Abortion and the Senseless Death of Savita Halappanavar

On Wednesday morning, several media outlets, including the Irish Times, the BBC, and the CBC, reported that Savita Halappanavar, a Hindu woman living in Ireland, had died from blood poisoning after doctors in a Galway hospital refused her request to abort the fetus that she was told she was miscarrying.

We do not yet know all of the facts of the case. Several inquires are being conducted. We do, however, learn this much from media reports. Ms. Halappanavar was 17 weeks pregnant. On October 21, she presented at a hospital in Galway complaining of back pain. Upon examination, she was told that she was having a miscarriage, and that it would soon be over. This did not happen. Instead, her ordeal continued for several more days. After a full day of “severe” pain carrying a child that was certain to die, Ms. Halappanavar asked that her pregnancy be terminated. Physicians were reported to have said that since they were in Ireland and the fetus had a heart beat they could not terminate the pregnancy. (In Ireland, the unborn have a constitutional right to life.) Ms. Halappanavar continued to suffer for a further two and a half more days before her fetus died and was removed from her body. By this time she was quite ill. She was then transferred to an Intensive Care Unit but she did not recover, dying some days later on October 28of complications due to septicaemia (blood poisoning.)

Since 1992 it has apparently been legal in Ireland to terminate a pregnancy that poses a “substantial” danger to a woman’s life. But there is quite a bit of uncertainty surrounding just what this implies in practice, since there are a range of ways one can interpret the notion “substantial”. This may be why doctors were reluctant to cede her request. Unsurprisingly, given the legal situation, it is in their interest to interpret this notion conservatively.

This lack of clarity imposes serious costs on women. It imposed the ultimate sacrifice on Ms. Halappanavar. Indeed, the costs of forcing a woman to sustain the life of a fetus with no hope of survival are vastly greater than any benefit (direct or indirect) one might see in sustaining such a fetus.

Three serious costs are worthy of note. The first of which is, of course, the cost of dying against one’s wishes in a way that appears to have been entirely preventable. Related to this harm and perhaps a consequence of imposing them are two further harms.

The first is the harm of forced intimacy. The American moral philosopher Margaret Little has brought this harm to light in her powerful and nuanced article “Abortion, Intimacy, and the Duty to Gestate.” Little argues that pregnancy is a kind of intimacy. It involves being physically intertwined with, “inhabited” and “occupied” by, another being. Most will agree that being forced to be intimate with another being is harmful. It follows from this that forcing a woman to remain pregnant without her consent is harmful to her; it is similar to the harm of being forced to be sexually intimate with another person. It is therefore wrong to force women to sustain unwanted pregnancies.

The final kind of harm is one that involves being forced to live according to a religious doctrine that one reasonably rejects. This harm was done to Ms. Halappanavar, a Hindu, in the most overt way. It was reported that she was told that she was in Ireland and that therefore she had to abide by the religion of its majority. Ireland is a Catholic country and its laws reflect that. But it is also increasingly a pluralistic and multicultural society. Approximately twenty percent of its population are not Catholic. This means that in its borders are people who reject on entirely plausible grounds its predominant religion but who are nonetheless bound by its laws. Forcing someone to live by religious code that they reasonably reject offends against their liberty and their equality because it involves coercing them by mechanisms that they do not see as legitimate. It does violence to a woman’s liberty to make her live by a religious doctrine that is not justified to her with reasons that she can accept from her own point of view.

It was wrong to impose these costs on Ms. Halappanavar merely in order to sustain the life of a fetus for a few extra days. No law should ask for such a sacrifice from any woman. It’s time that Ireland liberalized its abortion policy. The rights of women and religious minorities require nothing less.

 

Further Reading

1. Little, M. O. ‘Abortion, Intimacy, and the Duty to Gestate’, Ethical Theory and Moral Practice 2 (1999), 295-312.

2. Skelton, A. ‘Henry Sidgwick’s Practical Ethics: A Defense’, Utilitas 18 (2006), 199-217.

 

 

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5 Responses to Abortion and the Senseless Death of Savita Halappanavar

  • Mysore Shilpa says:

    I agree doctors go through the dilemma in their practices daily. But they completely blocked their medical decision making capacity in the name of religion and legality.
    Was there any ethics committee or could they have convened one ASAP to immediately address the issue?

    When the personal belief system contradicts the patient’s and family request at least they should transfer the care to another doctor / institution / closest hospital in another country who would have seen the sense in their request.

