Sir, – Mr Halappanavar and his solicitor are right when they say the proposed inquiry is flawed because “it is private, it is confidential, evidence will not be taken under oath and people will not be cross-examined”. But they are wrong, I suggest, in saying the only alternative is yet another expensive, time-consuming, drawn-out public inquiry, the costs of which would be borne entirely by taxpayers.
There is the option of a civil action for negligence. It would be free of the flaws mentioned. With prioritisation it would establish the truth quickly, and the costs would be borne by the losers. – Yours, etc,
Sir, – In the context of the current debate, the information presented to the Irish public about the consequences of abortion on a woman’s mental health has been largely misleading and contradicts the consensus international view.
Being suicidal because of an unwanted pregnancy has been deemed in two referendums to be a rationale for an abortion. The mental health, and the possibility of suicide, in women in relation to abortion are therefore of central importance to our national debate and to any legislation/regulation that may be forthcoming. Consequently, some clarification of the scientific findings in relation to mental health and abortion is necessary.
Last year the department of health in the UK funded a project to report on the specific issue of mental health and abortion. The project was commissioned by the Academy of Medical Royal Colleges and undertaken by the National Collaboration Centre for Mental Health (NCCMH) at the Royal College of Psychiatrists. The project's remit was to examine all the evidence from the world scientific literature, while maintaining a neutral position about the moral issues. The review ("Induced Abortion and Mental Health"), can be viewed on the NCCMH website and is written in non-medical language accessible to those without specialist training ( www.nccmh.org.uk/publications_SR_abortion_in_MH.html). The key conclusions from this comprehensive review are that up to 95 per cent of abortions are for unplanned pregnancies; and where a pregnancy is unplanned, the mental health outcome for those women who have an abortion is the same as for those women who go on to have a baby.
The evidence from our colleagues in the US is equally clear. The American Psychological Association formed the Task Force on Mental Health and Abortion to examine the scientific research without prejudice. They found "No evidence that having a single abortion causes mental health problems" ( www.apa.org/pi/women/programs/abortion/index.aspx).
In relation to the question of suicide and abortion, there is no evidence that women post-abortion are at an increased risk of suicide (see both reports above), but there is evidence that suicide is associated with unwanted pregnancies in countries where abortion is not available.
In summary, and put simply, the psychiatric evidence indicates that in situations of unplanned pregnancy, women who choose abortion are not increasing their risk of mental ill-health by taking this choice. – Yours, etc,
Sir, – The question posed by Vincent Browne “ Isn’t it obvious that only the woman herself is the person to make that moral judgment? (Opinion, November 21st) is ludicrous and indicative of a morally bankrupt status. Is Vincent Browne suggesting that only those affected by legislation should be allowed influence it? In that case I’m suggesting a top tax rate of 10 per cent, the abolition of car tax and compulsory retirement for journalists over the age of 65! It’s time for Vincent Browne to ramble in the grass instead of The Irish Times. – Yours, etc,
Sir, – It is worth noting that despite the very obvious and profound ethical issues which arise from the tragic death of Savita Halappanavar, the proposed inquiry team will not include a professional ethicist.
We would find it unthinkable that a financial audit takes place without an accountant or brain surgery is undertaken without a medical doctor. Yet, this most sensitive of inquiries is to be launched without an ethicist (ie a professional philosopher expert in the area) being on the team.
In fact, it is a remarkable but sad reality that the vast majority of ethics committees and counsels within medicine, academia and business in Ireland are made up of people who have no formal philosophical training whatsoever.
It is little wonder that Mr Halappanavar has no confidence in the HSE’s ability to carry out a thorough and fair inquiry. – Yours, etc,
Sir, – It is almost 30 years since the 1983 referendum, which led to the insertion of the “right to life” amendment. This means that no Irish citizen born since 1966 has voted on this issue. Much has changed in Ireland since that generation came of age; surely it’s time the majority of the population (ie those under 47) got an opportunity to express their opinion on this subject? – Yours, etc,
Sir, – For the record I am in favour of the right to life; the right to life of the mother. – Yours, etc,
Sir, – Despite the ruling on the X case there is enough ambiguity and uncertainty around the grounds for a lawful termination to suggest the events that may have led to the death of Savita Halappanavar could yet be repeated. That is an unacceptable prospect and so something must be done. Twenty years of political inactivity and neglect appears to have resulted in the most bitter of fruit.
