Friday, 31 May 2013

Plus ça change....

The Rights of Man By Thomas Paine

(This review was written on 4/4/2003 and 7/6/2004. )

I read Thomas Paine’s Rights of Man for the first time in March 2003 (Penguin Classics, 1985). It was published in two parts, the first in 1791 and the second in 1792. It became a best seller and continues to be sold and read. It has become a classic of political polemics.

Paine wrote a devastating critique of the monarchic, aristocratic and non-representative forms of government which existed in Europe at the end of the eighteenth century. His vitriol was particularly aimed at the British system with its lack of a popularly supported constitution, its succession of foreign and powerful monarchs, its House of Commons appointed by a corrupt electoral system, and the House of Lords with its hereditary and entirely non-representative membership. The executive lacked fresh minds and talent, and the system encouraged gross corruption. There was no attempt to alleviate a host of national problems, and there was unfair taxation on the poor with little taxation of the rich and of the great land holders. Finally, he complained that the natural resources of the nation were wasted on successive wars and on unnecessary squabbles and divisions with other nations.
George III

Paine’s political philosophy encompassed the principle of fully representative and democratic government in the form of a republic, although, if he could have envisaged a monarch without political power as exists in some countries in Europe to-day, he might have accepted a monarchy with full executive powers in the hands of a representative government.

Paine’s political concepts and philosophy were inspired by the American Revolution of 1776 and the decision of each of the 13 states to establish a representative state assembly which was responsible to the people. The republic concept was confirmed by the union of the13 states to form a national assembly or Congress, with an elected president with limited tenure. Paine lived in America before and during the Revolution and, later, after the fall of the Bastille, he lived in France. He expressed great admiration for the French who had set up a National Assembly without great perturbation, replacing aristocratic power and abolishing the privileges of the monarch, the aristocracy and the leaders of the Church.

In the second part of his treatise Paine continues his thesis in favour of fully representative government, but he also puts forward radical ideas to reform the penal taxation of the common people and to increase taxation on the land owners and others in power. He was in favour of the social policies now prevailing in modern states, including children’s education allowances, widows and old age pensions, birth and marriage grants, soldiers and sailors’ pensions, and financial aid for disadvantaged people. No such services were available at the time and it was not until 1911, with the passage of Lloyd George’s Insurance Bill, that the first steps towards a welfare state were taken by Westminster.

Edmund Burke
Paine was radical, forthright and remarkably far-seeing in his views. He showed extraordinary courage in challenging the long established authority of the British monarch and the two houses of parliament. His diatribes against Edmund Burke, the self appointed spokesman of the British establishment opposed to the French Revolution, occupies much of the text and is a telling exposé of the conservative powers and corruption of the British aristocracy and land-owners. By living abroad during most of his active life, he avoided imprisonment and the clutches of the British authorities.

Paine was clearly obsessed by the need to promulgate his radical ideas and he was naive in believing, as he did, that other European countries would soon follow the examples of America and France. It was to take another 40 years before the House of Commons abandoned the rotten boroughs and other electoral abuses with the Reform Bill of 1832, while the monarchy gradually lost its powers during the nineteenth century and the House of Lords remained intact in its privileges until these were gradually eroded in the twentieth century.

It is said that politics is the art of the possible. Paine must not have been aware of this adage. He faced an all powerful establishment in Britain and an abject, passive and impoverished population. His belief that the republic form of government would lead to reduced taxation was, of course, never realised, although the burden of taxation is now borne by the entire population but still biased in favour of the rich and the privileged. At least this is so if we are to judge from the situation in Ireland where the rich and particularly the tax emigrant are proportionally less taxed. However, his proposals to assist the disadvantaged and the dependants of society have been gradually and fully realised in all European countries to-day.

His support for the democratic system of government has been widely achieved in Europe, North America and the Antipodes, as well as Japan, South Africa and a few other countries. But his belief that democracy would lead to an ideal political system, ensuring the happiness of all, was surely naive when we witness the situation in Ireland to-day. The corruption of the old systems of government, so deplored by Paine, has extended to all branches of current society, and includes politicians, public servants, the police, the professions, business and the public at large. We are an increasingly litigious society with a lust for money, acquisitions, power and privilege. Politicians put party before country and are reluctant to make unpopular decisions which might anger an acquisitive electorate but which may be essential for justice and equity, and for the public good. We need to change the electoral system in Ireland. We should change to the one seat transferable vote to eliminate the worst elements of the current system, and the party whip should be withdrawn except for specific legislation such as finance bills. Unlike Thomas Paine, few of our politicians are radical enough to advocate or to implement such changes.
Aren't we the clever ones?

