In May 2022, Irish social and mainstream media were alive with heated discussion of the terms of proposed agreements between three corporate entities: the National Maternity Hospital (NMH), St. Vincent’s Healthcare Group (SVHG), and the Health Service Executive (HSE), the statutory body that runs Ireland’s public health service. The central question, picked over in a dozen ways, was “Can commercial and charities law secure Irish maternity care against the perceived threat of religious influence?” The disputed agreement was about the future of the National Maternity Hospital. The current building at Holles Street was old when James Joyce wrote in Ulysses about a nun admitting Leopold Bloom to the hospital when he arrived in search of the labouring Mina Purefoy. In Holles Street, ‘[a]ll that surgical skill could do was done and the brave woman had manfully helped’. One bright day, the National Maternity Hospital will move out of that building to be co-located with St. Vincent’s University Hospital. It will join that hospital as part of St Vincent’s Healthcare Group. It will occupy a building yet to be built, on land owned by St. Vincent’s Holdings, the charity that now owns the Group.
These three enfolded entities are all named for St. Vincent de Paul for a reason. Until April 2022, the Religious Sisters of Charity were owners of St. Vincent’s Healthcare Group and of the campus where the new maternity hospital will be built. It is normal for the Irish state to build valuable assets from which private religious entities benefit. Today however, the public is less satisfied with that status quo. In 2017, a woman-led campaign for a “public and secular” maternity hospital criticized the state’s intention to work with the Religious Sisters of Charity. They emphasized the congregation’s dark history. In living memory, the congregation ran industrial schools and arranged coerced adoptions. They also ran Magdalene laundries, where women who had transgressed Irish sexual and moral norms were incarcerated, and made to do heavy work unpaid. The congregation has still not made full financial reparation to those harmed by their actions.
In response to this campaign, the congregation eventually withdrew from hospital ownership and governance. Yet, although the nuns have now “left the pitch,” the campaign has continually foregrounded the relationship – past and present – between Irish maternity care and religious ethos. In May, supporters of the move to St. Vincent’s lost patience with feminist demands that the new hospital should be state-owned and built on state-owned land. In one striking intervention, the journalist Alison O’Connor warned that campaigners were gripped by a ‘phantom Catholic threat’, itself the product of a ‘post-traumatic Catholic syndrome.’
Certainly, there was a phantomic air to repeated invocations of ‘the nuns’. The Sisters of Charity congregation in Ireland is dwindling and surviving members are elderly. Today, living nuns are rarely visible or potent figures in Irish public life. The deal’s defenders were quick to stand up for ‘the nuns’ but most often did so by reference to women long dead, who worked to provide mass healthcare before the state itself could. More often, nuns appeared as thin caricatures, by turns grotesque or comedic. Protestors dressed as nuns and carried placards reading ‘Sun’s out/Nuns out’ or ‘Huns Before Nuns’. The website of the conservative radio station Newstalk illustrated a story about the dispute with a picture of Sister Michael from the popular comedy ‘Derry Girls’. In a testy email to a woman constituent, one government politician wrote, “I can’t see the trap door that the nuns will jump out of.” A right-wing columnist teased that feminists feared “nuns under the bed.”
Campaigners, however, remain concerned that the Sisters’ legacy will live on in deconsecrated corporate form – perhaps at the level of board culture – threatening the National Maternity Hospital’s clinical independence and risking stagnation of progress towards women’s reproductive freedom. Although Ireland has legalized abortion, services are fragile in places and care is not available to the full extent permitted by law. Irish legislation permits abortion care on limited grounds but does not guarantee access to care.
