In day to day conversations and on Facebook I’ve been avoiding speculation and talking instead about a range of possibilities as to what could have gone so wrong in Galway University hospital which has an excellent record. It is however time now to speculate for a very good reason.
Speculation on the events leading to the death of Savita Halappanavar has for some time now been fuelling arguments for and against the enactment of legislation – as recommended by the Supreme Court a full two decades ago – to regulate and clarify the Irish constitutional position: that an abortion is permissible to protect the life of the mother. It needs to be emphasised that the only circumstance in which this young woman’s death has relevance to the debate on the need to move on such legislation is if there is any scenario in which the medical staff weighed the baby’s life against the mother’s and favoured the baby.
The reason I am about to speculate is that the most likely happenings in Galway are being ignored in favour of accounts which can be used to engage in the current debate. However, the most likely account has enormous significance for the abortion debate beyond the rare cases of risk to a mother’s life but a long way short of anything that could be described as liberal abortion law, never mind abortion on demand.
Incidentally, while I’m attracted in principle to the view that there should be no speculation and therefore no debate until an enquiry has established the facts of what happened, in practice holding such a line was never possible and is completely irrelevant now after weeks of comment.
The following is most likely what happened. I can only assume that it is ignored by media because it is irrelevant to the current spectacular row over the need for legislation to protect the life of a mother.
The death of Mrs. Halappanavar was the first maternal death at Galway University Hospital in 17 years. [i] We are not, therefore, talking about a hospital with a poor record. Moreover, despite all the allegations about “Catholic country” comments and missing notes – both of which need thorough investigation – it doesn’t seem remotely likely that the hospital staff were unaware of the legal or Catholic church position but for some unexplained reason decided to favour the baby’s life over the mother’s life. On the contrary it is, I think, safe to assume that the staff involved were caring, experienced and familiar with law and Catholic doctrine.
It is virtually certain that if at any moment from her first entering the hospital, it became clear that Mrs. Halappanavar’s life was in danger, these staff would have performed an abortion. So what happened? Here is the most likely explanation.
Mrs. Halappanavar was miscarrying, i.e. the baby at that age was doomed to die. However, Mrs. Halappanavar was not yet in mortal danger and there were no indications that she might die. Because, Catholic teaching and Irish law give an equal right to life to mother and to baby until the mother’s life is threatened, an unfortunate baby with just a short time to live would be monitored and allowed to die naturally. A mother’s distress, discomfort or illness would be irrelevant. Threat to life is the sole criterion for legal abortion in Ireland.
The truth that Irish media have been neglecting is that Mrs. Halappanavar’s treatment and death have very likely got nothing whatsoever to do with clarifying a mother’s superior right to life when her life is threatened but a great deal to do with the treatment/management of miscarriage. The position in Ireland is that abortion is not a permissible part of that treatment/management.
I’ve no information on how often abortion might be considered in the treatment of miscarriage but it does seem to be an issue for Catholic hospitals outside Ireland.
“The experiences of physicians in our study indicate that uterine evacuation may not be approved during miscarriage by the hospital ethics committee if foetal heart tones are present and the pregnant woman is not yet ill, in effect delaying care until foetal heart tones cease, the pregnant woman becomes ill, or the patient is transported to a non–Catholic-owned facility for the procedure.”[ii]
If in Ireland we are using the death of a young woman to inform or fuel an important public controversy, it is vital that the full controversy be aired or that the relevant controversy be aired or at the very least that the relevant controversy not be ignored.
[ii] Freedman, L.R. et al “When There’s a Heartbeat: Miscarriage Management in Catholic-Owned Hospitals” in American Journal of Public Health. 2008 October; 98(10): 1774–1778. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636458/