OPINION:Irish medical practice does not need the introduction of an abortion regime into our hospitals
Savita Halappanavar’s death is a tragedy that has radiated outwards to embrace the world.
Everyone has been moved by the grief of the husband and parents of this young woman whose life was cut short.
A mother dying during pregnancy has a particular sadness. If it turns out that it could have been avoided with the exercise of care by those who were entrusted with her medical treatment, that will be a source, not only of sadness, but of great concern.
Cases of medical negligence do, unfortunately, occur in Irish hospitals as in hospitals throughout the world, where a doctor or other healthcare worker fails to exercise the care expected of a professional in the circumstances presenting themselves. Sometimes, mothers with sepsis during miscarriage die although they have received the very best of care.
If, however, Savita Halappanavar’s death was the result of an unwillingness to take the medical steps necessary to save her life, that would be so profoundly in conflict with the true position of law and medical ethics prevailing in Irish hospitals as to require the most serious investigation, as is about to take place.
A doctor who was unaware of the position would have a very great deal to answer for. If advice to delay came from on high, that would be scandalous and require very serious interrogation.
At present none of us, as members of the public, knows the true explanation. The account given by Praveen Halappanavar, as presented through the media, indicates that his wife was denied necessary treatment through a belief that the law or medical ethics relating to her unborn child required such neglect.
Before the inquiry into her death has completed its work, we can only speculate on what actually happened. But something far more radical than speculation has already taken place.
Advocates of legalised abortion have assumed that necessary medical treatment was denied because of religious or other considerations relating to the life of the unborn child. They argue that this indicates the urgent need for legislation in accordance with the Supreme Court decision in 1992.
Confronting miscarriage
Is this an argument that has any weight? I suggest that it actually has no substance. Savita Halappanavar’s death occurred from septicaemia during a miscarriage. In the aftermath of her death, we have heard from obstetricians who are experts in treating pregnant women in potentially life-threatening circumstances, confronting miscarriage on a very regular basis.
Naturally they have been circumspect in their remarks in order not to prejudice the inquiry, but none of them has suggested that the treatment afforded to women in the situation that presented itself is compromised in any way by legal or ethical restraints relating to the unborn child. The Medical Council guidelines contain no such restraints.
We have had a very long public debate on abortion for more than three decades. Medical experts of every value position, including proponents of abortion on demand, have contributed to the debate. The Oireachtas has held extensive public hearings on medical practice during pregnancy.
Throughout these 30 years, there has been no suggestion from anyone that the process of miscarriage raises any legal or ethical concern whatsoever for mothers.
Sepsis requires very close monitoring and treatment. It is dangerous and potentially fatal. In Britain between 2006 and 2008, it was the leading cause of direct maternal deaths. Thirteen women died, of whom five were pregnant under 24 weeks’ gestation.
Women die, not because doctors are pro-life and deny or delay necessary treatment but because the condition is medically challenging. Some deaths occur without negligence, though the Royal College of Obstetricians and Gynaecologists states, in relation to the maternal deaths from sepsis between 2003 and 2005, “Sadly, substandard care was identified in many of the cases . . . ”
The case is being made by abortion advocates that this tragic death is a reason for politicians to rush to implement the Supreme Court decision permitting abortion at all stages of pregnancy on the basis of suicidal ideation. There is no validity in this argument.
To take such a step is not necessary for the proper care and treatment of mothers undergoing miscarriages. Ireland is up among the very safest countries in the world in the medical care of women during pregnancy.
Appropriate care
Miscarriages, sadly, occur frequently. How Irish doctors treat miscarriage is an integral part of this medical care and no-one has ever suggested that mothers are denied fully appropriate care during miscarriage. Yet apparently Mr Halappanavar was told directly the opposite by a consultant.
That is the mystery which needs to be unravelled. One can only speculate as to its resolution.
But one thing seems certain: that Irish medical practice today does not need the introduction of an abortion regime into our hospitals.
For politicians to rush to judgment and transform the culture of Irish medical care by authorising the termination of the lives of unborn children based on suicidal ideation would be a tragedy. For politicians to take this step on an assumption that has no factual basis in the context of the treatment of miscarriage would be a double tragedy.
Savita Halappanavar’s death has given a new focus to the wider debate on abortion.
Let us all ensure that, in engaging in that debate, we respect the values of letting the full story be heard, keeping open minds on facts that need to be established and avoiding going down a path of profound injustice from which it would be very hard to retrace our steps.
William Binchy is a barrister at law and legal adviser to the Pro Life Campaign