I believe the fundamental problem in retaining a viable democratic system, where personal freedom is the norm, is that the individual must share with freedom a sense of responsibility to society, the environment and future generations. The problems created in a litigious and corrupt society by powerful and selfish sectional interests, including a selfish public, can only lead to the eventual destruction of democracy and to the desecration of the land which God gave us as a sacred trust to care for nature and future generations. At this very moment in Ireland we have developers who are corrupting the planning policies, we have residents refusing to pay for waste removal and we have a minority who are opposing a more rational hospital system. Even our professions are shedding their vocational principles and their traditional compassion for others. Government must put country before party and must not yield to minority pressures aimed at disrupting the democratic process if parliament approves of legislation which is deemed necessary for the public good. The stark contrast between the privileged and the majority of the Irish population, and the ubiquitous corruption, would surely evoke the anger of Thomas Paine if he lived here to-day. 

Friday, 24 May 2013

The meek shall inherit the earth. Really? When?

King Leopold’s Ghost, by Adam Hochschild. A story of greed, terror and heroism in colonial Africa. Published 1998 by Pan Books. Pp 366, SB photos.

This is the story of the conquest of Congo by Leopold II of Belgium. The early pages of this book start with the original exploration of West Africa in the 15th century by the Portuguese. This was followed by the rapid development of the slave trade, particularly to Brazil and later to the Caribbean Islands and to the islands and southern states of the North American Continent. The Congo was then a well organised country based on the tribal system, with a central and powerful king and some elements of internal organisation. This well established system was soon destroyed by the depredations of the slave trade and the cooperation and connivance of many Congolese tribal leaders and entrepreneurs. It was not until the early nineteenth century that Europeans began to explore the interior of the Congo, having been largely inhibited from doing so because of the size of the Congo River and the extensive number of cascades within one hundred miles of the estuary which made navigation impossible.

In the middle of the 19th century the scramble for African colonies commenced ostensibly, according to the European powers, to bring civilisation and Christianity to the pagan and primitive hordes. The British and French were particularly to the fore in the scramble and they shared with others the same hypocrisy and greed in their expansive aspirations.

This book is a long and critical account, firstly of Stanley, his origin, life and character, his extraordinary explorations in Africa and how he was lionised by the European powers and the Americans towards the end of his remarkable exploratory career.

The Congo was taken over by Leopold 11 personally without the cooperation or cogniscence of the Belgian people and the Belgian Parliament. While he never visited the Congo, his abiding ambition was to develop a colonial policy for Belgium, not so much for the Belgian people but for his own gratification. Thanks to his prestige and his extraordinary diplomatic skills, and his use of various agents in Europe and in the United States, the Congo was eventually recognised by Congress in the United States and later by the European countries as a Belgian settlement with Leopold as its executive head. He constantly underlined his laudable purpose of bringing trade to the natives, of civilising them and of introducing Christianity. The Belgian people and many of those who encouraged and cooperated with him, such as Stanley and others interested in colonial expansion, were mislead by Leopold's laudable aspirations.

Bismarck was at first opposed to Leopold’s policies, but he eventually succumbed to his influences and, in November 1884, he organised a large assembly of European leaders in Berlin to decide on the division of Africa. At this Congress the Congo was recognised by all the European countries as the particular responsibility of Leopold and as a Belgian possession. It was a vast part of equatorial and Southern Africa, largely unexplored, and with little idea of its vast size and its potential wealth of natural resources. It proved to be 74 times the extent of Belgium.

Hochschild’s story is a horrifying one of how the tribes were treated by Leopold’s representatives in his obsession to make as much money as possible, at first through the ivory trade, which was then a very valuable commodity before the development of plastics and other man-made materials.  Later, following Dunlop’s discovery of the pneumatic tyre, there was an explosive expansion of the rubber trade with the discovery of the rich supply of the wild rubber plant in the rain forests of the Congo. The cruelty in dealing with the local tribes is almost beyond description and one wonders if Hochschild, in underlining the scandal of the terror, has gives an exaggerated account of this appalling period of man’s inhumanity to man.