    In medical termination of pregnancy act there was a provision to end the incomplete miscarriage when it was threatening the life of mother even in Ireland. Why was it not followed?

    To deny the required evacuation of the uterus in the background of incomplete miscarriage with a dying heart rhythm of the foetus is exposing the patient to sepsis and DIC (Disseminated Intravascular Coagulation).

    When once DIC and sepsis sets up as nothing was done in the golden hour, there is no way the patient survives.

    As per reports, Savitha was not asking abortion which connotes another meaning. She was asking medical help to evacuate the uterus from the incomplete miscarriage. Looks like it is scary to seek medical help in a foreign country. It takes a lot for patients to come to a doctor for help. This was clearly medical negligence .

    There is another religious practice which I can not understand. This comes from Jehowa witness group. They decline blood transfusion even after discussing the pros and cons of their decisions. Again do not get me wrong. They are entitled to their choices.
    This makes the doctor’s life miserable when the doctor knows that the patient can survive provided they get the replacement of blood.
    But this is entirely different platform.
    It is hard when legal, religious practices prevent the doctor – patient relationship to see things in perspective.

    Savitha should have signed AMA ( against Medical advice ) and release herself from the hospital take a flight and get to India rather than to suffer there in a foreign hospital under the religious fanatics. I know it is hard when you have pain and bleeding. But that was her last hope and straw while sinking.

    Dr Shilpa

  • Anil Kumar says:

    Please check these videos too -

    http://www.youtube.com/watch?feature=endscreen&v=mXZCOaRVrbg&NR=1

    http://www.youtube.com/watch?v=gON-8PP6zgQ

    Press Statement from:
    Joseph Dias, Gen. Sec., The CSF
    The Catholic-Christian Secular Forum
    +91 9769555657 csfpost@gmail.com

    The CSF urges government to Amend MTP Act in view of increase in Abortions & Sex Determination
    The CSF takes strong exception to portrayal of Savita case as Anti-Catholic / Racist by World Media
    The CSF Abortion Statement from the Secular, Humane and Church point of view

    The politicians and sections of the media seems to have gone gaga over the case of Savita, who was reportedly denied an abortion in Ireland, resulting in her death. The right wing, Bhartiya Janata Party (BJP), Ministry of External Affairs, Communist Brinda Karat… et al jumped into the act, taking potshots at the universal Catholic Church’s and Ireland’s abortion laws, based on feedback received by Savita’s family. Two investigations are on and its results should have been awaited. It is yet to be conclusively established that the cause of death was denial of abortion, which is illegal. The incident has been wrongly portrayed, giving it religious or even racist connotations, without the Catholic viewpoint being equally emphasized.

    Practiced in Breach?
    The Church’s stand on issues like abortion, may be practiced more in breach than in practice; but this is hardly any justification for Vatican to change its doctrine . The Church respects the Catholic victims of such tragic circumstances and uses its resources to care for the child or the affected, like those with critical deformity, chronic illness, AIDS/HIV patients, senior citizens, homosexuals, destitute, etc. But so is the Church’s stand at variance with the popular one, on matters such as divorce, contraception, gay marriage, right to die, alternate fertilization, women priesthood… Christians worldwide are in the forefront of the human rights and social justice movements and yet are the most persecuted or opposed for their beliefs, which appeal to their conscience.

    Here are some issues, which have been missed out in the abortion debate, featuring Joseph Dias, The CSF general secretary to the electronic media:

    http://ibnlive.in.com/videos/305741/is-it-time-for-the-catholic-church-to-change-its-views-on-abortion.html

    The CSF Press Statement and this Appeal to see the Savita case in the right perspective

    1. Abortion is Murder.
    The Savita case is not a religious one. The right to life is universally accepted as the most basic human right out of which all others flow, with society and rulers duty bound to protect life. Murder is taking of life intentionally by choice and this is what abortion is, which violates an even higher moral law or the right to conscience and hence cannot be acceptable.

    2. Its the law of the land.
    Millions of various nationalities work or reside abroad and it is a must that they follow law of the land. Many Indians are in the gulf or Islamic states, where they dutifully follow laws and there seems to be little outcry for their basic human or religious rights, if violated. Can we expect foreigners in India to disobey Indian law eg. Italian marines case.

    3. Its asking the doctors to commit a crime.
    The issue of Ireland’s abortion law has come up in many referendums over the last 30 years, under different powers-that-be and the citizens of that country have repeatedly rejected abortion for the asking. Unless the law is amended suitably, it stands and advocating the doctors to kill the child is asking them to commit a cognizable offense and violate the law.

