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abortion, pregnancy

How sick must a pregnant woman be in Ireland for her doctor to say her life is at risk?

While a full analysis of the tragic case of Savita Halappanavar’s death from sepsis at 17 weeks in her pregnancy is not possible without access to her medical records, there is a key piece of information provided by her husband that supports his claim that a termination was not allowed or was delayed because of the law. It is the fact that the medical staff were checking fetal heart tones. Not just once a day as is sometimes done during a previable induction so the mother knows which day her baby died, but several times a day.

Fetal heart tones are not checked with any medical purpose in mind until viability (around 23-24 weeks). The presence of fetal heart tones was irrelevant because survival of a baby at 17 weeks with ruptured membranes and/or advanced cervical dilation is impossible. Ms. Halappanavar was not 22 weeks pregnant where there might be a 3% chance of survival (depending on weight, sex of the baby, gestational age, whether it is a singleton or a multiple gestation etc). At 17 weeks with ruptured membranes, regardless of cervical dilation, this pregnancy could only end in with a fetal demise. In a study from 2006, when membranes ruptured at 21 weeks or less the outcome was “dismal.” In fact, in this study there were no survivors when membranes ruptured between 18 and 19 weeks. Whether a fetus has cardiac activity at 17 weeks with ruptured membranes and a dilated cervix is simply not part of the medical decision making tree.

Then of course there is the matter of infection. When membranes rupture at 17 weeks the risk of infection just walking in the hospital door is 30-40% and, according to the American College of Obstetrics and Gynecology (ACOG), “At any gestational age, a patient with evidence of an intrauterine infection….is best cared for by an expeditious delivery.” By her husband’s account, she had abdominal pain on or shortly after arrival, a potential sign of infection. On the Tuesday, two days after she was admitted, he reports that she was shaking and complaining of chills. In this scenario those symptoms can only mean infection. And when a woman with a previable fetus has an intrauterine infection the treatment is not antibiotics and watch the fetus, it’s antibiotics and expeditious delivery.

I’m told that while Irish law technically allows abortion to save the life of the mother, many practitioners fear recrimination and exactly when the life of the mother is “at risk” is a murky question. I can easily argue that Savita’s life was at risk the moment her membranes ruptured at 17 weeks. However, does Irish law mean a different kind of risk? And if so, how would doctors judge that risk to be present? Ruptured membranes and fever? Shaking chills? Bacteria in the amniotic fluid? Positive blood cultures? Sepsis? Cardiovascular collapse? How sick must a pregnant woman be in Ireland be for a doctor to state that her life is at risk?

Whether the delay in Ms. Halappanavar’s care was fear of criminal repercussions or personal dogma, both of these scenarios are permitted to exist because of laws that trounce evidence based medicine. Her husband’s claim that Irish law played a role rings true because the team was checking for fetal heart tones when the only vital signs that mattered were Savita’s.

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Discussion

33 thoughts on “How sick must a pregnant woman be in Ireland for her doctor to say her life is at risk?

  1. ….relevant paragrphs from a publication of Catholic health Association USA,

    http://www.chausa.org/Pregnancy_complications_can_bring_on_complex_ethical_questions.aspx

    “The beginning-of-life directives are grounded in a concern for the “inherent worth and value of every human life due solely to the fact that we are made in the image and likeness of God and destined for eternal union with God,” Slosar said during his presentation on “Ethics at the Beginning of Life: Complex Cases, Difficult Decisions.” Slosar is senior director of ethics for St. Louis-based Ascension Health.

    He said that this concern for human dignity leads Catholics to recognize an obligation to preserve life and a corresponding obligation never to directly kill innocent human life. Complex ethical issues may arise when there are two lives at stake — the mother’s and the baby’s — and the effect of a therapy would be good for one of them and bad for the other.