George Washington Williams
From an early stage rumours of corruption and of cruelty and killings began to emanate from the Congo but it took many years through the efforts of a few dedicated people to bring the scandal to the notice of the world. An early critic was a Negro from America, Washington Williams, who, for an American black, was loudly outspoken about the scandal at an early stage but was largely ignored. The next major critic and the most persistent and most effective was Edmund D. Morel who had been on the staff of the Elder Dempster Line which had the transportation contract carrying the ivory and rubber from the Congo to Europe. He suspected from the nature of the cargoes which were being exported to the Congo that the Congolese got little benefit from trade with Belgium and that the heavy export of armaments suggested to him that, rather than receiving the benefit of trade, the local population was enslaved by the administration. Morel resigned from the shipping company and became a long-term and very vocal advocate of the need to publicise the appalling conditions in the Congo and the need to bring international influence to bear on Leopold and the Belgians.

Roger Casement
Morel was subsequently followed by Roger Casement who had already spent some years as a lowly and poorly paid representative of the British Government in other parts of Africa. As a result of Morel’s campaign and increasing public pressure, Casement was sent out as an official British representative to investigate the conditions in the Congo. Casement confirmed Morel’s charges. He returned to England and joined Morel in his campaign and issued a long and damning report to the British Government. However, those of us living in Ireland to-day will not be surprised to read that interests within the government altered his report and partly frustrated the efforts of Casement to influence world opinion. It is an account of the frustration these heroic and altruistic men suffered from the political leaders and the obloquy they not infrequently met from those who had a vested interest in imperial policies. Like all whistle blowers, they needed all their patience and tolerance to persist in their one sided battles.

Joseph Conrad’s classic, the novel Heart of Darkness, was based on the horrors of Leopold’s Congo and the people who administered the colony on his behalf. It is a barely concealed account of some of the most notorious figures who were noted for their inhumanity, arrogance and corruption. I cannot recall that I have read Conrad’s novel but, as a follow up to Hochschild’s history of the Congo, I shall endeavour to find it in the local library.

One wonders just how guilty was Leopold for the prolonged atrocities and holocaust of the Congo. Was he in denial about the circumstances which prevailed there or did he really believe that some of his more laudable principles were being followed? After all he did not discourage Protestant and Catholic missionaries and there is little evidence that the missionaries were vocal about conditions among tribes. They may have unconsciously become part of the system and they only became more vocal in their criticism as they became more aware that public opinion internationally was moving against Leopold. They must have been aware of the slave labour, the chain gangs, the widespread taking of hostages of women and children to punish the recalcitrant men, the chopping off of hands and whippings as punishment, and the many beheadings.

Reading the account of Leopold’s Congo and of the many holocausts which have occurred since the 19th century, one wonders despairingly whether Homo Sapiens is naturally corrupt and sadistic. The phenomenon of doubling, as described by Anthony Clare in his book on male behaviour, reminds us that the most virtuous and most moral individual who behaves with the greatest compassion and rectitude in a civilised community may commit the greatest crimes against humanity when he becomes a member of certain political or religious movements. We have many examples of such people when they conform to the norm and for the benefit of the pack. In Ireland we have a less serious but nevertheless relevant situation where an electorate, representing a Christian and moral society, shows little interest in political or corporate corruption and has no compunction in electing corrupt people to parliament although they are elected as guardians of society.

Later, as Morel’s propaganda began to influence international opinion, it appears that the missionaries became an important source of information about atrocities in the Congo. Clearly the change in international attitudes had given the missionaries greater courage and compulsion to report circumstances which conflicted with their religious principles. Or had it simply become easier and more convenient for them to respond to their consciences?

The last few chapters of the book are the most interesting and revealing in relation to the scramble and rape of Africa. In dealing in general with international injustices, Hochschild points out that the same exploitation and injustices, cruelties and exterminations occurred in many other African colonies during and after the scramble. These were rarely if ever mentioned, almost certainly because the more powerful and influential European countries were responsible. Morel, Casement, Washington Williams, Sheppard and the other few voices that eventually shamed an indifferent world into acting on the Congo were rare exceptions. They were the whistle blowers of the local Congo scene and perhaps Belgium and Leopold were more vulnerable to international criticism than their more powerful neighbours. In addition to the European rape of Africa, the author reminds us of the many other exploitations and examples of mass injustice such as the American Indians, the Australian aboriginals, the Spaniards in South and Central America, the Great Hunger in Ireland, and numerous similar examples throughout history. In all cases it underlines the exploitation and destruction of the weak by the strong, and it always involves the grabbing of the land from the indigenous population. It is a recurring part of history where a blind eye is turned by the advantaged about the plight of the disadvantaged. The story of the Congo must be a depressing one for those few who can really claim to be virtuous and who have the courage and inspiration to fight the vested interests of the wealthy and powerful. The widespread abuse of populations over history must leave a sense of pessimism about the future behaviour of the human race. It took years for the whistle blowers of the Congo to influence the leaders of Britain to act on the Congo but these leaders did so with bad grace and only when their own welfare was at risk because of the pressure of public opinion.

