Savita’s request for ‘abortion’ is irrelevant – it’s medical judgement that carries weight

Much has been written about the tragic case of Savita Halapannavar. I don’t have a lot to add to the excellent analyses of Thirsty Gargoyle, David Quinn, Tim Stanley and William Oddie

Those calling for the liberalisation of Ireland’s abortion laws are making much capital of the fact that Savita was allegedly denied an abortion. According to the rhetoric, Ireland’s law should have allowed her to have an abortion, the moment she asked for one. Savita was miscarrying a wanted child. She was in agony and experiencing considerable distress, therefore she asked for the treatment for her miscarriage that she believed was most likely to swiftly deliver her from torment, which is more than understandable. Faced with an identical situation, most of us would do the same, I had a suspected ectopic in one of my pregnancies, the pain was excruciating and I would have done almost anything to make it stop.

Though Savita had unquestionable medical knowledge, like most of us, she was not a qualified obstetrician. She was not requesting an abortion, but what she believed was the most appropriate course of treatment for her miscarriage; one that would get the ordeal over for her quickly. Though medics must consider the feelings of their patients when it comes to treatment, they are not obliged to follow patients’ demands, no-one can force a surgeon to operate against their will, particularly not if the surgeon does not believe it to be in the patient’s best interests. Though a patient is able to withhold medical consent, they are not able to determine the precise and exact nature of their treatment. A pregnant woman cannot force a doctor to induce her baby at 36 or 37 weeks or carry out a planned cesarian simply because it is her will. She may think she has a valid medical reason, but ultimately the decision is in the hands of the doctors, as is the case with any medical treatment. Being a pregnant woman does not privilege one when it comes to determining medical treatment.This case is not about the refusal of abortion, but the mismanagement of a miscarriage and medical malpractice. James Reilly, Ireland’s health minister, himself a doctor, noted that allowing a miscarriage to occur naturally can often be the safest option.

For those blaming Ireland’s Catholic culture, this is not the view of Archbishop Diarmuid Martin who believes that Ireland “is now a highly secularised society, and many look to the Church through a secularised lens to the point that, in a sense, one could speak of what I call ‘a climate of undeclared heresy’ that pervades many dimensions of understanding of Faith among Catholics.” We do not know whether the medic who reportedly uttered the phrase ‘this is a Catholic country” said this in support of the law or against it; either way they were theologically, medically and legally uninformed.

All of us who identify as pro-life would like to express our sincere condolences to Savita’s family on the loss of this beautiful young woman and her baby. No-one believes that a woman should be compelled by law to sacrifice her life for that of her unborn child and as everyone has pointed out, treating Savita would neither have contravened Catholic bio-ethics nor Irish law.

None of that is any consolation however, an enquiry needs to take place and if necessary dismissals and re-training need to occur to ensure Ireland manages to maintain its place as one of the safest places in the world to give birth, a country safer for pregnant women than the UK.

13 thoughts on “Savita’s request for ‘abortion’ is irrelevant – it’s medical judgement that carries weight

  1. Careful about leaping to any kind of conclusion, Caroline.

    The tragic, deceased woman presented with a cervix already open, waters already broken, and sepsis already present. The question has to be asked: why? Where did the miscarriage start, and under what circumstances?

    One of the possibilities that I considered was racism – why was the statement ‘this is a catholic country’ repeated? (Allegedly). But the medical questions are much more interesting.

    What we are seeing is an outbreak of rabble rousing and lynch mob mentality. The ravings from the ignorant, ill informed and prejudiced is that it is all about Catholic dogma – but the teaching from the congregation for the Doctrine of faith in these circumstances is that surgical intervention in these circumstances (to save the life of the mother) is entirely legitimate.

    There is no religious or legal foundation for refusing surgical intervention. So what is left? Is everything actually as we have been led to believe?

    The Irish health minister says that he is privy to information that he cannot yet share. One must keep ones powder dry. By all means challenge bigotry prejudice rabble-rousing, bigotry and mob law, but wait for the enquiries to report.

    1. I agree, we just don’t know what happened, but I am trying to contextualise Savita’s reported request for abortion, which is what the media and pro-choicers have jumped upon.

      It was a miscarriage and thus the abortion laws would seem to be largely irrelevant to the treatment she should have received, treatment in which she may have had very little say. I have seen a lot of commentary suggesting that her request for the removal of her baby should have come before all other considerations.

      There are significant differences in the reporting of this case; 3 Irish papers have different timelines of events and Savita’s husband has corrected events given in a previous interview.

      But you are right, it may be just a tragically rare and inevitable death in which very little could have been done to save her.

    2. “The tragic, deceased woman presented with a cervix already open, waters already broken, and sepsis already present. The question has to be asked: why? Where did the miscarriage start, and under what circumstances?”

      Ruari you’ve hit on something potentially explosive there, as I’m sure you are aware. This could turn very nasty. I hope my thoughts are mistaken.

  2. I am aware, Caroline, and I wanted to PM you in advance but could not find a route. But I would caution against leaping to conclusions; all relevant questions have to be asked, in order to ascertain the situation on arrival at the hospital and the treatment she then received.

  3. Dear Ruari I agree with you and Caroline on this. The case is being widely publicised and the Guardian has already run two articles blaming Savita’s death on Irelands lack of an Abortion law like that in Britain. This seems a highly questionable assumption on a case where the facts are far from clear.

