Cartwright Report condemns cervical cancer treatment

The report was triggered by the publication of an article by Sandra Coney and Phillida Bunkle, ‘An Unfortunate Experiment’, in Metro magazine in June 1987. This alleged that dozens of cervical cancer patients at National Women’s Hospital, Auckland, were receiving inadequate treatment.

Dr Herbert Green of the hospital’s cervical cancer clinic had become convinced that abnormal cells in the cervix, ‘carcinoma in situ’, did not always progress to invasive cancer. According to Coney and Bunkle, from 1966 he began monitoring women without treating them or informing them that they were taking part in an experiment. A number of women developed cervical cancer, and some of them died.

Two of Dr Green’s colleagues, Drs William McIndoe and Malcolm McLean, became worried about the experiment and tried to convince the medical establishment of its dangers. In 1984 they published a paper that they hoped would provide incontrovertible evidence of this. It took the Metro article, however, to bring the issue into the open.

The 18-page article caused public outrage and a Committee of Inquiry was established, headed by District Court Judge Silvia Cartwright. The resulting ‘Cartwright Report’ condemned the experiment and proposed radical new measures to ensure patients’ rights. The report’s recommendations led to the establishment of a National Cervical Screening Programme, a Health and Disability Commissioner, a Code of Health and Disability Services Consumers’ Rights, and nationwide patient advocacy services.

A number of women sued for damages and received settlement packages. Several doctors faced disciplinary charges, though charges against Dr Green did not proceed as he was deemed mentally and physically unfit to stand trial.

Silvia Cartwright was made Dame Commander of the Order of the British Empire in 1989 for her services to women, and from 2001 to 2006 she was New Zealand’s governor-general.

In the decades since the inquiry, a number of commentators, including University of Auckland historian Linda Bryder, have strongly criticised the Cartwright Report. They have argued that there was no ‘unfortunate experiment’ and that the regime at National Women's was unexceptional for its time. Some have also observed that changes to the medical profession and the development of patients' rights would have occurred regardless of the inquiry.

Image: The unfortunate experiment (detail) (Women’s Health Action Trust )