Not offering all management options to the patient

A report on the death of Savita Halappanavar was published on Thursday.

The report, described by Minister for Health James Reilly as a “hard-hitting report which spares nobody and doesn’t pull any punches”, identifies three main factors which led to Ms Halappanavar’s death.

They include:

– A failure to adhere to clinical guidelines for prompt and effective management of sepsis when it was diagnosed

– Not offering all management options to the patient as she experienced inevitable miscarriage, even though the risk she faced increased from the time her membranes ruptured

– Inadequate assessment and monitoring that would have allowed the clinical team to recognise and respond to the signs that her condition was deteriorating.

That seems like a less than “hard-hitting” and no punch pulling way of putting it. It’s not just that the hospital didn’t offer the patient all management options, it’s that the hospital refused the Halappanavars’ urgent requests for the most obvious and effective management option. Refused them. Repeatedly.

The report, which does not mention any names, also makes significant recommendations aimed at improving legal clarity and medical handling of complicated obstetric emergencies, including sepsis which led to Mrs Halappanavar’s death.

It found an apparent over-emphasis on the need not to intervene until the foetal heartbeat stopped and not enough emphasis on the need to focus on monitoring and managing the risk of infection. “The interpretation of the law related to lawful termination in Ireland, and particularly the lack of clear clinical guidelines and training, is considered to have been a material contributory factor in this regard,” the report added.

Deranged focus on the heartbeat of a fetus that is not going to survive, at the expense of focus on the condition of the adult woman who wants to live and get pregnant again and be happy. It’s a sick, morbid, hateful system.

Among the report’s main recommendations are:

– The Oireachtas should urgently consider amending the law – including any necessary Constitutional change – to help provide clinicians with a clear legal context for the management of “inevitable miscarriage”

If the bishops will let them, or fail to prevent them.


  1. Brian Lynchehaun says

    I completely agree with you, except regarding the bishops. They haven’t had significant power in decades.

    At this point, the only thing holding back decent law-making is cultural inertia, and the belief that they need to act conservatively because everyone in the country wants them to act conservatively.

    With regards to religiousity, Ireland flipped in a single generation (I don’t mean that the kids are less religious than the parents, I mean that Ireland became less religious generally), from highly religious to virtually none. The politicians are still operating under the old view.

  2. says

    Still amazed that they can make the heartbeat the absolute marker of a patient who must be cared for and then ignore the heartbeat of the mother…

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