Thursday, November 15, 2012

Medical (perhaps) and bureaucratic incompetency, not Catholicism, killed Savita

Update:  I am revising this post because I realize I might unfairly be blaming the doctors who attended this woman, having read some opinions on this.  I will post my updates after the original post; in the meantime, I offer my apologies to the doctors at the hospital in Ireland.



-- Original Post --

The death of Savita Halappanavar is tragic.  I pray for her soul and consolation for her family.

I also know that the finger of blame will be pointed at the Catholic Church in Ireland.  Here is what is being reported, so far:

Savita Halappanavar's husband, Praveen, said doctors determined that she was miscarrying within hours of her hospitalization for severe pain on Sunday, Oct. 21. He said that over the next three days doctors refused their requests for a termination of her fetus to combat her own surging pain and fading health.

"Savita was really in agony. She was very upset, but she accepted she was losing the baby," he told The Irish Times in a telephone interview from Belgaum, southwest India. "When the consultant came on the ward rounds on Monday morning, Savita asked: `If they could not save the baby, could they induce to end the pregnancy?' The consultant said: `As long as there is a fetal heartbeat, we can't do anything.'"

"Again on Tuesday morning ... the consultant said it was the law, that this is a Catholic country. Savita said: "I am neither Irish nor Catholic," but they said there was nothing they could do," Praveen Halappanavar was quoted as saying.

He said his wife vomited repeatedly and collapsed in a restroom that night, but doctors wouldn't terminate the fetus because its heart was still beating.

The fetus died the following day and its remains were surgically removed. Within hours, Praveen Halappanavar said, his wife was placed under sedation in intensive care with systemic blood poisoning and he was never able to speak with her again. By Saturday her heart, kidneys and liver had stopped working and she was pronounced dead early Sunday, Oct. 28.

Whether or not a doctor actually said, "This is a Catholic country" is irrelevant.  Ireland's constitution outlaws abortion.  However, its supreme court held in 1992 that abortion was permitted  if the mother's life was in danger.  No one seemed to legislate the inconsistency or promulgate clear guidelines as to when action could be taken.  And so you have a hospital worrying less about the life of Savita and more about liability.

And let us say her doctor was a staunch Catholic - what could he or she do?

Deliver the baby and administer care to both mother and child.

The Catechism of the Catholic Church 2273 states:

Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law.

Section 2274 states:

Since it must be treated from conception as a person, the embryo must be defended in its integrity, cared for, and healed, as far as possible, like any other human being.

Of course it would be likely that the baby would have died, being delivered - whether via induced labor or c-section - at 17 weeks.  But that is not abortion since the intent is not to kill the child.

Do people really think that the Catholic Church would allow a mother with an ectopic pregnancy - one where the embryo implants in the fallopian tube - to die an agonizing death?  That is nonsense. The treatment may, in fact, kill the child but again, it is not an abortion as the death of the child is not the intent.

So rather than a blanket condemnation of Catholicism (I took the image above off the Facebook page of someone who already told me that it is "in his DNA" to hate Catholics), perhaps people's wrath should be directed at the doctors and ask why they did not follow common sense and pursue a course of action of simply delivering the child.  I would ask a medical professional to confirm this, but it seems to me that a dilation and evacuation (dilating the cervix and using suction to basically vacuum out the womb, which is the typical procedure for abortion at 17 weeks) for someone with blood poisoning is riskier than delivery of the child via c-section.

But, for some people . . . it is easier - and preferable - to hate.

Eternal rest grant them, your servant Savita and her child, oh Lord.  Let perpetual light shine upon them.  May their souls rest in peace through your Mercy, oh God.  Amen.  (+) 

And may Your Grace flow upon Praveen and her friends and family, that they may be consoled.  Amen.  (+)

-- Update --

This article was brought to my attention:


From the available facts, we know that Mrs Halappanavar was miscarrying and that she died within days of being admitted to hospital from septicemia and E Coli ESBL.

We do not know for certain whether ending the pregnancy upon her arrival in the hospital would have saved her life, but to repeat, if medical staff needed to do that they could have done it.

Therefore the 'woman dies because she was denied abortion' storyline is simply not true. The 'woman dies because of Catholic opposition to abortion' is also not true.

We simply do not know for certain at this stage whether Mrs Halappanavar would have died no matter what was done. This is what the investigation into her death will ascertain.