There is no political appetite to legislate for the X case. Abortion is the single most divisive and dangerous issue any politician will engage with. It seems almost impossible to have a reasoned and tempered discussion on the issue without it descending into bilateral abuse and rhetoric. The main problem with this debate is that it is dominated by the extremes. The “pro-life” and “pro-choice” groups have set themselves up in direct opposition to one another; and any who occupy the middle ground run the risk of being caught in the crossfire and so have been sidelined and silenced – although they may well be in the majority.
There is fault to be found in both of the polar opposites as they have positioned themselves. The “pro-choice” group has failed to take seriously enough that abortion is always a tragedy and should not be glossed over callously as no more significant than a tooth extraction. Whether abortion on demand (which I am absolutely opposed to) or due to threat to the mother’s life, rape or unviability of foetus, it is the termination of life and to minimise that is to undermine our own humanity. I say this not as a religious person, which I am, but as a human being. Respect for life is not the sole preserve of the religious.
When it comes to the “pro-life” group the principal fault is the failure to take seriously the life of the mother. Their pro-life stance is somewhat selective. The mother is portrayed as a vessel whose sole purpose is to support the life within her with no account for her own humanity, welfare and integrity. Her motivations in choosing abortion, no matter how traumatic or medically necessary, are ignored and her actions are described in terms of murder regardless of the circumstances. This is cruel and for want of a better word tantamount to misogyny.
The only hope for a reasonable debate and a mature and responsible approach to this issue which we have never faced up to as a nation is for the middle ground to find its voice. It is possible to be both “pro-life” and “pro-choice”. We can simultaneously respect the right to life of the unborn and the life of the mother.
If we refuse to let the extremes dictate the agenda the previously vacated middle ground can become common ground and we can show the world there is a third way that isn’t about mothers v babies, but rather about discovering a much richer and comprehensive reverence for all life. That perhaps is a choice we could all sign up to. – Yours, etc.
Sir, – Prof John Baker (November 21st) warns your readers of the danger of being misled by the recent statement of the Irish Catholic Bishops’ Conference on the tragic death of Savita Halappanavar. He writes from a position of absolute certainty that, as his letter puts it, “what she needed was precisely ‘the direct and intentional destruction of an unborn baby’ as the only available means for saving her life”.
This is a degree of certainty about the cause of Ms Halappanavar’s death that is not available to the rest of us. Hopefully, whatever inquiry or inquiries are eventually established will be able to reach definitive, honest conclusions on this. In the meantime Prof Baker and other commentators do no service to Savita’s family by prejudging the outcome of inquiries into her tragic death. – Yours, etc,
Sir, – This week I am working in New Delhi on business, where I have seen the media reporting of the tragic death of Savita Halappanavar from the perspective of India.
The story makes the front pages of Times of India and other newspapers most days. It is also reported in the television most evenings. The reporting is that Dr Savita Halappanavar was denied a life saving abortion as Irish doctors cited Catholic tenets. The media also expresses doubt about the ability of the Irish Government to have an independent investigation and cites concerns around this expressed by Savita’s family in India. Also highlighted are the efforts of officials in India to bring pressure on the Irish government to have an independent investigation and amend Irish law.
The story has also sparked debate about abortion and the welfare of women and children in India. One newspaper story about Savita is followed by another headline questioning if the law on abortion in India is more humane that the Irish law. The story highlights the fact that 47 of 1,000 newborn babies in India die each year. This compared to three in Ireland. Also 20 in Botswana and 13 in China. These figures do not include female foeticide or female infanticide, the major reasons for alarmingly skewed sex ratio in many states. Newspaper reports also quote the rural development minister who says that in many parts of India a public health system simply does not exist.
Other shocking stories report that one woman dies every two hours in India due to unsafe abortions, which are legal in India, but not if done to terminate female babies.
Tuesday’s newspapers in India reported on comments from Minister of Health, Dr James Reilly and the Cabinet meeting to discuss the report by the expert group on abortion. Mr Reilly is quoted as saying the issue had divided the country. Really? When I left Ireland a few days ago every person I talked to wanted the Government to bring legislation to clarify the circumstances when an abortion could legally be done. Have half the people changed their minds in the last few days? – Yours, etc ,
Sir, – Tragically, Savita Halappanavar knew she was seriously ill and for whatever reason, it seems she was denied the treatment she knew she needed and begged for. Surely the bottom line is whether or not conversations between and a patient and doctor belong in the public domain? – Yours, etc,