Wednesday, 14 November 2012

Woman dies in Irish Hospital after been refused an abortion


     A thirty one year old dentist died at University Hospital Galway in Ireland on 28 of October after being refused an abortion.  To begin, I think it would be prudent to explain the situation in Ireland with regard to abortion. Abortions are constitutionally forbidden in Ireland since the Eight amendment was passed in a bitter and divisive referendum in 1982. In 1992 the abortion debate once again came to the fore when the Supreme Court ruled in Attorney General v. X (commonly known as the X case) that abortion was permissible when the life of the mother was in danger either medically or through the risk of suicide. This opened up the flood gates for another acrimonious debate. The government put forward a raft of amendments before the people in 1992 in response to this judgement. Its first proposal the Twelfth Amendment which would have prevented the risk of suicide for being a lawful reason for having an abortion; this amendment failed. The other amendments which accompanied the Twelfth amendment were passed. The Thirteenth amendment guaranteed that the state’s prohibition of abortion would not affect a woman’s freedom to travel; this effectively made it possible for women to have abortions abroad without fear of prosecution. The Fourteen Amendment guaranteed that women would be allowed to procure information about abortion services in foreign countries without fear of prosecution.  In 2002 the Twenty-fifth Amendment was put forward which like the Twelfth tried to remove suicide as an acceptable reason to have an abortion in the state, however like the Twelfth amendment it was rejected by the people.
Since 1992 successive governments have failed to pass a law regulating for abortion in the circumstances where a woman’s life is at risk. This means while technically such abortions are legal doctors have no clear framework to work on i.e. at which point is a women’s life sufficiently at risk to allow an abortion? This was brought to the fore in 2010 when the European Court of Human rights ruled on A, B and C Vs Ireland. Most of the plaintiffs’ pleas were rejected but the Court found that Ireland’s failure to put forward a regulatory framework in line the X case violated C’s rights. C had a cancer which was in remission and she unintentionally fell pregnant.  Unsure about the risks to her health she procured an abortion in the UK , which was incompletely performed and she suffered infection as a result. The court found that C’s rights were violated as there was no mechanism at home which could have judged whether she could avail of a legal abortion.  Ireland has significantly modernized since the passing of the Twelfth Amendment in 1982, both divorce and contraception has been legalized. The power of the Catholic Church has been severely reduced for a variety of reasons the top three been: Irish Catholics are much more inclined to ignore the hierarchy than before, a long string of sexual abuse scandals have  reduced the power of the Catholic Church and Ireland has become much more ethically and religiously diverse. Despite these changes abortion is still a hot button issue and most political parties are internally divided on the issue. In 2011 a coalition of the centre-right Fine Gael Party and the centre-left Labour (the smaller of the two) came to power and promised to legislate for the X case. In February 2012  pro-choice MP  Clare Daly of the United Left Alliance (which is an a coalition of a variety of small hard left parties and independents) put forward legislation  for regulating abortion before the Dáil (the Irish lower house). This bill was defeated by the government who had appointed their own panel of experts to recommend legislation. Despite the government’s commitments to put forward regulations there are rumblings among some Fine Gael and Labour MPs and Senators that they might resist such moves.
                It was in this context that this tragedy took place. The woman, Savita Halappanavar (31) a native of India, was admitted to hospital on the 28th complaining of back pain. According to the national broadcaster,RTÉ,  she was told nothing was wrong but a couple of hours later she was readmitted as she was not feeling well. It was discovered she was suffering a miscarriage. She was informed that miscarriage would be over in a number of hours instead it continued for three days.  The Irish Times conducted an interview with Mrs Halappanavar’s husband she asked for an abortion on Monday.  However on Tuesday morning the medic told her they would not do so because the foetus still had a heartbeat and that Ireland was ‘a Catholic country’ (a controversial point as all reference to the Catholic Church was removed from the Constitution in 1973). This must particularly offensive to the Mrs Halappanavar who was a Hindu.  On Tuesday her condition worsened with the onset of shivering and vomiting. On Wednesday the foetal heartbeat ceased at which point surgery was performed.  She was removed to a high intensity unit and died on Sunday the twenty-eight. According to the Irish Times report an autopsy delivered two days later she died of septicaemia and E.coli ESBL. Mrs Hallappanavar’s body was reposed in Galway and then returned to her native India.  The Irish Independent  reported the Mrs Halappanavar’s family is planning to sue the hospital for not terminating the pregnancy and thereby endangering her life.  
