An avoidable tragedy?

 

It is not possible to say categorically that earlier medical intervention to end Savita Halappanavar’s pregnancy by “expediting delivery” of her miscarrying foetus would definitely have saved her life. Medical science is not that certain. Septicaemia can take hold fast, uncontrollably, and devastatingly. But earlier intervention could have saved her life, and it would have been available to her in many other hospitals (although, for theological rather than medical reasons, not defined as an “abortion”).

There are profound questions raised by this tragic death for the hospital and its obstetric team about the management of this case and its protocols, and for the Medical Council about the ambiguity of its guidelines or its failure to ensure that they are fully understood. There is also an unarguable imperative on the Government to clarify the legal position .

An early medical intervention, according to the testimony of husband Praveen Halappanavar, appears to have been ruled out by attending doctors because a foetal heartbeat was still being recorded. Such an interpretation of their ethical obligations to the foetus, it is certainly arguable, perhaps unfortunately, may well be in line with the constitutional prohibition on abortion except where there is a real and substantial risk to the life, as opposed to the health, of the mother. Medical Council ethical guidelines also allow that “In ... exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the life of the mother, while making every effort to preserve the life of the baby.

Was the view being taken by the medical team that, although in deep discomfort and pain and bearing a foetus that could not go to term, and despite the subsequent outcome, Savita Halappanavar’s life was not actually threatened in the early stages of her crisis, even if the life-threatening possibilities were inherent in her condition? Were they therefore constrained not to perform an abortion?

The problem is that such a good faith medical diagnosis, which may well vary from hospital to hospital as a report in this paper yesterday pointed out, draws us into a grey, and perhaps unjusticiable, area of the current law. And it begs questions not so much about the conduct of the Galway medical team as about the inadequacy of the Constitution’s already controversial provisions. Would the Irish people really wish to deny a woman in her position an abortion when, legally speaking, her life could not be said to be in jeopardy?

Which brings us to the imminent report of the expert group on abortion and its proposals for belatedly putting the constitutional provision into law. The sooner the Government can bring clarity to the legal morass that this case and others have exposed, the better. But, in reality, it may bring cold comfort to those moved by the appalling plight of Savita Halappanavar.

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