The Irish Catholic Bishops have seen fit to clarify the church’s view on gynecology given Savita Halappanavar’s death from sepsis at 17 weeks in her pregnancy and the concern that evacuating her uterus was delayed because the fetus still had a heart beat. The full statement is here, but this is the excerpt I find most troubling:

- Whereas abortion is the direct and intentional destruction of an unborn baby and is gravely immoral in all circumstances, this is different from medical treatments which do not directly and intentionally seek to end the life of the unborn baby. Current law and medical guidelines in Ireland allow nurses and doctors in Irish hospitals to apply this vital distinction in practice while upholding the equal right to life of both a mother and her unborn baby.

I spent quite sometime trying to understand how one could possibly translate this statement into medical care. I’ve been a doctor for 22 years and an OB/GYN for 17 years and I admit that I am at a bit of a loss. My three interpretations are as follows.

  • Terminating a pregnancy is “gravely immoral in all circumstances.” All circumstances includes 17 weeks and ruptured membranes. Unless I misunderstand the meaning of “all,” then Irish Catholic Bishops also view ending a pregnancy at 17 weeks with ruptured membranes and sepsis, either by induction of labor or the surgical dilation and evaluation (D & E), to be “gravely immoral.” They must also view ending a pregnancy for a woman who previously had postpartum cardiomyopathy and a 50% risk of death in her pregnancy as “gravely immoral.” So if you have a medical condition that is rapidly deteriorating because of your pregnancy, too bad for you if you live in Ireland. Because the mother and unborn baby have equal rights to life, Irish law spares women the anguish of choosing their own life. Neither can be first, so both must die.

Full article by Dr Jen Gunter here
 
 
The Master of the National Maternity Hospital is a woman under pressure. When I arrive at the agreed time for an interview, I am told at the front desk of the antiquated building on Holles Street that there are others waiting ahead of me. The “others” sitting in the small entrance hall waiting for Dr Rhona Mahony include a significant one – the Minister for State at the Department of Health, Alex White.

When Dr Mahony arrives about 10 minutes later to greet White, an apologetic secretary says that she is not sure how long I’ll have to wait as the master also has to go down to theatre.

Being the head obstetrician at a hospital with 700 staff and where about 27 babies are born each day is an onerous responsibility. She wears the stress lightly, although with the country convulsed over the death of Savita Halappanavar and the issues arising from that, everybody working at the coalface of the maternity services must be particularly deeply affected.

Full article by Sheila Wayman here
 
 
The husband of Savita Halappanavar is considering lodging a complaint to the Ombudsman to assert his ownership of his wife’s medical notes, his solicitor has said.

Gerard O’Donnell said he had taken instructions from Praveen Halappanavar to seek direction from the Ombudsman on whether he or Galway University Hospital owns her medical records.

Mr Halappanavar has objected to the use of his wife’s notes in a HSE inquiry into her death. He has said he has no faith in a HSE-run inquiry and does not want her notes used in it.

Mr O’Donnell had asked that the hospital, where Ms Halappanavar died last month, hand over the original medical notes. However, the HSE has said it owns them.

A spokesman for the Ombudsman said last night it was unlikely her office would have a role in this dispute.

Mr Halappanavar met Minister for Health James Reilly for 25 minutes yesterday in Galway.

Ms Halappanavar died on October 28th, having presented a week earlier at the hospital with back pain. She had been 17 weeks pregnant and had been found to be miscarrying. Mr Halappanavar says she asked repeatedly for a termination and this was refused as the foetal heartbeat was present.

The Health Information and Quality Authority will publish the terms of reference of its inquiry into her death next week.

The investigation, for which no time span is indicated, will make use of outside expertise, a spokesman indicated.

In a statement, the authority said it would investigate the safety, quality and standards of services provided by the HSE at Galway University Hospital to “critically ill patients, including critically ill pregnant women, as reflected in the care and treatment provided to Savita Halappanavar”.

Mr Halappanavar said after yesterday’s meeting with Mr Reilly that he was pleased to finally meet a Government representative four weeks after his wife’s death. He said he stressed to the Minister that he did not believe the HSE or Hiqa investigations would be far-reaching enough. “I’m just glad that we met and he just passed on his condolences to the family,” said Mr Halappanavar.

Mr O’Donnell said his client was prepared to go to the European Court of Human Rights if an independent public inquiry was not set up. Galway University Hospital last night confirmed it would co-operate fully with the Hiqa inquiry.

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