    The principle of “double effect” is generally relevant in such cases, said Slosar. When applied to medical cases, this principle suggests that a treatment that offers a benefit but that also has a foreseen harmful effect can be justified in some cases. It can be justified when the treatment is therapeutic, the harm is an unintended side effect, a less harmful treatment is not available, the benefit is equal to or greater than the harm, and the harmful effect is not the means used to achieve the intended benefit.

    Slosar said that these concepts are codified in directives 47, 48 and 49. Directive 47 says that therapies whose purpose is to cure a serious condition in a pregnant woman are justified if they cannot be safely postponed, even if they result in the death of the fetus. Directive 48 says in the case of an extrauterine pregnancy — or a pregnancy occurring outside of the uterus — no therapy is allowed that is a direct abortion. (Directive 45 provides the definition of a direct abortion — a procedure that is not permitted in a Catholic hospital.) Directive 49 says that labor may be induced after a fetus is viable if there is a proportionate reason to do so.

    Slosar explained how each directive might be applied to patient situations.

    He described the fictitious case of an expectant mother at 20 weeks’ gestation with preterm premature rupture of membranes causing leakage of amniotic fluid, a condition that puts the life of the preterm fetus at serious risk and that puts the mother at risk for a life-threatening infection. Intravenous antibiotics are administered, but the mother develops a life-threatening infection anyway. In order to eliminate the infection source, the patient and her physician consider inducing labor. The direct intention is to evacuate the infection, an infection that in this case can only be treated through the removal of amniotic fluid. This treatment outcome can only be achieved if labor is induced, in this scenario. That course would result in the death of the baby, who has not yet reached the age of viability.

    Directive 47 states: “Operations, treatments and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.”

    Applying directive 47 to the example of the woman’s crisis pregnancy, Slosar explained that the physician could be justified in inducing labor because the intention is to eliminate an infection that is threatening the mother’s life and because other treatments have not been successful. The baby’s death is a foreseen, but unintended, consequence.”

    ….there is more there, on anencephaly & the ectopic pregnancy treatment debaet….

    He said that this concern for human dignity leads Catholics to recognize an obligation to preserve life and a corresponding obligation never to directly kill innocent human life. Complex ethical issues may arise when there are two lives at stake — the mother’s and the baby’s — and the effect of a therapy would be good for one of them and bad for the other.

    The principle of “double effect” is generally relevant in such cases, said Slosar. When applied to medical cases, this principle suggests that a treatment that offers a benefit but that also has a foreseen harmful effect can be justified in some cases. It can be justified when the treatment is therapeutic, the harm is an unintended side effect, a less harmful treatment is not available, the benefit is equal to or greater than the harm, and the harmful effect is not the means used to achieve the intended benefit.

    Slosar said that these concepts are codified in directives 47, 48 and 49. Directive 47 says that therapies whose purpose is to cure a serious condition in a pregnant woman are justified if they cannot be safely postponed, even if they result in the death of the fetus. Directive 48 says in the case of an extrauterine pregnancy — or a pregnancy occurring outside of the uterus — no therapy is allowed that is a direct abortion. (Directive 45 provides the definition of a direct abortion — a procedure that is not permitted in a Catholic hospital.) Directive 49 says that labor may be induced after a fetus is viable if there is a proportionate reason to do so.

    Slosar explained how each directive might be applied to patient situations.

    He described the fictitious case of an expectant mother at 20 weeks’ gestation with preterm premature rupture of membranes causing leakage of amniotic fluid, a condition that puts the life of the preterm fetus at serious risk and that puts the mother at risk for a life-threatening infection. Intravenous antibiotics are administered, but the mother develops a life-threatening infection anyway. In order to eliminate the infection source, the patient and her physician consider inducing labor. The direct intention is to evacuate the infection, an infection that in this case can only be treated through the removal of amniotic fluid. This treatment outcome can only be achieved if labor is induced, in this scenario. That course would result in the death of the baby, who has not yet reached the age of viability.

    Directive 47 states: “Operations, treatments and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.”