                Despite her death on the 28th of October the issue only made headlines late on the 13th of November.  Once the story broke it made the front-page in Ireland’s three major broadsheets the Irish Times, Irish Examiner and Irish Independent. The story was also carried on the British news sources such as the BBC website, the Guardian, and  on the Independent’s news site. The Irish social media has gone into overdrive over the story with #Savita and #RIPSavita being the most popular hashtags. They are closely followed by  #Dail and #Dáil which refer to a planned protest outside the Irish Houses of Parliament in protest over Mrs Halappanavar’s death. While on the political discussion site politics.ie burst into acrimonious bickering between pro-life and pro-choice posters on the topic which went on for multiple pages until the mods were forced to temporally suspend the thread in order to review ‘potentially problematic posts’ in order words posts which were overly abusive or which were libellous (the thread was restored at 5.40 GMT). Facebook was also of angry messages giving out about the hospital and Irish abortion laws.
                As was to be expected a large number of politicians gave their opinion on the case. According to Evening Herald Clare Daly of the ULA demanded ‘immediate action’. The independent broadcaster TV3 reported that the Minister of Health called Mrs Halappanavar’s death a tragedy, he commiserated with her family and ordered the Health Service Executive to draw up a report on the case but he added it would be inappropriate to make more comments until such a report was finalized.  The Taoiseach (Prime Minister), Enda Kenny, also referred to her death as a tragedy, when asked on whether an independent inquiry was to be considered he commented that while he is not rule anything out there were already two inquiries been pursued.on her death and he revealed that the report by the expert panel on the X case was given to the minister of health the previous day. Ivana Bacik the leader of the Labour Party in the Senate and a prominent pro-choice campaigner said the government should put in place regulations in line with X case immediately. This was echoed on the Campaign for Labour Policy’s website. This organisation is a pressure group of grassroot Labour supporters unhappy with Labour’s performance in the government coalition and which wants to see Labour pursue more left wing policies. However like other political parties Labour is divided on the issue. TV3 reported that Bacik’s senate colleague John Whelan condemned her remarks and declared his pro-life credentials, while Fine Gael MP James Bannon declared that he would not support such legislation. According RTÉ seven MPs brought up the issue in the Dáil. The opposition Sinn Féin party said that Government should introduce regulation in line with the X case as promptly as possible. The other main opposition party Fianna Fáil called for an independent inquiry. While in the Senate Ronan Mullins who is a socially conservative Catholic commented that people where jumping to conclusions and that people should not use the death to further their agendas. On RTÉ News legal and medical professionals called on the government to legislate regulations on line with the X case. As it stands it is unclear what exactly constitutes a threat to a woman’s life and indeed the question was raised that is unclear at which point the risk to Mrs Halappanavar’s emerge.
                As well as the HSE report the Irish Independent reported that Galway Roscommon University Group (which administers Galway University Hospital) is also undertaking its own review. It also quoted a statement from the hospital:
“Galway Roscommon University Hospitals Group (GRUHG) co-operates fully with coroners’ inquests. In general, in the case of a maternal death, a number of procedures are followed, including a risk review of the case and the completion of a maternal death notification form.
“External experts are involved in the review and the family of the deceased are consulted on the terms of reference, are interviewed by the review team and given a copy of the final report.”
Whether this issue represents a watershed on the Irish abortion debate is hard to tell, what is to be guaranteed is that an extra element of emotion to an already contentious debate. Hopefully it will wake up some people to why such legislation is needed. Both those in Fine Gael and Labour have to stay the course and stare down the pro-life dissenters in their ranks. If needs be they may have to move across the aisle and secure the support of members of the opposition parties to secure the votes they need.

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