This book is an important contribution to our knowledge of human nature, if nothing more. It is a reminder that power corrupts, and that to-day, with the huge military and economic power of the American nation and its fundamentalist tradition which appears to be as strong as ever, and its disastrous foreign policy, the world may well be a dangerous place, not only for humanity but for its very survival. America may now hold the key to survival. Some aspects of recent American history and the principles based on its foundation as a nation give us some hope but American international policies over the past 150 years cannot but leave serious concerns about the world and its occupants. Bearing in mind America’s appalling interventions in Middle and South America, in the Congo after it had gained its freedom in 1960, and in other nations where many corrupt, non-democratic and evil governments were supported by the Americans for economic, military and political reasons, such concern is justified. The population explosion is an added and fundamental factor which, through its consequences of civil and international strife, must be a further threat to humanity and the well-being of the earth and future generations. 

Morel, Casement and the other few who opened the can of worms which was the Congo under Leopold’s rule are the real heroes of this world but, like all whistle blowers, their courage and self-sacrifice does not earn them the credit and the approval of a venial world. They receive less credit and recognition from the masses than those who have achieved wealth through corruption and self-seeking

Monday, 20 May 2013

Doctors! Listen up.

A Practical Treatise on Midwifery. Robert Collins, MD. Longman, Rees, Orme, Browne, Green and Longman . London, 1836. Pages 526. Tables.

This monograph was published in London in 1836.  Its author Robert Collins was Master of the Dublin Lying-in Hospital (the Rotunda) for seven years from 1826 to 1833.  The Rotunda was established in 1745 and the statutory period of mastership started in 1788 and has remained so since. The same system was adopted and still remains at the more recently established Dublin Lying-in Hospital, the Coombe (1834), and the National Maternity Hospital, Holles Street (1930). One exception to the seven year rule was John Cunningham who was master of Holles Street from 1931 to 1941 when he was granted three extra years by the Charter Amendment Act in the Oireachtas to complete and commission the building of the new hospital in Holles Street and to compensate him for loss of private practice (1)

The book is divided into several chapters, including information in tabular form. It provides an account of the 16,404 deliveries which took place in his hospital during his seven years of Mastership.  It is an incredibly thorough account of all the complications and problems presented to him and to his assistant masters. As an account of his stewardship it is the forerunner of the excellent Annual Reports which have been a feature of the three Dublin Maternity Hospitals for many years, and which have been traditionally presented to the profession and the public at an annual meeting of the Royal Academy of Medicine
I bought the book from R.D Gurney Ltd in 1977 for £65.  I had seen it mentioned in the Gurney catalogue with a reference to the surprising fact that, long before Semmelweise, Collins had referred to the importance of hygiene in the prevention of puerperal infection.  His predecessor and father in law was a Dr.Clarke who was unusually committed to cleanliness and hygiene in practice and who reported a low prevalence of puerperal infection. Collins describes his own efforts of frequent fumigation of wards, beds and bed clothes and general cleanliness which lead to a period of not one single death from puerperal infection during the last four and a half years of his Mastership. 

It is extraordinary that his colleagues in Dublin and in the wider United Kingdom ignored his findings and the findings of his predecessor with the result that puerperal infection appeared again in the Rotunda after his mastership had finished, with the high mortality associated with it at these times. Like many hospital infections which are endemic in our hospitals to-day, there were recurring outbreaks of infection with heavy maternal mortality in the maternity hospitals. Such infections were extremely rare among private patients during the eighteenth and nineteenth centuries because they were invariably delivered at home.

Nor were Clarke and Collins the first to report good results with a programme of cleanliness. Reading A.M.Lysaght’s biography of the naturalist Joseph Banks (2), I found a reference to a Dr. White who in 1773 in England wrote a book on the care of pregnant women and on the technique of delivery, in which he claimed that he had never lost a patient from puerperal fever, simply through observing elementary rules of hygiene and ventilation. But his work was largely ignored and maternal mortality remained shockingly high until well into the next century. It was only towards the end of the 19th Century that a conservative profession accepted antisepsis and asepsis after the work of Pasteur.