    Applying directive 47 to the example of the woman’s crisis pregnancy, Slosar explained that the physician could be justified in inducing labor because the intention is to eliminate an infection that is threatening the mother’s life and because other treatments have not been successful. The baby’s death is a foreseen, but unintended, consequence.”

    ….there is more there, on anencephaly (no!!) and the ectopic treatment (debates!!) and Ascension health is a huge chain of catholic hosptals, their own website explains why its wrong for them, even to refer a patient, to someplace else that wld do the abortion….

    Posted by Sgaile-beairt | November 20, 2012, 2:44 pm
  2. um i dont know why that pasted several times, you can delete the repeats!!

    Posted by Sgaile-beairt | November 20, 2012, 2:44 pm
  3. Reblogged this on Trans/plant/portation and commented:
    I nearly always find questions of degree helpful in breaking down reductive arguments, and Dr. Gunter does it very well in this article on the woman who died last month in Ireland when doctors refused her an abortion.

    Posted by evmaroon | November 20, 2012, 3:03 pm
  4. Your blog should be prescribed reading for our politicians. Emma (Ireland)

    Posted by demosthenes10 | November 20, 2012, 3:15 pm
  5. Thanks so much for your coverage on this.

    Have you seen this?

    http://www.nwlc.org/resource/below-radar-health-care-providers-religious-refusals-can-endanger-womens-lives-and-health

    It’s a report by the National Women’s Law Center on situations exactly like Savita’s. Catholic hospitals in the US – not Ireland, the US – are *told* to wait for the fetal heart to stop, no matter what the mother’s condition is.

    I’m guessing there are a lot of deaths like Savita’s here that never get reported because the survivors don’t know what happened.

    Do you know if there is anyone anywhere who tries to monitor this? It seems like an all but hopeless task. It’s making me furious…

    Posted by Ophelia Benson | November 20, 2012, 3:17 pm
    • I can tell you that I spent time working in a Catholic hospital in NYC and management of OB complicatons were far less inflexible. The classic case, for example, is treatment of cervical cancer in early pregnancy – the aim was always to treat the cancer first and foremost.

      Posted by Ben Rush MD | November 28, 2012, 2:11 pm
  6. When everyone is thinking the same it usually means that nobody is thinking at all.The pro abortion/choice lobby around the world are judge and jury over Irish medical professionals who with their midwifery colleagues have helped Irish maternity units to be consistently in the top 3 or 4 in the world for maternal health.(and the uSA is where in the table ?….ah I thought so silence ) Adjusting for statistical accuracy when comparing an average of 70,000 live births per year extrapolated to 100,000 for the comparitive ratios we are actually number one in the world for maternal health.The abortion lobby is also omniscient regarding all of the facts regarding the Galway tragedy…for example was the deadly anti biotic E-coli infection acquired before or after hospitalisation? acquired in the hosptial through poor hygiene practice or from food prior to presenting…15 healthy adults died in germany last year due to a deadly e-coli infection…Btw does an abortion actually reverse an aggressive e-colli infection? the president elect of the Indian federation of oby/gyns appears to dissent from the party line…”abortion may have hastened the death of Savita” the medical report will reveal the truth. http://www.thehindu.com/news/cities/bangalore/city-doctor-defends-irish-counterparts/article4100988.ece

    Posted by Ray Mc Intyre | November 20, 2012, 3:25 pm
    • So, are you trying to claim that Ireland’s overall maternal health outcomes REQUIRE women to be denied full reproductive health care? That the refusal to allow abortion is somehow causally related to why other women have healthy pregnancies? It doesn’t matter if a hospital system is great for 99% of its patients–if it refuses to provide care that would improve the health & save lives of those 1% of patients, it is a grotesque violation of those 1% of patient’s rights, and no matter how great the medical system is for other patients, it is no excuse for violating the rights of those who are victimized by ideological discrimination and refusal of care.