I also read this comment from Reddit.com:


While I am politically pro-choice, here's the deal--an abortion wouldn't have been guaranteed to save her life. Period. I'll do my best to explain what I am pretty sure was happening.
1) Either the fetus or the placenta got its blood supply cut off to some degree. This caused necrosis of the associated tissue.
2) This necrotic tissue produced septicemia ("blood poisoning"), which is an infection that intrudes into the circulatory system, causing widespread damage.
3) Due to this, the woman's body became unable to sustain the life of the baby any long. The baby still had a heartbeat, but the mother's body was in the process of terminating the pregnancy. This isn't something that happens right away, but a process.
4) The family was told that the pregnancy was causing a septic infection in the mother. They assumed that an abortion would have cured this infection.
5) The physicians refused for a couple reasons. First, even by chemically terminating a pregnancy, it would have taken time to remove the infected fetus or placental tissue. Even then, the infection had spread throughout her body and it would be a hard fight to counteract it. Also, chemical abortions place stress on the body, potentially more stress than her system could handle at the time without killing her.
Now, I realize that Ireland has an abortion ban. However, couldn't they have gotten this woman to England, where she could have had the baby aborted, if this would have saved her?
What I believe happened is that the doctors believed the trouble of getting her to another country to perform a procedure her body was already in the process of performing was more effort than they thought necessary. They believed antibiotics could counteract the infection. No one thought the baby would survive. They simply thought this was the best way to save the mother, and they were wrong. It happens. Doctors aren't miracle workers.
TL;DR--Not a simple abortion vs pro-life case, but a complicated medical decision that had no clear up-side.
Source: from a medical family and currently studying medicine
Edit: Posted this below, but relevant. Even if they would have aborted the baby in Ireland, the source of the infection would have had to get out of her body. They would have had to make the choice between letting the fetus pass from her body naturally or to go in surgically. In her infected state, surgery was pretty much a no-fly zone. Far too risky. So, they would have let her pass the fetus naturally, even if it was chemically aborted. So, performing the abortion in-house wouldn't have sped up the removal of the cause of the infection whatsoever. An abortion would have done next to nothing, no matter where it was performed, unless they could surgically remove the fetus, placental tissue, and other associated anatomy, and even then they would have had a systemic infection to fight.

So, the issue still comes down to whether the doctors' performance was the right one medically, and even then, there are circumstances that can end in tragedy regardless, through nobody's fault.  More will be known with an inquiry.

Some have suggested that the Church's position on double effect is in play here.  What is meant by double effect is this:

The principle that says it is morally allowable to perform an act that has at least two effects, one good and one bad. It may be used under the following conditions: 1. the act to be done must be good in itself or at least morally indifferent; by the act to be done is meant the deed itself taken independently of its consequences; 2. the good effect must not be obtained by means of the evil effect; the evil must be only an incidental by-product and not an actual factor in the accomplishment of the good; 3. the evil effect must not be intended for itself but only permitted; all bad will must be excluded form the act; 4. there must be a proportionately grave reason for permitting the evil effect. At least the good and evil effects should be nearly equivalent. All four conditions must be fulfilled. If any one of them is not satisfied, the act is morally wrong.

I do not think that applies here.  The child was already dying and if it was the cause of the septicemia, then the action could have been taken to remove the child and make the attempt to save both its life and the mother's.

This is no doubt a great sadness.  However, the premise that the Catholic Church is to blame for Savita's death is a false one, fueled by ignorance, or bigotry, or both.  Unfortunately, I do not believe that will sway the minds of those intent on proving the pro-life community "wrong" or using this as "proof" that the Catholic Church is evil.

3 comments:

Renee said...

More recent...

Ireland's abortion laws: we need to get the facts straight

But some would dispute whether or not Savita’s death is an appropriate catalyst for that change. In Ireland, it actually is legal to induce a birth when a mother’s life is at risk. EilĂ­s Mulroy notes the following:
The decision to induce labour early would be fully in compliance with the law and the current guidelines set out for doctors by the Irish Medical Council. Those guidelines allow interventions to treat women where necessary, even if that treatment indirectly results in the death to the baby. If they aren't being followed, laws about abortion won't change that. The issue then becomes about medical protocols being followed in hospitals and not about the absence of legal abortion in Ireland.
Because Savita's case is under investigation, Mulroy asks questions but, wisely, avoids inferring answers: why, in this instance, did the hospital not induce (as it could and should) and is its decision not to induce reflective of a wider institutional failure?
It is possible that new legislation is necessary to clarify the existing medical consensus. But it does not logically follow that Ireland needs a total rethink of its entire approach to abortion that brings it in line with Europe’s essentially pro-choice culture. Aside from the specific medical case for abortion in Savita’s situation, inducing labour to save her life would not necessarily have conflicted with Catholic moral teaching, either. In 1951, Pope Pius XII explicitly ruled that such a procedure “can be lawful.” If it is true, as the Halappanavar family claims, that the Galway doctors said they would not provide a termination because "this is a Catholic country", then they got their theology unforgivably wrong.

maidrinruadh said...

Indian doctor also believes abortion may not have been any solution http://www.thehindu.com/news/cities/bangalore/city-doctor-defends-irish-counterparts/article4100988.ece

maidrinruadh said...

Indian doctor also believes abortion may not have been any solution

the hindu.com