From the Irish Catholic Bishops’ Office:
The death of Mrs. Savita Halappanavar and her unborn child in University Hospital Galway on the 28 October last was a devastating personal tragedy for her husband and family. It has stunned our country. We share the anguish and sorrow expressed by so many at the tragic loss of a mother and her baby in these circumstances and we express our sympathy to the family of Mrs. Halappanavar and all those affected by these events.
In light of the widespread discussion following the tragic death of Mrs Halappanavar and her unborn baby, we wish to reaffirm some aspects of Catholic moral teaching. These were set out in our recently published Day for Life message on 7 October last, available on www.chooselife2012.ie.
- The Catholic Church has never taught that the life of a child in the womb should be preferred to that of a mother. By virtue of their common humanity, a mother and her unborn baby are both sacred with an equal right to life.
- Where a seriously ill pregnant woman needs medical treatment which may put the life of her baby at risk, such treatments are ethically permissible provided every effort has been made to save the life of both the mother and her baby.
- 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.
- Some would claim that the unborn baby is less human or less deserving of life. Advances in genetics and technology make it clear that at fertilization a new, unique and genetically complete human being comes into existence. From that moment onwards each of us did not grow and develop into a human being, but grew and developed as a human being.
With many other religious and ethical traditions we believe in upholding the equal and inalienable right to life of a mother and her unborn child in our laws and medical practice. This helps to ensure that women and babies receive the highest standard of care and protection during pregnancy.
Indeed, international statistics confirm that Ireland, without abortion, remains one of the safest countries in the world in which to be pregnant and to give birth. This is a position that should continue to be cherished and strengthened in the interests of mothers and unborn children in Ireland.
November 25th, 2012 | 9:00 pm
These two paragraphs are the met, but do not address the question:
-Where a seriously ill pregnant woman needs medical treatment which may put the life of her baby at risk, such treatments are ethically permissible provided every effort has been made to save the life of both the mother and her baby.
So could the doctors have induced delivery when there was practically no chance for the infant to survive, if that delivery is necessary to save the life of the mother? Yes, or No?
- 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.
As a practical matter, how does a doctor avoid criminal liability or adverse license action in “close cases?”
No guidance.
November 26th, 2012 | 1:01 am
[...] EUROPE EDITION Published November 26, 2012 Anno Domini Irish Bishops Issue Statement on Death of Savita Halappanavar – Matthew Schmitz, [...]
November 26th, 2012 | 8:33 am
[...] Statement on Death of Savita Halappanavar – Matthew Schmitz, First Thoughts [...]
November 26th, 2012 | 9:18 am
From what I’ve read, Joe’s first question is irrelevant to the case at hand. Inducing delivery would have put the _mother_ at greater risk. Indeed, this is often the rationale for a Caesarean, which is major abdominal surgery, to reduce the risk to the mother. In this case, a Caesarean would also have put the mother’s life at greater risk.
Joe’s second question suggests that law cannot differentiate medical practice in spite of the availability of expert advice. Perhaps he might want to consider how the law differentiates in the case of, say, open heart surgery, where only one life is at stake.
What I have yet to see from those who would politicize this tragedy to advance legalized abortion in Ireland is an indication that the mother’s situation was affected negatively by not aborting the child. All current indications are that she died of a massive infection, though the details may change as investigations continue.
November 26th, 2012 | 9:20 am
For many people, no matter how compelling the argument against abortion appears to be, something seems intuitively and profoundly wrong when both the mother and the unborn child are allowed to die under circumstances in which one of them could have been saved.
November 26th, 2012 | 9:53 am
It is indeed extremely tragic for this young family to lose both baby and mother when I’m sure there was great joy and expectation at becoming parents.
However, from what I have read, it seems that a serious infection, namely e-coli, was the main source of the problem. The fact that the baby was alive for some days puts this in my opinion back in the expert judgement of well qualified members of the medical profession. My prayers are with Savina’s husband. May all life be preserved anywhere possible. Abortion is a scourge everywhere it is legal. God guide us .