    4. Ireland as per WHO is one of the safest for mothers.
    The World Health Organization (WHO) in Its most recent report on global maternal death rates found that only 3 out of every 100,000 women died in childbirth in Ireland. Compare this with an average of 14 in Europe and North America, 190 in Asia and 590 in Africa. Thus, Ireland is one of the safest nation in the world to be pregnant, which speaks commendably for its mother’s health care system.

    5. Ireland has abortion precedents and its laws are humane.
    How many times have we seen relatives of a departed blaming the doctors? The grief and anguish is understandable, but to say her death was because the child was not aborted, is something only qualified medical professionals may conclude. The Irish Supreme Court has ruled in favour of abortion, if there was reasonable risk to the mother, including her threat to suicide. Further, Savita died 3 days after a miscarriage. It is not that doctors sat there doing nothing. Complications do arise and one cannot blame the doctors for every miscarriage or death, as is natural, but unfair to their efforts.

    6. Ireland and the medical institution is not ‘Catholic’ as alleged.
    Ireland is not a theocracy, but a sovereign republic, where a democratically elected government rules. Ireland Catholics stand up vociferously against Catholic clerical pedophilia and Church abuse. The Galway Hospital is not a ‘Catholic’ medical facility, in that it is not run or owned by any official Catholic Order or even affiliated to any Christian church. It is managed, along with several other hospitals in the region, by a management team put in place by the government’s Health Services Executive. Doctors have called for further focus on optimal care to pregnant women.

    7. A track record of abortion, with strictest limitations, proves it get widespread.
    In England and Wales in 2011 alone, there were about 2 lakh ‘murder’ by abortion cases recorded. In India, a minimum of 11 million babies are ‘murdered’, many of cases of female infanticide. In the 5 year period preceding 2012, it is estimated that around 25 lakh legal abortions took place. At the time the Indian Medical Termination of Pregnancy Act (MTPA) in its present form came into being in 1972, there were only 25,000 cases reported. Thus, the culture of death by choice tends to become all pervasive, even in India, where it is lawful to abort. Given these facts, there Is need to amend MTPA and make it reflective of Indian culture and protect the unborn girl child.

    8. The Church’s stand on abortion, reflects its views on the sanctity of life in all its forms.
    The Church treats life as a precious creation of God, which one is duty-bound to nurture at every stage – from womb to tomb. Hence, its legitimate concerns, not just on abortion, but also euthansia, contraception, fertility practices, sexual lifestyles, etc. and its serious attempts to fight for a more equitable and ethical society one hand and provision of a caring support system for the affected persons on the other. The pro life stand of the Church is all inclusive and does not stop at birth, rather continues in all life situations and aspects – physical, mental and spiritual. The Church is therefore foremost in its world campaigns for not just the unborn, but also for the sick, orphans, dying, hungry, elderly, terminally ill, unwed mothers…

    9. Life begins at conception and thereafter both mother and child have equal rights as different humans.
    European states like Malta, Poland, Monaco, Andorra, San Marino, N.Ireland part of UK… have stringent abortion laws. A person or life begins at conception. One cannot give more rights to the mother and less to the unborn child. Both have an equal right to life. An unborn child has a right to be treated with dignity and respect, especially since the unborn life cannot defend itself. Science shows that a child is no less human, with a heartbeat as early as 18 days after conception. The unborn child on conception is not potential life, but life with potential – new, unique & not to be snuffed out or extinguished. It is therefore also wrong to permit ‘murder’ by abortion even a day into pregnancy, as allowed by legislation, ranging from as less as 20 weeks in India. An unborn life is the most vulnerable & defenseless member of the human race, who has no choice or say.

    10. The Christian basis for abortion is its concept of life and the body. But abortion is no quick fix solution, from the secular view.
    Christians believe – Life and our bodies are sacred as they come from God. They are temples of the Holy Spirit, created in the image of God and saved from eternal damnation through the death and resurrection of Jesus Christ. Our bodies are not our own, to do with them what we will. The body is to be used with respect, not selfishly, but rather in service, after which we move on to spend eternity with God in heaven. Until then, Christians are called upon to be stewards / guardians, caring for His creation, especially all forms of life and all kinds of human beings. From a purely secular and medical point of view too, abortions are undesirable, as they are proved to have serious traumatic psychological impact on the mother, create a skewed / warped society to the disadvantage of women and irresponsible world citizenry.

