There are mitigating circumstances and circumstances taken into account by clinicians. The HSE may wish to add to some of this. For example, we know that in the screening of this kind, international evidence tells us that up to 40% of patients would not wish to have this information disclosed. It is just one fact I would point to. It cannot be seen as something that happens in every situation, irrespective of the considerations. An approach to what might be termed non-optional disclosure does not mean clinical considerations or the realities of individual situations between clinicians and patients are not taken into account and precisely how and when that disclosure takes place.

It is important and it goes to the core of our policy in disclosure that it should not be seen as an event or the passing over of a piece of paper or information. It is a relationship with the patient where trust and confidence are maintained. The patient has a piece of information shared and sometimes it is bad news and difficult to take on board. Patients do not fully absorb it on the first occasion. There needs to be a proper and quality relationship.