November 26th, 2012 | 10:02 am
Mike Melendez –
The issue, however, seems to be that she contracted the infection from being in labor for over 48 hours with failure to progress, with a dilated cervix. Induction, according to the husband, was refused precisely because it would deliver a nonviable fetus.
We’ll see if the investigations confirm this timeline or not.
November 26th, 2012 | 10:52 am
We don’t know the source if the infection but it may have been chorioamnionitis, an infection of the fetal membranes and placenta. The woman had ruptured membranes according to the reports. If this was the case, evacuation of the uterus would have been possible by current Irish medical guidelines and Catholic doctrine (note Savita was NOT in a Catholic Hospital). This is stated more clearly in an analysis of the case on the website of the International Catholic medical association http://www.fiamc.org. The National Catholics Bioethics Center in both it’s handbook of hospital practice as well as recent commentary on this recent case state that evacuation of the uterus would be acceptable in this case. Catholic practice, as stated by Pope Pius XII in 1951, allows medical and surgical interventions to save a mother’s life, even if the unborn baby dies as a result, when there is NO other alternative. One name for this is indirect abortion, and it is permitted by Irish guidelines.
Part of the problem is that some naive bioethicists, clergy, and non-medical commentators weigh in on very serious life and death situations, when they do not understand the gravity of allowing medical neglect of a mother in imminent danger of death when there is NO prospect of saving the baby.
November 26th, 2012 | 10:56 am
Yes, the doctors could have induced delivery. I agree the bishops did not spell this out clearly enough, and this contributes to the lack of clarity.
M Davenport, MD, FACOG
President, AAPLOG
American Association of ProLife ObGyns
Medical Director, Magnificat Maternal Health Program
http://www.aaplog.org
http://www.mmhp.org
November 26th, 2012 | 11:01 am
[...] Irish Bishops Issue Statement on Death of Savita Halappanavar Matthew Schmitz, First Things In light of the widespread discussion following the tragic death of Mrs Halappanavar and her unborn baby, we wish to reaffirm some aspects of Catholic moral teaching. Leave a Reply Click here to cancel reply. Name Required: [...]
November 26th, 2012 | 12:05 pm
Catholic practice, as stated by Pope Pius XII in 1951, allows medical and surgical interventions to save a mother’s life, even if the unborn baby dies as a result, when there is NO other alternative. One name for this is indirect abortion, and it is permitted by Irish guidelines.
Mary Davenport,
My understanding is that there is disagreement as to what makes an action (such as an abortion) “indirect.” As I understand the position taken by Bishop Thomas Olmsted in the case of the “Phoenix Abortion,” I would imagine he would disagree that evacuating the uterus while the unborn child was still alive was “indirect.” (I could, of course, be utterly wrong.) It makes sense to me, in cases where a pregnancy threatens a mother’s life, and no one involved wants the baby to be lost, to consider any lifesaving intervention to be an indirect abortion, no matter what technique is used to terminate the pregnancy. It is a bit like Sophie’s choice. When she was required by the Nazis to chose to send either her son or her daughter to death as the only alternative to having them both killed, when she chose to save her son, could she really be accused of intending her daughter to die?
November 26th, 2012 | 12:31 pm
Mary Davenport –
Again, investigations haven’t been completed, but it appears the hospital administration was more directly concerned with the state of the law allowing this rather than Catholic doctrine allowing it.
That said, the state of the law regarding such cases in Ireland – or lack thereof – has evolved that way in no small part due to the influence of Catholic doctrine.
November 26th, 2012 | 3:07 pm
Dear Mr Nickol,
This is not a Sophie’s choice if there is 100% chance of the death of the unborn, and serious risk of maternal death.
There is NO choice that saves the baby. in some instances.
As some people (not schooled in certain overly legalistic schools of bioethics) have said: one dead vs two dead – it’s a no-brainer.
Physicians have to answer the husband and children of the dead woman, who ask why they didn’t save their mother when the baby was going to die anyway. Ethicists do not; they just have to ethicize.