    11. Devout Catholics want no change in the Church’s stand. We call upon the government to create a society where abortion on demand will not be necessary.
    The Church’s stand on abortion stems from creation as described in the Genesis story of the Bible and specifically from the 6th Commandment – thou shall not murder. Repeated Vatican documents & exhortations of the popes, ever since then have emphasized the same. Catholics do not expect the Church to change its doctrine according to what deviants from the faith want. The essence is life and treating the body with respect. The Church has never said the life of the unborn is more important than that of the mother. The answer lies in the government providing both mother and child with equal and adequate health and medicare. The government must revisit the abortion legislation to protect the life and human dignity of the unborn child, as these laws have proved to be disastrous, succeeding only in the ‘murder’ of millions of lives, with severe moral and social impact. The Church offers victims of abortion, its love, care and support – where ever possible.

    Frequently man lives as if God did not exist, and even puts himself in God’s place… He claims for himself the Creator’s right to interfere in the mystery of human life. Rejecting divine law and moral principles, he openly attacks the family.
    - Pope John Paul I

  • Dere O'Shaughnessy says:

    The system in IRELAND is very corrupt hospitals the Churches etc We live in morphine
    based society where we all killed or culled by the stuff it was not lack of
    abortion that killed her, but morphine most certainly the standard
    triage system, that exists to take people out, cashing them in, welcome
    to the production line of life that we are all on,

    If’s and maybes ARE not allowed, no chances allowed for the best
    mentally, no hope IS allowed, no miracles allowed, natural cures are
    most certainly not allowed, Ginkgo Billoba etc banned in the republic of
    Ireland etc
    You are all a Sleep not thinking if they change the law we all
    may not even be born the future, we are all walking dead ,shame shame shame
    Shame on you the medical profession etc you are all on Money THE
    Path not a Caring Path. Tears pave the path of how cruel the system is,
    Feel, Care, Help people create miracles , if this is it we want to be
    here as long as possible not controlled like cattle ETC MOO MOO ,
    can’t you see wake up people your life is the only treasure.

  • Clearly there is much that we don’t know about his case, and inquiries are underway. There may have been malpractice or misdiagnosis, the staff may have misinterpreted the law. In which case it would be prudent to clarify the law. Or none of thees may be the case, and it was simply a tragic result of applying the laws and standards which the medical staff were obliged to follow. But this does not entail that the law should be changed. Hard cases make bad laws.

    In Ireland the unborn have a constitutional right to life. This is not religious law, it is secular law. Ireland, as a country governed by elected politicians, has taken the decision that the rights of the woman do not automatically trump the rights of the unborn. So no religious rights are infringed by applying it. It will not do to claim that this law only exists because Ireland is a historically Catholic country. No country can have laws which are independent of its historical development. I daresay that the strict laws on narcotics in parts of south-east Asia are substantially informed by Islamic rules against intoxicants – does that make them automatically immoral or invalid? Does it mean foreigners ought not to have to obey them? Laws on human rights are a product of Christian beliefs in the sanctity of life and the value of each individual before God. Should we therefore get rid of them, and enforce entirely communitarian laws instead? Nor is a ban on abortion a specifically Catholic matter – the original Hippocratic oath contains it, some five centuries before Christ.

    Surely a society has the right to determine its laws in a way which will be for the benefit of society – which is pretty much the point of having laws at all. Although one might disagree about the philosophical basis of particular laws, where a law is coherent and morally defensible, it won’t do to say it should be changed, simply on the basis of a rare negative outcome. Ireland has decided that the loss of a handful of mothers’ lives is a price worth paying for the security of the presumably thousands of lives of children who would otherwise have been aborted. Stripped of religious rhetoric, that seems to me a perfectly defensible position (which is not to say you have to agree with it).

    And the fact that the couple were of a particular religion does not mean that they should have an opt-out from the laws of the state in which they choose to live, or the right to apply their own legal system. Should Muslims in Europe be allowed to cut off the hands of any one found stealing from their houses? Or should non-Muslims in Saudi Arabia be allowed to bring vast quantities of alcohol into that country, simply because they don’t want to observe the laws? Religion aside, I’m sure we could all think of laws with which we disagree and would rather not have to follow (like paying for parking tickets?). Bu as members of a society we follow its rules. Otherwise society breaks down, and everyone loses.

    I plan to read the Margaret Little piece,because it looks deeply flawed from the summary; I’ll comment later.

  • karen block says:

    I will never visit Ireland again because of this lack of respect for women’s lives-Let women die to save the unborn? do the unborn live when women die? no more visits to Ireland and I will spread the word

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