Three doctors


Via PZ, another doctor weighs in, making it very clear what the treatment for Savita Halappanavar should have been. It’s medical knowledge from an OB-GYN plus Jen Gunter has actually had the same complication herself.

Not only do I know these scenarios backwards and forwards as an OB/GYN, I had ruptured membranes in my own pregnancy at 22 weeks, a rescue cerclage, and then sepsis. I know how bad it can be.

As Ms. Halappanavar died of an infection, one that would have been brewing for several days if not longer, the fact that a termination was delayed for any reason is malpractice. Infection must always be suspected whenever, preterm labor, premature rupture of the membranes, or advanced premature cervical dilation occurs (one of the scenarios that would have brought Ms. Halappanavar to the hospital).

Read the whole post. It’s informative and infuriating.

There’s an update.

Since posting this piece I learned that Ms. Halappanavar’s widower reported that she was leaking amniotic fluid and was fully dilated when first evaluated. There is no medically defensible position for doing anything other than optimal pain control and hastening delivery by the safest means possible.

Ben Goldacre wonders if any of the doctors involved were also involved in the recent statement that abortion is never needed to protect the life of the mother.  It looks as if the answer is yes.

…one of the organisers of the conference was Eamon O’Dwyer, professor emeritus of obstetrics and gynaecology at NUI Galway, which is attached to University Hospital in Galway, where Savita Halappanavar died.

A response –

Certainly Eamon O’Dwyer is an interesting character. He’s at least 85 years old. He was raised by the Christian Brothers and has been happy to defend them in print. http://www.irishsalem.com/religious-congregations/christian-brothers/defendin…. He was performing symphysiotomies until quite recently http://business.highbeam.com/5900/article-1G1-221653495/men-butchered-us-thre…and is generally serious God-squad.

It would interesting to know how much influence he has on the policies of the hospital which is not, apparently, overtly religious.

Jesus H fucking christ.

Update: the post I did on that conference last month.

Comments

  1. Rodney Nelson says

    I really hope the consulting physician has his (according to the news reports he’s a he) license to practice medicine revoked for gross malpractice.

  2. says

    I’m hoping for manslaughter charges against the care team and a big fucking lawsuit against the hospital.

    No messing around, IMO: those doctors let a woman die because they couldn’t bring themselves to abort a dying foetus.

  3. Shaker Srinivasan says

    The doctors shouldn’t have to bear the brunt of the blame here. It should go to self-serving politicians and religious zealots.

    A call based strictly on medical grounds might have been clear in Savita’s case, but I shudder to think how many Savitas may have died or incapacitated because religion and law muddled the decisions, when the precipitating events were not so clear.

    As President Obama said recently in an interview with Jay Leno,

    This is exactly why you don’t want a bunch of politicians, mostly male, making decisions about women’s health care decisions. Women are capable of making these decisions in consultation with their partners, with their doctors, and for politicians to want to intrude in this stuff often times without any information is a huge problem.

    What goes for the politician goes for the priests, too.

  4. says

    @shaker

    I completely agree that the politicians should be held accountable for their dreadful policy and heel dragging. However at the end of the day the doctors were presented with a woman in need of medical attention that they could provide and did nothing for far too long. I leave the legal aspects to the lawyers but morally this woman’s death is first and foremost on their hands.

  5. jb says

    Found this on Pandagon, its worth a read:

    http://io9.com/5958187/what-happens-to-women-denied-abortions-this-is-the-first-scientific-study-to-find-out

    “We have found that there are no mental health consequences of abortion compared to carrying an unwanted pregnancy to term. There are other interesting findings: even later abortion is safer than childbirth and women who carried an unwanted pregnancy to term are three times more likely than women who receive an abortion to be below the poverty level two years later.”

    “We find physical health complications are more common and severe following birth (38% experience limited activity, average 10 days) compared to abortion (24% limited activity, average 2.7 days). There were no severe complications after abortion; after birth complications included seizure, fractured pelvis, infection and hemorrhage. We find no differences in chronic health conditions at 1 week or one year after seeking abortion.”

  6. Shaker Srinivasan says

    @michaeld

    Consider this: had Savita presented herself in a similar condition to her identically qualified OB/GYN in Canada, Japan, UK, or India, would you have any doubt that she’d have been alive today? I don’t. I’d wager that the chances of her being alive today would be high, had she been attended to by the same [Catholic] doctors and hospital staff in these countries instead of Ireland.

  7. Matt Penfold says

    Consider this: had Savita presented herself in a similar condition to her identically qualified OB/GYN in Canada, Japan, UK, or India, would you have any doubt that she’d have been alive today? I don’t. I’d wager that the chances of her being alive today would be high, had she been attended to by the same [Catholic] doctors and hospital staff in these countries instead of Ireland.