November 26th, 2012 | 3:58 pm
I’m not sure that the right question is being asked here. It seems to me, as I stated earlier, that Savina entered the hospital with a really bad infection. This, in my opinion compromised the life of her baby; who was still alive at that point. Sadly, something caused the baby to die.
It has not been explained to me why an abortion would have saved Savina’s life. Has that been medically proven? I hope that people are not putting too much trust in what removing the baby would do to cure Savina. What about the infection? Wasn’t that the real issue?
November 26th, 2012 | 4:27 pm
Mary Davenport,
Are you saying that if the infant faces certain death, say, within a few days, and the mother’s life is seriously endangered if doctors wait those few days for the infant to die on its own, then removing the infant (which cannot possibly survive at that stage of the pregnancy) is acceptable to Catholic bioethicists?
one dead vs two dead – it’s a no-brainer.
That makes sense to me, and yet it does not seem to have been the principle in Bishop Olmsted’s mind when he excommunicated Sister Margaret McBride (or declared her to have excommunicated herself).
It seems to me that there is more than one understanding of “indirect” abortion, and depending on which hospital or which diocese a woman with a life-threatening pregnancy is in, she may either be saved or allowed to die.
November 26th, 2012 | 4:56 pm
I can only ask my question again: Was the situation caused by the pregnancy or by an bad infection? Was the baby the source of the infection being untreatable? Could this woman have died of this infection even if she was not pregnant?
This is truly a medical question for expert medical and sound moral judgement.
November 26th, 2012 | 7:20 pm
Bernadette O’Connor,
For what it’s worth (I am not a doctor), here is my understanding. The woman began to have a miscarriage and went to the hospital. She knew she was miscarrying, and wanted an abortion. A miscarriage can go on for several days, or possibly longer. It is my understanding that a miscarriage cannot be stopped and the baby saved. So in this case, the baby had no chance of survival. However, the baby’s heart was still beating, so the hospital refused to remove the baby, since it was too young to survive on its own. During the time the woman was in the process of miscarrying, she developed the infections. Presumably, if the baby had been removed early, the woman would not have become infected. It seems reasonable to me to assume that the longer a woman is in the process of miscarrying, the more vulnerable she is to infection, although I am also assuming it would be difficult to say for certain that the same infection would not have followed an abortion.
So my understanding is that the baby could not be saved, but the delay in waiting for the baby to die naturally conceivably put the woman at risk for the infection that killed her. The woman might have been saved, but the baby could not have been saved, and rather than aborting a baby that had no chance of survival, they waited for it to die.
While I am speculating, I will speculate that different Catholic medical ethicists will have different opinions about what is properly done in such a case, and different bishops might make different calls for hospitals under their control.
But it should be noted in this case that it was a matter of what the hospital considered legal under Irish law, not what a Catholic ethics committee or bishop decided was the proper course of treatment, since the woman was not in a Catholic hospital.
November 28th, 2012 | 7:43 am
It’s “permissible” to perform medical treatments that help the mother while harming the foetus, under certain circumstances, okay.
But is it also “permissible” to refuse the same treatments ? Like what happened in this particular case ?
There’s a big difference between saying “Doctors -could- have performed the procedure” and “Doctors -should- have performed the procedure”.
November 28th, 2012 | 10:36 am
@ Mike Melendez:
“Inducing delivery would have put the _mother_ at greater risk… In this case, a Caesarean would also have put the mother’s life at greater risk. ”
You really, really need to substantiate this. Are you a doctor? Do you specialize in Ob/Gyn? Do you have specific knowledge of this case?
You justify the decision in this case based on an assertion for which, as far as I can tell, you have absolutely no evidence. It’s rather hypocritical of you to accuse others of “politicizing” this event when you’re bending over backwards to do so yourself.
Perhaps I’m wrong, and you do have specific information to share. If you do, please share. Otherwise, I’m forced to conclude that you’re making a deliberate attempt to confuse the issue and mislead readers.