The Collins book is modern in its design and presentation.  There is little difference in the arrangement of its tables of contents and those of a more modern book on midwifery.  Apart from the detailed recording of events and the numerous tables included, the author refers frequently to the literature on his subject and is generous in his acknowledgment of the contributions of others.  He is sceptical about the validity of the then currently accepted and fashionable forms of treatment, such as bleeding and purgation, although this does not prevent his prescribing the most bizarre forms of treatment for his patients with infections, convulsions and other complications. How so many of the patients survived bleeding, purgation, hot baths, counter-irritation and other active measures is a mystery and a remarkable tribute to the healing powers of nature.   It is also a reminder of the need to look objectively at the value and possible harmful effects of many of our own present day interventions. Although evidence based medicine may be a very recent concept in the history of medicine, we are still committed to many unsubstantiated forms of treatment – no doubt thus retaining the art of medicine as well as the science.

Dr Collins emphasises the importance of prevention in other situations as well as in the prevention of puerperal infection. This interest in prevention must have been the forerunner of the fine tradition in midwifery where prevention and intervention have gone hand in hand for many years, unlike the dichotomy between the two disciplines which still exists in the practice of internal medicine and surgery. One wonders if physicians and surgeons, in their neglect of prevention, are motivated by the pecuniary advantages of intervention as opposed to counselling, and the personal power they enjoy over their patients. In dealing largely with healthy mothers and children, the obstetrician has little choice but to advise about the factors which maintain the health of the mother and child.

It is not my purpose to review Dr Collins’s book in detail, but it is an opportunity to review the mastership system as it has existed in Dublin since the establishment of the Rotunda in 1745. Much is written nowadays in the context of the large modern hospital about the structuring of medical staff and about organisation and administration.  Relations between the medical staff and administration have inevitably given rise to some serious difficulties because of the necessity of both in to-day’s modern hospital and because of the difficulties inherent in defining their respective functions.  Doctors in demanding an independence of action in relation to their vocation and in attempting to maintain the highest professional and ethical standards, may find themselves in conflict with some administrative decisions. 

Currently we are faced with serious problems in the organisation of our health services and particularly our hospital services. These include the cost of modern medical and surgical interventions, not all of which are based on evidence based medicine, and the burgeoning use of drugs and of investigations, some of which can be hazardous, expensive and even unjustified. The   physician and surgeon should have the final decision about the investigation and treatment of patients but, in view of the complexity of modern medicine and the fallibility of each one of us, no doctor in hospital practice should be allowed to practice in isolation. Accountability through proper staff communication and audit are imperative and this can only be done acceptably and properly through a proper staff structure.  We are all fallible but we should make every effort to protect our patients by ensuring that our professional intervention will not cause harm. 

No doctor should be reluctant to accept surveillance by his own colleagues and no doctor should be allowed to practice without some accountability to his profession and to the public. In my opinion this is particularly important in private medicine and in private hospitals where the consultant has less contact with his colleagues. The increasing need for accountability is the result of the failure of professional standards, knowledge and judgements to keeps pace with the burgeoning increase in medical technology and skills and the decline in clinical skills. The need is further increased by the very powerful financial incentives which exist in certain areas of medical practice. It is no wonder that there is increasing pressure both within the profession and outside for audit and accountability.
In the free enterprise system of medicine existing in most Western countries it is obvious that many doctors are motivated as much by their own financial and personal ambitions as by their professional and ethical obligations to their patients.  It is inherent in the doctor-patient relationship that it is the doctor who mainly decides about the nature of intervention and who receives the financial reward.  When the rewards are considerable, as in the case of surgical procedures and invasive investigations, it becomes clear that professional standards and the well- being of the public must be safeguarded, and be seen to be safeguarded, by some form of peer review and professional accountability. This is particularly relevant to private hospitals and private practice.
It would be unwise to deny the difficulties of establishing a satisfactory peer review system in our profession.  Apart from the prejudices and denials of some colleagues who would oppose any form of supervision, the increasing division of medicine into many different and highly specialised areas makes general peer review more difficult. However, good standards of professional conduct and competence can be maintained by certain measures carried out within the profession itself.  These measures would depend on regular staff reviews, and the publication of an annual report by each department. A Chief-of Staff should by appointed who would have adequate executive powers to ensure high standards among all his colleagues and who would have the responsibility to intervene when these standards might be at fault.