    The Irish courts, backed up by the ECHR, have ruled that abortion in Ireland is legal if the woman’s life is at risk. Therefore the doctors could have terminated Survita’s pregnancy legally, but they chose not to do so.

    Now it is true the guidelines issued by the Irish Department of Health are poorly written. However it seems the doctors at no stage sought legal opinion, or applied for hearing before a judge. Therefore we can rule out confusion of the legal situation.

  8. says

    @Shaker:

    I am about half a second from screaming, so forgive the curtness of this response.

    These were doctors. They had the opportunity to save Savita Halappanavar’s* life. They had an opportunity that was presented to them. They had an opportunity they could have taken. In the end they may have gotten in trouble for it, but no judge in the entire world is going to pass blame at doctors for saving peoples’ lives.

    The politicians are partially responsible, yes. The doctors are also partially responsible. But it is the doctors who killed Savita by refusing to provide medical attention. Politicians couldn’t have saved Savita at that time. Only doctors. Doctors who refused to help Savita.

    (I will eschew my usual overuse of pronouns in this post and all subsequent posts about Savita Halappanavar so that I never forget her name.)

  9. sheila says

    The doctor’s did what they did (and more importantly, what they didn’t do) because of catholic dogma.The politicians did what they did (and more importantly, what they didn’t do) because of catholic dogma.

    Either way, catholic dogma killed Savita. Not that I’m letting doctors or politicians off the hook.

  10. says

    At the end of the day if you follow an unjust law that puts someones life in greater risk and they die you are personally morally responsible for that death. It doesn’t matter to me that they may or may not be legally responsible or that others don’t share in the blame. At the end of the day people who look on and gamble with peoples lives in the face of dangerous laws are the ones first and fore most responsible for that death.

    If I put you in a real Milgrim style experiment where a potentially lethal blast of electricity will hit a person. There’s a switch you can flick to prevent/stop that electricity but someone tells you you can’t flick it. If you don’t at the end of the day you were there and you could stop it and save them.

  11. left0ver1under says

    I hate to jump to a conclusion and claim racism, and I haven’t read all the threads and news to know if it was, but I have to wonder if her ethnicity, being from outside the UK and ROI, and not being a christian played a role in her murder. Would she have been mistreated and killed if she were Irish or British?

    Yes, I do consider her death to be a murder. And I wouldn’t be surprised to hear that they they held her hostage, preventing her from leaving and obtaining treatment that might have saved her life. The Irish government has young women hostage in the past, preventing them from travelling to another country for an abortion.

  12. Rohit Verma says

    These are the contacts of the OBG team of Gallway hospital.
    You guys can lodge a protest to them
    Obstetrics and Gynaecology
    Prof. J. Morrison:091 – 544717
    Dr. G Gaffney:091 – 544717
    Dr. D. Egan: 091 – 515600
    Dr. F. Cullinane:091 – 542008
    Dr. M. O’Leary: 091 – 544528

  13. says

    Shaker – it’s telling that you don’t include the US in your question. You’re quite right: what happened to Savita also happens here, and not seldom.

    You peeps do realize Savita is only the tip of the iceberg, yes?

    I’ve just been re-reading the report by the National Women’s Law Center from January 2011, which makes it crystal clear that it happens, regularly.

  14. ismenia says

    Yesterday, my mother and I were discussing Bring Up The Bodies and what an arsehole Henry VIII was. I found myself thinking that I am so glad that Britain is not a Catholic Country. At least we don’t get this level of crap from the CofE (we do get some crap but that’s another discussion).

  15. Shaker Srinivasan says

    Ophelia,
    Yes, I am quite aware of the situation here in the U.S. I couldn’t have been happier with the results of the recent elections. Had they been otherwise, efforts such as this would have gathered such a momentum that would have hurtled this country into a religious abyss – Ohio HB 125 [Bill to amend section 4731.22 and to enact section 2919.19 of the Revised Code to generally prohibit an abortion of an unborn human individual with a detectable fetal heartbeat]

  16. Amy Clare says

    I can’t imagine how terrified Savita must have felt as she realised the doctors were going to let her die. Those doctors must have known what needed to be done, but chose not to do it.

    I can only think of two scenarios. Either they were so cowardly and selfish that they thought more about getting arrested/sued than about a woman’s life, or they actually agree that a woman’s life is inconsequential when compared to a fetus’s.

    Given that they could have successfully argued that Savita’s life was in danger, I can’t see how they could have had any real fear of prosecution. They could have taken their case successfully to the European Court of Human Rights if it came to it. So I end up concluding that those doctors willingly let Savita die because they agreed that her fetus’s life was more important.

    There ought to be laws to *protect* women from deranged ‘doctors’ like this.