  4. Explosive indeed. Some of us may have already asked ourselves the signifcant question. Only when the full facts are revealed will we discover how complex the story might be.
    What we know for sure is that a poor mother and her baby boy or girl are dead and a husband is left in shock and grieving. They and all concerned need our prayers.

  5. Iv’e commented on a recent article (the third) in the Guardian
    http://www.guardian.co.uk/commentisfree/2012/nov/16/savita-halappanavar-death-irish-abortion-debate?
    This article is calling for the 1967 Abortion Act to be extended to Northern Ireland My comment is as follows

    “Another Day, Another Pro-Abortion Article in the Guardian.

    The fact is that we do not know what caused the death of Savita Halappanavar and we certainly do not know whether the Irish Abortion Laws have the slightest relevance to her death. Even had she been given an Abortion immediately she asked for it it might not have made the slightest difference to her death, we simply do not know. She may have had a pre-existing condition she may not have been given the correct Anti-biotics or she may have been given the best possible care by Doctors and Nurses who did everything humanly possible to save and who followed all the established medical guidelines and procedures, we simply do not know at this stage.

    The only comment I have heard so far stating that an Abortion would have saved her life is from her husband who is undoubtedly still in a state of shock and who is also not medically qualified. Despite the lack of any supporting medical evidence or opinion the Doctors and Nurses in this Hospital are being routinely villified and they cannot say anything until the investigation is complete and then after the investigation there will be an Inquest. Surely the Guardian and others should wait until there is at least some medical evidence available ?

    The Article says

    “It’s almost 30 years since pro-choice campaigners warned that the 1983 amendment to the Irish constitution guaranteeing “the right to life of the unborn” would put women’s lives at risk”

    but why has it taken 30 years if the amendment was so dangerous ? Women have been having babies in Ireland for the last 30 years and as has been pointed out on previous threads according to the WHO Ireland has one of the lowest Maternal Mortality Rates in the world routinely coming in the top 5 or 6 countries and ahead of Britain so the facts would seem to show that women’s lives are at less risk in Ireland than they are in other countries such as Mainland Britain. The facts therefore do not support the views expressed in this article.

    Finally on the subject of the Abortion Act 1967 not applying to Northern Ireland this is because in 1967 Northern Ireland had a Devolved Parliament. Had the Scottish Parliament existed in 1967 the undoubtedly Abortion would have been a Devolved function to Scotland. We now have Devolution throughout the 4 Nations of the UK and normally in Guardian Articles and Editorials the notion of Devolution is applauded except when it comes to Abortion when suddenly the UK Law should apply. The Northern Ireland Assembly can pass an Abortion Law if it wants to it is not for the UK to impose that decision on Northern Ireland.

  6. Hi Caroline, Caroline’s friends and Carolines contacts.

    Do any of you have reliable contacts with the medical profession in the Republic? I ask because I am in possession of information that indicates this tragedy is about antibiotic resistant infection. I have been advised of the particular strain. Creekridge concern is that the infection was acquired in the community, rather than in a hospital, laboratory, or in food-processing.

    Please get in touch with me via Caroline and lets me down. I will be going with the story anyway, but I do need to check.

    Best wishes to all

  7. Sorry – some strange stuff in the immediate previous post. That should read: the greatest concern is that the infection was required in the community, rather than in a hospital, laboratory or in food processing. Please get in touch with me via Caroline and let me know. I will be going with the story anyway but I do need to check.

  8. In the Indian Newspaper “The Hindu” November 16, 2012
    http://www.thehindu.com/todays-paper/tp-national/tp-karnataka/city-doctor-defends-irish-counterparts/article4100316.ece

    Gynaecologist Hema Divakar, president-elect of the Federation of Obstetric and Gynaecological Societies of India (FOGSI) for 2013-2014, (so clearly a senior and respected Gynaecologist) said
    “Based on information in the media, in that situation of septicaemia, if the doctors had meddled with the live baby, Savita would have died two days earlier.” “Delay or refusal to terminate the pregnancy does not in itself seem to be the cause of death. Even if the law permitted it, it is not as if her life would have been saved because of termination,” she said. “Severe septicaemia with disseminated intravascular coagulation (DIC), a life-threatening bleeding disorder which is a complication of sepsis, major organ damage and loss of the mother’s blood due to severe infection, is the cause of death in Savita’s case. This is what seems to have happened and this is a sequence which cannot be reversed just by terminating the pregnancy.” “Based on available information, Savita would have reported pain and infection and doctors would have indicated a miscarriage as the 17-week foetus may not have grown as expected. Its growth would have been deteriorating because of the infection. Having understood that the baby was not going to make it, the couple would have asked for termination. But as Savita’s infection may have required aggressive treatment at that stage, doctors must have felt the need to prevent complications. The usual [practice] is to meddle the least till the mother is stable.”

  9. Thanks for that, Neil. It is pretty sound confirmation of the immediate cause of death and a useful counterweight to the current movement.

  10. A miscarriage is one of the worst things that can happen to a woman especially if it is a subsequent one and you had duly and urgently needed to have a baby since menopause might be knocking at the door. It is not only those kind of women who are hurt but any woman who wishes to be a mother would also feel hurt for having a miscarriage. In addition to this emotional pain women feel, it also causes a lot of physical pain from the cramps to the sight of a lot of blood. Now, what does one have to look out to make sure that it is showing its signs and not anything else like the first trimester bleeding?-

    Our own internet site
    <i="http://www.healthmedicinecentral.com/where-is-your-pancreas/

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