Women and doctors deserve our protection
Rite & Reason:The RTÉ Prime Time interview with Praveen Halappanavar was both distressing and disturbing. It stands in sharp contrast to the seemingly cold formality of those in power. Expressions of sympathy that do not listen lack something.
We do well to remember that nowhere outside the circle of family and friends is the tragedy of Savita Halappanavar’s death felt more keenly than among the staff of Galway University Hospital whose kindness has been acknowledged by Mr Halappanavar.
Furthermore, a properly constituted team of independent medical experts should be able to assess the correctness or otherwise of the clinical management of his wife’s care.
However, at the core of this tragedy there is another important issue. Praveen Halappanavar has insisted that a consultant dealing with his wife’s case denied several requests for a termination on the grounds that it was the law and that “this is a Catholic country”.
He has further stated that there is no mention of these requests or comments in the hospital records. If this is true then this is a very serious matter which neither the HSE inquiry nor Hiqa is competent to deal with effectively.
Last Thursday this newspaper revisited the tragic story of Michelle Harte who, while suffering from malignant melanoma, was advised by doctors to terminate an unplanned pregnancy.
Her solicitor, Michael Boylan, said that while her obstetrician was willing to carry out the procedure the hospital’s “ad hoc” ethics committee refused permission after what he described as “an appalling delay”.
She went to England for a termination. She died some time later. This is by no means the first case in recent times in which an ethics committee has intervened in clinical decision making.
In considering these matters it is important that this should not be an exercise in Rome bashing. The Roman Catholic Church like other churches has important things to say about medical ethics but at the end of the day in a state-funded health service every citizen should have access to all services lawful within the state and consistent with best medical practice.
Procedures or treatments considered immoral by individuals can always be declined.
There are questions to be asked about ethical decision making in Galway University Hospital: Who sets the standards?
Is there an ethics committee or an ad hoc group of any kind (not to be confused with a research ethics committee) and if so who are the members, who appoints them and to whom are they accountable? Did such a body have any influence, directly or indirectly, in the case of Savita Halappanavar?
The Church of Ireland holds the view that “Christians reject the practice of induced abortion . . . save at the dictate of strict and undeniable medical necessity”.
While there is no point in rehearsing all the failures that have led us to where we are today it is worth saying that when the first constitutional amendment on abortion was being promoted the Church of Ireland warned it could lead to the introduction of abortion.
The personal tragedy that has destroyed the dreams of a beautiful young couple from India who wanted to share their future with us is a painful fact that we have to live with. We cannot undo harm done but we must learn from it.
The claim that Ireland is one of the safest places in the world to be pregnant has nothing to do with this event. We might as well say there was no need to abolish the death penalty because we don’t hang people very often.
The fact is that senior doctors who specialise in obstetrics tell us that irrespective of what happened in Galway there are situations where a termination is necessary but in a grey area where they need legal cover.
They deserve that protection and more importantly women deserve that protection. My personal view is that legislation alone will never cover all possible eventualities and that we have to trust our doctors.
Therefore whatever legislation is proposed should provide for a standing professional body to which doctors can turn for independent advice and,where necessary, direction and approval for their actions.
We have talked long while others weep. It is time to act.
GORDON LINNEYis former Church of Ireland archdeacon of Dublin