Savita Halappanavar inquest verdict

 

Sir, – Savita Halappanavar was a tragic victim of our State’s restrictive legal position on abortion.

We, as doctors, need the freedom to provide the best medical care to our patients. For too long, the health of Irish women has been compromised by restrictive laws, which have no place in the field of medicine. Irish doctors have been unable to follow best-practice, unable to offer women the treatment they want and unable to follow internationally- standardised guidelines. We need to be released from the chill of these legislative restraints so doctors can treat an illness before a life- threatening situation develops.

Following the outcome of the Galway inquest, Doctors for Choice is of the view that the Government and legislature should provide, as a matter of urgency, the freedom to doctors and pregnant women to be able to safely manage a pregnancy before a life-threatening situation develops. Similarly, if the Irish Medical Council cannot provide security to the medical profession that they act in the best interests of women, they should lobby our legislators to change the law accordingly. Otherwise women’s health will continue to suffer, women’s lives will be jeopardised and more tragedies will inevitably follow. – Yours, etc,

Dr MARK MURPHY,

Dr MARY FAVIER &

Dr PEADAR O’GRADY,

Doctors for Choice,

Strandhill, Co Sligo.

Sir, – What has happened to Irish medicine when a coroner’s jury (“Savita Halappanavar jury returns unanimous medical misadventure verdict”, April 19th) finds it necessary to call for a national recommendation that “blood samples should be properly followed up”? – Yours, etc,

Dr JOHN DOHERTY,

Cnoc an Stollaire,

Gaoth Dobhair, Co Donegal.

Sir, – The eighth recommendation of the jury in the Savita Halappanavar inquest, that “medical notes and nursing notes should be separate documents and kept separate” is not foolproof. Several years ago I was in hospital overnight for a “procedure” the following morning. I said to the night nurse that I gathered that I had to fast for it. I was told that I didn’t. I persisted, not very strongly, and was told that my procedure was not one that required fasting. I gave up. Why argue with an experienced nurse? She arrived in the morning and said, “You are fasting: it was in the doctor’s notes but not in the nurse’s notes!” – Yours, etc,

BRIAN LOUGHEED,

Arlington Heights,

Killarney, Co Kerry.

Sir, – According to the Royal College of Obstetricians and Gynaecologists Guidelines on Bacterial Sepsis in Pregnancy (Green-top 64a), “Between 2006 and 2008 sepsis rose to become the leading cause of direct maternal death in the UK”. This document goes on to say that “the signs and symptoms of sepsis in pregnant women may be less distinctive than in the non-pregnant population and not necessarily present in all cases. Disease progression may be much more rapid than in the non-pregnant state.”

Surely termination of the pregnancy at the point where it is no longer judged to be viable is the only way to reduce the substantial risk to the life of the mother of a condition that is a leading cause of maternal death, whose signs are less distinctive and may not be present in all cases, that progresses rapidly.

This judgment, that the pregnancy was no longer viable, was made quite early on in the hospital care of Savita Halappanavar, yet we know from the failure to monitor vital signs that the substantial risk to her life from sepsis was not properly evaluated. This failure may, of course, be a consequence of risk evaluation in a sub-critical population size: ie, we may be too small a nation for clinicians to see enough cases of rapid deterioration of sepsis to septic shock for them to properly evaluate the substantial risk to the life of the mother. – Yours, etc,

NICHOLAS SCULLION,

Roslevan, Ennis, Co Clare.