The Mastership system in the Dublin Maternity hospitals has many advantages which might be applied in some measure at least to the structuring of the modern general hospital.  The publication of the annual reports and the free discussion of these reports at the Royal Academy of Medicine ensure the highest of obstetrical standards.  The Masters have sufficient power and influence to guide professional policy, to innovate and to intervene if necessary in relation to professional standards and performance. Their appointment is limited to seven years, thus obviating the danger of a permanent dominance by any one person and of the many disadvantages arising from a long tenure of office, a situation which is all too frequent in our general and teaching hospitals where progress may be retarded by the excessively conservative and long-standing influence of some colleagues, such as the professors of medicine and surgery.   

It is also an advantage that the master is not necessarily appointed from the in-house staff, although he (or she) is apparently assured of continuing on the staff after the term of office is completed. No doubt unsuitable or unfit masters may have been appointed but, because of the background of the candidates and the certain awareness of their qualifications, the poor appointment must have been relatively rare. For every poor appointment there must have been many who made a contribution to the high standards of midwifery which has made the Dublin school of midwifery internationally famous.

I would suggest that each general hospital should have a Chief of Staff elected for a limited period by his colleagues. He or she would have the same administrative standing as the chief executive officer of the hospital and would be granted special sessions for administration. He would chair a medical committee which would include the chairmen of the major medical departments of the hospital. He would be responsible for standards of accountability among his colleagues and would have certain disciplinary powers. About thirty years ago the Cogwheel Report was published in the United Kingdom (2). It advocated a medical structure somewhat along these lines. It seems puzzling to me that the Cogwheel recommendations were not widely accepted. There may have been professional resistance to the proposal but I am sure such a staff structure must be part of hospital organisation in other countries. My views on the current hospital system in Ireland can be found in my monograph published in 2006 (3).
I believe the high standards of Dublin midwifery and the international reputation of the Dublin school must rest squarely on the mastership system and on the professional accountability of the maternity hospitals. It also rests on the strong emphasises on health education and prevention, and the clinical management which is inherent in obstetrical practice in this city. This system should be retained and jealously guarded by our maternity hospitals. Its advantages should be remembered when we are trying to solve the problems of staffing and the administrative structure of our modern general hospitals.

To return to the Collins book on midwifery, I would sum up by referring to his foresight and clinical judgement in controlling puerperal infection long before the bacterial origin of disease was discovered. Many of the treatment methods used in the early nineteenth century midwifery must have done more harm than good. They had no obvious rationale nor did they have any basis of evidence to support them. It was long before the concept of evidence based medicine was introduced but it is a reminder that we still practice medicine which has never been justified on the grounds of proper trials.


(1)  Joseph Banks in Newfoundland and Labrador, 1766. A.M.Lysaght,   Faber & Faber. London, 1971, p35.

(2)  First Report of the Joint Working Party on the Organisation of Medical Work in Hospitals. H.M.Stationary Office, London, 1967.

(3)  Is the Health Service for Healing? Risteárd Mulcahy, Liberties Press, Dublin, 2006.

Monday, 13 May 2013

One born every second....

 An Essay on the Principle of Population. Thomas Malthus. Penguin Classics, 1970, pp 291.

Thomas Robert Malthus was born in 1766. After schooling, he had a brilliant academic career in philosophy and science in Cambridge. He later became a priest in the Anglican Church, a profession which allowed him time to read, write, correspond widely and travel. He published his first book on population An Essay on the Principle of Population in 1798 and subsequently he published five further editions up to 1820 and a summary of his views, including additions and emendations, entitled A Summary View of the Principle of Population in 1830. He also published several other works on political economy and social philosophy.

No work, apart from Darwin’s The Origin of Species, received so much attention, both approbation and criticism, as this first essay, and both Darwin and other evolutionists acknowledged the considerable influence Malthus had on their opinions and conclusions. By 1820 a bibliography of titles dealing with his views on population required more than 30 pages of text. The substance of Malthus’s writings was based on his belief that every animal species, including man, will increase in numbers by geometric progression every generation if they exist in an optimum milieu where checks on survival do not exist. Geometric progression implies doubling in numbers every generation (1,2,4,8,16 etc).

An optimum milieu exists for humans in the absence of civil strife and war, of the epidemic diseases and providing there is adequate nutrition for the entire index population. These are the positive factors which are consistent with optimum survival. He also wrote about preventive factors which adversely influence population growth. They include sexual restraint, celibacy, late marriages, infanticide, poor community organisation, and factors described by him euphemistically as ‘corruption of morals and vice’ which apparently include contraception, abortion, homosexuality, sterilisation and ‘illicit’ sexual activities. He did not envision the prospect of the current many extra-marital births and he believed that sexual restraint was the only method of control consistent with virtue and happiness.