November 28th, 2012 | 11:14 am
What I find unfathomable is that Bishops should have any say on the medical care of someone who is not Catholic. An individual may choose to limit their care to what the Bishops approve, but that should not be binding on everyone.
Once it is part of the law, with potential professional or even criminal sanctions against the doctors, the doctors will necessarily withhold potentially life saving abortions because of legal risk. The supposed exemptions do not work, because in many cases it is unclear just how much risk is allowed and how risky the current situation is for the mother. There have been cases like this in the past and there will be more in future.
November 28th, 2012 | 12:47 pm
“From that moment [conception] onwards each of us did not grow and develop into a human being, but grew and developed as a human being”
Is a single cell seriously to be equated with a human being? How radically must we change the definition of a human being for this to be true? If a single cell which is genetically a “human” cell counts as a being, how many beings am I made up of? How many do I kill every time I scratch an itch?
November 28th, 2012 | 1:32 pm
A few things…
1.) @ChuckV – Why should bishops have any say in MEDICAL DECISIONS AT ALL even for Catholics?!
THEY ARE NOT DOCTORS. This is a MEDICAL decision, not a religious one. They do not have the expertise necessary to properly assess the situation. It is only by religious interference that you would EVER end up with the results in a case like Savita’s.
Would you go to a medical doctor for spiritual advice? No? Why would you go to a clergyman for medical advice?
2.) @Bernadette asked, “Was the situation caused by the pregnancy or by an bad infection? Was the baby the source of the infection being untreatable? Could this woman have died of this infection even if she was not pregnant?”
Answer: The infection was caused due to miscarriage being allowed to last simply because the fetus still had a heart beat, causing unnecessary, prolonged exposure of highly vulnerable epithelial tissue.
If she was never pregnant this wouldn’t have happened because 1.) she wouldn’t have been exposed the way she was (and you could say the same if she hadn’t miscarried) and 2.) her immune system wouldn’t have been compromised and unable to fight off the infection. (Pregnancy already causes immunosuppression. The trauma caused by miscarriage made this even worse.)
The exposure to infection, the inability to fight the infection, and death is a direct result of being pregnant, miscarrying, and then not receiving proper medical treatment thanks to religious interference.
3.) This was a clear cut case. The fetus will die. There was no other option. The only options should have been about the welfare of the mother.
Not only was she in excruciating pain waiting for the miscarriage to finish, but she was put at unnecessary risk of infection, and that’s what killed her.
I’m not a doctor, but I am a biologist and I’m extremely well versed in how infections happen. Aside from a direct breach from a cut or puncture, the next source of infection is almost always epithelial cells.
A dilated cervix exposes extremely vulnerable epithelial cells because they don’t have the same defenses as say the epithelial in your lungs or intestines.
This is made worse because bodies in stress/trauma are immunosuppressed. This woman was not only pregnant but miscarrying. Add a high chance of infection with an inability to fight off everything that gets in and that’s what happened here.
The chances of infection would have been reduced to almost nothing had they dealt with the fetus when it was certain it couldn’t possibly survive. Abortion in this case should have been the immediate step. The results of this case were caused directly caused my religion preventing proper medical care.
November 28th, 2012 | 4:00 pm
[...] it’s highly relevant to our debates over the use of drone strikes and the tragic death of Savita Halappanavar. In a nutshell, the principle is that ”sometimes it is permissible to bring about as a [...]
November 28th, 2012 | 7:27 pm
Maybe this seems too obvious, and I apologize if I’m missing the bigger ethical picture. Apparently the mother was admitted at the point where she was miscarrying her embryo. That embryo had no hope of survival. The mother at that point, as I understand it had an even chance of survival. The right decision is to save the life of the mother, not only because that is the right thing to do for her but also for her present and future family. It’s interesting that it’s OK for the Irish doctors to allow both mother and embryo to die and to thereby prevent any possibility of future lives. The are murderers not only in the present but also of the future. It makes no sense.
November 29th, 2012 | 8:02 am
[...] the Irish bishops as published in First Things. I had decided to put sanctity-of-life issues on the shelf for a while, and yet, here, in black [...]
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