In May, the dispute about the National Maternity Hospital became an intense contest over legal language. Leading clinicians at the National Maternity Hospital have repeatedly insisted that they were satisfied to rely on legal agreements providing a “cast iron guarantee” of clinical independence, free from religious interference. Drafts of the agreement between the hospital, the Group, and the HSE were published online. They were published, in part, to reassure the public that careful use of private law could exorcise the ghost of religious ethos. This letter to the Irish Times from St Vincent’s Healthcare Group is typical of how defenders of the National Maternity Hospital deal used the documents: insisting that a combination of charity law and ‘bespoke governance arrangements’ has secularized the Group – even to the point where its commitment to preserving the values of its founder, Venerable Mary Aikenhead, are stripped of Catholic content.
Although there is no doubt that the National Maternity Hospital is now committed to providing abortion care, there is something uncanny about the prospect that abortions might be provided by a hospital group recently owned by nuns, and transferred from their ownership only with Vatican permission. Avery Gordon writes that the uncanny can alert us to a haunting. Haunting makes itself known in our unsettled sense that coherence of the present is askew; that some uncontrollable dread remnant of the past is stuttering into view, making the present ‘waver’.
In the days before the government finally approved the deal, attention turned to a clause in the lease committing National Maternity Hospital to provide all “clinically appropriate and legally permissible healthcare services.” For critics of the deal, this phrase opens a route to denial of care, based on a religiously-inflected assessment of “appropriateness” or an unduly narrow reading of what the law permits. The cabinet decided, after some internal conflict, that this phrase posed no real difficulties but the question of how doctors interpret law governing care contrary to religious ethos was never addressed in detail. In that moment, some summoned the ghosts of reproductive medicine as it was in Ireland under the influence of religious ethos. They thought of the women who gave birth at the National Maternity Hospital under Alec Spain and Arthur Barry; who responded to the effective statutory ban on artificial contraception by reviving symphysiotomy, an often brutal childbirth operation believed to slightly widen a laboring woman’s pelvis by severing one of its ligaments, enabling multiple births in quick succession without resort to C-section. (Today, at National Maternity Hospital events, leading clinicians still pose in front of Alec Spain’s portrait). They thought of Michael Neary ‘indirectly’ sterilizing patients by performing ‘compassionate’ hysterectomies, complying with his employers’ institutional ethos and with that same law on contraception. They thought of how his colleagues’ silence let that practice continue, even when the law changed. They thought of older obstetricians who told lawmakers that the near-total ban on abortion did nothing to undermine their care for Irish women, and of the Galway doctors who felt the law required them to wait as Savita Halappanavar edged closer to death, rather than terminate her pregnancy. All these ghosts, these harms, were quickly dismissed as matters in the past, if they were really considered at all.
Rather than deny these phantoms, Gordon’s work asks us to ‘animate them,’ allowing ourselves to be shaken by them. We can follow ghosts into the margins of legal text, in its errors and exclusions. Law bears traces of the ‘lost subjects of history’; the victims of state-sanctioned violence who are not properly remembered in elite public discourse. A contract can be a palimpsest. In what is present in the text and absent from it, we see past habits of power, past absence of choice, and lingering impressions of violence that were never properly healed. The ghosts we follow may not be harmless bogeys in the shape of nuns, figments of women’s conspiracist imaginations.
For Gordon, ghosts have a dual quality. State violence takes lives and in doing so it also takes alternative futures. Those of us who seek justice for victims of state violence lose something by brusquely explaining ghosts away, moving determinedly into a gleaming future of new hospital buildings and public-private partnerships. We lose the opportunity to rekindle the beautiful desires the state ruined when it killed or maimed those who held them. Gordon encourages us to follow ghosts where they lead, allowing them to incite us to rediscover suppressed worlds and to understand the conditions that made their suppression possible so that we can avoid them in the future. In May, Ireland could have conjured the ghost of a kind of medical-legal agency; compassionate, creative, and attuned to women’s needs. With patience, there may be other opportunities to address the ghosts who tried to make themselves felt in the margins of May’s dispute over contracts and their clauses, and time to follow where they lead.
- ‘Huns’ is an affectionate Dublin term for women. ↑
- Avery Gordon, Ghostly Matters (Minnesota, 2008) 51-52 ↑
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