There is a logical basis for his population hypothesis and he provides a number of circumstances during the 18th century where the population under appropriate conditions increased close to the point of geometric progression. The white population of the American Colonies was one and he quotes Humboldt who reported a doubling of the population in South America every 27 years.  In the summary of his writings published in 1830, Malthus refers to the population increase in Ireland from an estimated one million in 1695 to 6.8 million in 1820 (and close to 8 million at the time of the famine in 1847). There were other isolated examples in Europe where he credits such increases.

He believed that population increase depended on a corresponding increase in food supply but, because of the limitation of arable land, the finite space on the planet suitable for agriculture, crop failures and soil exhaustion, his concern led him to believe that  food production could only increase at the most by arithmetic progression (1,2,3,4,etc). He undoubtedly underestimated the increasing productivity of food which we have seen since his time through science and globalisation. However, it is certain that eventually there must be a final limit to food production if the human population continues to increase at its present rate and if our environment deteriorates, particularly as it is unlikely that problems of distribution can be easily solved.

Perhaps more important than the influence of food production, it is understandable that Malthus could not have anticipated the adverse effect an increasing population has had on the environment. Our wellbeing and even survival must be affected by climate change, shortage of fresh water, the dwindling of lakes and glaciers, the invasion of alien species, over fishing, the destruction of rain forests, and the continuous loss of many species of flora and fauna.

According to the United Nations, the population of the world passed the six and a half billion figure in 2006. It is anticipated that it will reach seven billion by the year 2012. It is increasing at a rate of 80 million a year and is likely to continue to do so at least until 2015. It is estimated that to stabilise the population would require a world fertility rate of 1 or slightly less. Fertility rates refer to the number of children born to each woman in the community.  Some of the developed countries have reached this level or are moving close to it, but the more populous developing countries have fertility rates of five or more. They include India, Indonesia, Pakistan, Iran, Nigeria and many other African countries. China has been attempting to control fertility for some years but because of its huge population it continues to add significantly to the annual increase.

Malthus showed that poor populations had high fertility rates and correspondingly high mortality rates. This was true 200 years ago but, while poor countries still have high fertility rates, their mortality rates have shown a significant fall because of modern public health measures controlling some of the epidemic diseases. The rapid increase in population in the African countries is at the basis of the failure to counteract poverty, despite the billions of charitable and aid money which has been sent to that continent in recent years.

With the changes in the world already showing tangible evidence of a serious imbalance between humanity and Nature, with the gradual depletion of the planet’s resources, with the continuing increase in world population and the persistence of poverty in so many countries, can we continue in our ways and still ensure the wellbeing of future generations? Can we claim to be fulfilling our obligations to care for our planet and for Nature?

I wrote the above paragaphs in 2007, 22 years after I had read the first Malthus publication of 1798.  I was aware of the population issue as early as 1968 having read and being influenced by the publication Population Bomb published by Paul and Anne Ehrlich in the United  States.  

Tuesday, 7 May 2013

John A. Costello - mixing politics with the personal...

The Reluctant Taoiseach – a biography of John A. Costello. Gill & Macmillan, 2010. David McCullagh, pp 530. Photos.

I bought this signed copy of Costello’s biography at the launch of the book at the Mansion House.
David McCullagh had already published a book on the first Inter-Party Government in 1998 entitled A Makeshift Majority. A History of the first Inter Party Government, His new book is a long read but is clearly well researched and gives a detailed, favourable and well-balanced account of his subject. It is an important contribution to the history of the neglected early years of the State including the 1940s and 1950s. It is of particular interest to me because of my father’s seminal part in setting up the inter-party government and in leading Fine Gail out of the doldrums after his election as President of the Party in 1944.

Costello may have been a reluctant Taoiseach but once he became the head of the government he retained his dominance both in government and in opposition from 1948 until my father resigned as President of Fine Gael in 1959 and James Dillon became head of the Party. Costello as Taoiseach, surrounded as he was by a disparate cabinet membership from five different parties, was soon to depend on only a few figures to advise him and to guide him in leading the combined parties involved in both governments 1948-1951 and 1954 -1957. His chief political intimates were Billy Norton and James Dillon and his close personal advisors were Paddy Lynch and his son-in-law Alexis Fitzgerald. My father, despite remaining head of Fine Gael and despite his long friendship with Costello, retired to the shadows of the Department of Education in Marlborough Street, and characteristically showed his loyalty to Costello’ leadership by remaining very much in the background. It was characteristic of my father’s modesty and lack of interest in personal power that he remained remote during the two parliaments from Costello and his principal advisors. I have always been critical of my father’s failure to oppose Costello’s decision to leave the Commonwealth without consultation with him and his party and I believe that Mulcahy’s failure to maintain his stated commitment to the Commonwealth was caused by his reluctance to endanger the stability of the government and to thus allow Dev to return to power.   