  17. Shaker Srinivasan says

    @jb
    One of the most unbelievably beautiful things every member of the clergy can do is flagellate himself to death to atone for every abortion that is performed in every part of the world. Shall we start with the Pope?
    [Thanks for the link; I am sharing it on my FB page]

  18. rnilsson says

    @ #3 shaker:

    The doctors shouldn’t have to bear the brunt of the blame here. It should go to self-serving politicians and religious zealots.

    Sorry, but I disagree. “But I was only following orders” defence died in the Nürnberg trials. War crime is war crime, also crime against humanity.

    Suppose a metropolitan bus company neglects to maintain its vehicles properly, the police swoop down for a road safety check and every single bus is deemed not traffic worthy – it must be removed from duty immediately. A month later the police perform another check and 21 out of 23 inspected buses are similarly condemned.

    Now, can a bus driver push the blame onto that company if the brakes fail and s/he causes a fatal accident? I very much doubt that. IANAL, but as I understand it, the driver always carries the ultimate responsibility. S/he has a duty to check it hirself, and if the vehicle is unsafe, s/he is obligated to refuse to take it onto the streets.

    The same principle really should apply to doctors, in fact to an even greater degree. Not to say the powers that be are blameless – they too ought to be punished sharply – but if you actually pull the trigger you get to pay the penalty. That is what Savita Halappanavar’s doctors/killers did in this case. Every one of them. Enjoy your porridge, Dox.

    And that is my not-so-humble opinion in this matter.

  19. says

    Shaker’s right though. In the US, at least, it’s hospital administrations that tell doctors not to do the medically necessary abortion, and it’s bishops who tell hospital admins to do that, and it’s the state that looks the other way.

  20. rnilsson says

    Well, I “appreciate” all that. What I’m saying is, simply, that the principle of personal responsibility has been well established in the case of genocide, war crimes and other atrocities against humanity. It is a pity that so far only a handful of such culprits have ever been brought to justice in The Hague etc.

    These hypocritical killers (a term most ironical here) also deserve to be made an example of, pour encourager les autres. By all means, also go after the background upholders in Church and Establishment – but first punish the monkey, as Mark Knopfler sings. No need at all to let the organ grinder go.

    These doctors sat in the driver’s seat and cold-bloodedly threw their own patient under the proverbial bus, only in order to assuage their imaginary sky lord’s viceroys. At the very very least, take them out of traffic!

    It may be useful also to look into the office for prosecution …

  21. rnilsson says

    Then we agree. One way to get at the higher-ups in the higherarchy :) might be to provoke the actual responsible killers to accuse their eggers-on for their dirty deed. My thinking. Not Irish, or I might be tempted to find a serious weapon to bring to them all. (Small blessings?)

  22. says

    Well that’s actually true, I think. The way I understand it from reading the NWLC report, the doctors could simply turn the admins in for breaking the law. In other words, the doctors have the goods on the administrators. There are a lot of doctors at a lot of hospitals who could (if they only would) testify in court that their bosses ordered them not to perform lifesaving abortions. That’s not legal.

  23. rnilsson says

    Yabut, wouln’t that put the doctors at personal peril themselves? After all, it was they who – whether actively or merely passively – needlessly killed their patient. And traditionally, doctors swear an oath to not needlessly kill their patients, in my understanding.
    So, first step should be to indict the doctors for murder or manslaughter, resulting in their subsequent unfrockment. That would at least remove this particular obstacle to their pointing an accusing finger. Perhaps lure them with some kind of immunity?
    Then go to town on their “superiors”! Do they have tar&feathers in Eire?

  24. says

    Yes, probably, plus many might not want to, given that they work at Catholic hospitals in the first place. That’s why I said “(if they only would)”…I think most wouldn’t, at least not unless something changes. I’m talking about US doctors here.

  25. rnilsson says

    Understood. My point was that it might serve as an incitement to do that in their own defence against a murder rap, in the actual instant case.
    Hypothetical, hypocritical – just smash this particular ball right out of flight! Again, my opinion.

  26. Sili says

    I really hope the consulting physician has his (according to the news reports he’s a he) license to practice medicine revoked for gross malpractice.

    Meh. He’ll just rehired as a hero in the US.

  27. Pteryxx says

    Three Catholic bloggers have all claimed that Catholic doctrine permits inducing delivery of a fetus certain to die. However nobody but apologists seems to be aware of this supposed option; see Daylight Atheism with numerous counterexamples here:

    http://bigthink.com/daylight-atheism/catholic-bloggers-dont-understand-catholic-doctrine?page=all

    That sounds very reasonable and compassionate. So here’s my problem with it: If Catholic teaching allows for the inducement of a nonviable fetus to save a woman’s life, how come the Catholic church doesn’t know that?

    The reason I ask is that, in every case I’m aware of where the Catholic church has had the power to set law or policy, the policy they create is the same one that killed Savita: that doctors can’t do anything as long as there’s a fetal heartbeat, even if the woman is dying before their eyes.

    (h/t Andrew G.)

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