Referendum on the Eighth Amendment

Amnesty International demands compulsory referral for abortion

Irish Times (Letter to the Editor)

Colm O’Gorman (Executive DIrector, Amnesty International Ireland

Sir, – Dr Andrew O’Regan (April 14th) has firm views on when health practitioners should be allow to refuse participate in abortion procedures if the referendum is passed. However, the limits he considers a trespass on practitioners’ rights are in fact how conscience-based refusal should be regulated in order to safeguard the patient’s rights too.

There is an important difference between conscientiously objecting to something – we all have a human right to thought, conscience and religion – and being allowed to act on that objection in a way that negatively impacts on others. . .

. . . So, yes, a health professional exercising conscience-based refusal should still have a duty to make a timely referral to another who will provide the service. . . . [Full text]

Majority of GPs favour Eighth Amendment repeal, campaigner claims

Halappanavar death a watershed moment, pro-choice GP campaigner says

Irish Times

Barry Roche

A significant majority of general practitioners now favour repeal of the Eighth Amendment, marking a significant change in doctors’ views over the past 15 years, according to long-time campaigner for abortion services Dr Mary Favier.

She says the death of Savita Halappanavar in 2012 proved a watershed moment for GPs, as much as for the general public.

“The death of Savita Halappanavar: that was the watershed moment – as much for GPs as for society at large,” she said. “There were just so many people upset, right-minded people who just said: ‘Oh my goodness, that’s dreadful, how could this possibly happen?’ ”

Ms Halappanavar died at University Hospital Galway a week after she presented with back pain and was found to be miscarrying, 17 weeks into a pregnancy. Although the pregnancy was not viable, her requests for termination were refused because there was a foetal heartbeat. She then contracted sepsis and died of multi-organ failure and septic shock. . . [Full text]

Savita Halappanavar death: nine members of medical team disciplined

Staff at Galway University hospital given limited sanctions for role in death of Indian dentist who was refused an abortion

The Guardian

Henry McDonald

Nine members of the Irish medical team that treated an Indian dentist who died after being refused an abortion have been disciplined.

Galway University hospital said the nine were part of a larger medical team looking after Savita Halappanavar before she died from blood poisoning in October 2012.

Halappanavar had demanded that her pregnancy be terminated after fearing the foetus was dead and likely to give her sepsis. Her request was turned down after medical staff said they detected a foetal heartbeat. She was 17 weeks pregnant and miscarrying when she fell ill. [Full text]

Termination of pregnancy as emergency obstetric care: the interpretation of Catholic health policy and the consequences for pregnant women.

An analysis of the death of Savita Halappanavar in Ireland and similar cases

Reproductive Health Matters 2013;21(41):9–17

Marge Berer

Abstract:

Issues arising from the death of Savita Halappanavar in Ireland in October 2012 include the question of whether it is unethical to refuse to terminate a non-viable pregnancy when the woman’s life may be at risk. In Catholic maternity services, this decision intersects with health professionals’ interpretation of Catholic health policy on treatment of miscarriage as well as the law on abortion. This paper explores how these issues came together around Savita’s death and the consequences for pregnant women and maternity services worldwide. It discusses cases not only in Ireland but also the Americas. Many of the events presented are recent, and most of the sources are media and individual reports. However, there is a very worrying common thread across countries and continents. If further research unearths more cases like Savita’s, any Catholic health professionals and/or hospitals refusing to terminate a pregnancy as emergency obstetric care should be stripped of their right to provide maternity services. In some countries these are the main or only existing maternity services. Even so, governments should refuse to fund these services, and either replace them with non-religious services or require that non-religious staff are available at all times specifically to take charge of such cases to prevent unnecessary deaths. At issue is whether a woman’s life comes first or not at all.

 

New Irish abortion law demands referral by objectors

Protection of Life During Pregnancy Act 2013

The Protection of Life During Pregnancy Act 2013 will permit abortions when there is a “real and substantial risk” to the life of a woman by reason of physical illness or suicidal ideation. In the former case, two medical practitioners must certify the risk.  In the case of threats to commit suicide, three medical practitioners, including two psychiatrists, must certify the risk.  In all cases, they must also certify that the risk can only be averted by abortion.  In emergencies, when there is an immediate risk of the mother’s death and the abortion is necessary to save her life, a medical practitioner may provide an abortion without prior certification.

Protection  of Conscience Provision

The Act  includes a protection of conscience provision that is limited to medical practitioners, midwives and nurses.  A provision that denied freedom of conscience to institutions has been dropped.  However, no conscientious objection will be allowed in emergencies when the mother’s life is in immediate danger.

One third of Irish psychiatrists signed a letter to the government asserting that abortion is not a treatment for suicidal ideation, so it is not clear how the part of the Act dealing with threats of suicide will function in practice.

The Act demands that medical practitioners who do not want to participate in the procedure must arrange “for the transfer of care of the pregnant woman concerned as may be necessary to enable the woman to avail of the medical procedure concerned.”  Many conscientious objectors are unwilling to refer patients for morally contested procedures because they believe that by doing so they become morally complicit in wrongdoing.

However, it is far from certain how much difficulty the mandatory referral requirement will cause, since the Act envisions abortion only in circumstances involving a substantial risk to the mother’s life.  This is very rare, and in such circumstances there is much less likelihood of conscientious objection, so the provision may not prove to be troublesome in practice.

On the other hand, government comments accompanying the earlier “heads of bill” noted that medical practitioners do not need to be of the opinion that the risk to the woman’s life “is inevitable or immediate.”  The more broadly this interpretation is construed, the more likely it is that conflicts of conscience will occur, and the greater will be the surrounding controversy.

While the proposed bill is the product of the controversy generated by the death of Savita Halippanavar in Galway in October of last year, it does not appear to propose anything that would have made a difference to the outcome of that case.  Her death was caused by a particularly virulent infection that is not normally found in maternity settings.  An emergency induction of the kind contemplated the proposed Act was legal at that time and had been decided upon when she spontaneously delivered a stillborn daughter.  (See A “medical misadventure” in Ireland: Deaths of Savita and Prasa Halappanavar)