His sojourn at the Department of Education seemed also to impair his very active organisational role as head of Fine Gael, which was so evident during the 1944-1948 periods.  Later he .was to become a force in defending PR when it was threatened by De Valera in 1958 and he showed firmness when, on his retirement as President of Fine Gael and despite his support of Costello’ as his successor, he refused to support Costello because the latter refused to take the leadership in a full time capacity. Mulcahy was only too aware that, whatever merits Costello had as a politician and parliamentarian, his attendances in the Dail left much to be desired during his pre-inter-party days and his terms as leader of the opposition between the two three year periods 1951-1954 and 1957-1959. During these periods Mulcahy continued his regular attendance in the Dáil and largely acted as Costello’s substitute although as head of Fine Gael he might be expected to be the leader of the opposition. Costello had returned to his busy Bar practice and only attended the Dáil on special and important occasions. It was typical of dad’s modesty to stay put in the background.

McCullagh was fair in his account of Costello’s personality. He was prone to blunt and plain speaking when he became angry. To the casual acquaintance, such as myself when I met him socially he appeared a rather gruff, impersonal individual of few words which I always attributed a shyness to him rather than a lack of grace but I found eight or more hours confined with him in the back of his Taoiseach’s car to be tedious on our way to the ‘Flatfoot Platypus’ by-election in Donegal shortly after the government’s formation in 1948. I was asked by my father to accompany him to the meeting. We had little to speak about and obviously nothing in common because of our difference in age and profession. The journey proved painful and embarrassing and Costello’s humour was clearly affected by his dislike of electioneering and was not helped by the appalling weather on that long day and certainly not by our rescue by the  RIC and their four wheeler when our cars was immobilised in a flood in Fermanagh.

 When we arrived in distant Milford in North Donegal the meeting was cancelled because nobody dared face the elements on that stormy wet night. A few grumpy words with the candidate and his immediate followers and some refreshments and we had to face the dreary return home.

Despite McCullagh’s tribute to Costello’s care of his constituency, electioneering was never Costello’s strong point and his own success as a candidate in Dublin North East was largely thanks to his many supporters and admirers who came to his aid at election time and not to his own devotion to constituency work.,   I recall at home, where we lived close to his constituency, hearing about the sense of urgency to support his campaign and the sudden rush of constituency activity. Whatever about my discomfort on the Donegal trip, Costello’s day attending the by-election must have been a nightmare for him. His life was the law courts and not the political hustling.

Costello was a most successful lawyer; he was not a shy person in his profession and clearly dominated law in Ireland with his friend Cecil Lavery. They provided a service to their clients without providing
the financial burden created by to-day’s huge legal fees. It was said during the forties and fifties that Costello charged three guineas to read a brief.   We have good reason to know that the author’s opinion is confirmed of his inherent kindness within his family and friends, and with the less fortunate.

De Valera, whilst in opposition during the first Inter-Party government, toured America and some commonwealth countries in an outspoken attack on Britain and the North, apparently to influence the Irish Diaspora and to seek international support for the Irish cause of unity. Dev’s intervention must have proved to be an embarrassment to these countries.   Costello was equally outspoken about the injustice of partition and it was to take some more years before Lemass was to take a more rational and effective approach to solving the northern question.  There is no doubt that Dev and Costello did more harm than good to our relations with the North. Costello’s hostility was particularly manifested after the British confirmed their support for the North’s status quo as long as the majority there was opposed to change.  He might have thought it reassuring that Westminster was willing to think otherwise if the unionist majority were not to last.

The chapters dealing with the second Inter-Party government, its failures (it seemed from the beginning to go into a slow decline over its three years), the two periods when Costello led the opposition and the general political problems which existed in the 1950s are valuable contributions to our recent history, particularly to those of us who were witnesses of the time. Other evidence of a slow fission within the Fine Gael parity was evident at this time too with my father’s declining influence and a more radical outlook on the part of the younger members. His successor, James Dillon, was hardly at an age and the appropriate political figure to lead the party to a new, more radical and successful future. Dillon’s opponent for the leadership was Liam Cosgrave but at the time Cosgrave had not yet advanced enough in the party to be the obvious choice.