      If you knew anything about gynecology, you would know that a dilated cervix and ruptured membranes are a huge risk of infection in and of themselves, and that the fetal tissue would act as a reservoir for infection as long as it was present in that situation, so removing it is in fact essential for management, and as Jen mentioned above, prompt delivery/termination in the context of infection is standard of care. And no, timely abortion would not have hastened Savita’s death, because it was the pregnancy itself and the prolonged exposure to the vaginal flora in the context of medical neglect that caused the septicemia to become so severe over the course of those days of neglect. If she had received a termination when she requested it, she never would have developed such septicemia, and more importantly, SHE, Savtia, as an individual deserves to decide whether or not she wishes to endure the risks of infection from a prolonged miscarriage–she chose not to, but she was forced to endure it against her will. Even in the highly unlikely event that she somehow had a severe infection unrelated to the gaping hole in her reproductive tract, she still deserved the right to decide that the pain and additional risk of having non-viable, flora-exposed tissue in her uterus was not a risk she wanted to take.

      Posted by LeftSidePositive | November 20, 2012, 8:40 pm
    • “When everyone is thinking the same it usually means that nobody is thinking at all.”
      So, let me get this clear: When everybody thinks that raping children is wrong, it means that nobody is thinking at all? When everybody thinks that nuking the whole world is a bad idea nobody is thinking at all? And when everybody thinks that a woman dying in horrible pain from a curable infection is bad, nobody is thinking at all?
      That’s just stupid.
      First of all, the Irish statistics are regarded as widely unreliable. First of all they export the abortion related mortality and morbidity are exported, of course. And before you take that as a concession that abortion is soooo dangerous, let me explain. Obviously, if a pregnancy is a serious threat to your health and life, an Irish hospital is not the place to go. Not all cases are emergencies as Savita Halappanavar’s. With cardiac problems your life might never be in accute danger until you’re dead so it is a forseeable risk and means that a woman will seek an abortion in the UK. It also means that this woman is at a much greater risk of death than your usual 1st trimester abortion. How convenient to point at those deaths then and say “abortion kills women”.
      Secondly, the avaible records for Irelans are unsystematic (there’s an attempt to change that) and they are very narrow. While other countries count suicide due to PPD in their statistics, Ireland doesn’t do that because heaven forbid you to admit that a pregnancy and child might not be all rainbows and unicorn farts.

      “for example was the deadly anti biotic E-coli infection acquired before or after hospitalisation? ”
      How is that relevant? The fact is still that the infection was there and should have been treated by evacuating the uterus. Failure to do so killed Savita Hallapanavar.

      “15 healthy adults died in germany last year due to a deadly e-coli infection”
      Before you spin this a little further: those deaths were the result of an epidemic with an exceptionally aggresive and resistent type of e.coli that got transmitted via contaminated bean sprouts. And to stay with the idea: Authorities closed down the producer of said sprouts and didn’t allow them to produce more of the infection just to treat people afterwards.

      “Btw does an abortion actually reverse an aggressive e-colli infection?”
      I’m glad you finally showed that what you probably need is biology 101. I’m going to use an analogy you might understand. Let’s say you get a nasty sliver in your foot, which leads to an inflamation and an infection, making you drip puss. Now, would you think that the sliver is the infection? No. Would you think that removing the sliver alone will cure the infection? No. Would you think that you can cure the infection while still keeping the sliver in your finger? No and no again. You need to remove the sliver AND you need to treat the infection. Now apply to Savita Hallapanavar and the fetus.

      Posted by Giliell | November 21, 2012, 2:57 am
  7. ….ophelia i really do think the fact that they hadnt figured out what to put on her death certifcate even after thy called the police, for the mandatory report of a death, is a big tell that theyre not getting reported right in ireland….not to metnion what others are now saying happened to them….a near death case in an australian catholic hospital just tweeted….why shld the us be any different??

    http://www.dailylife.com.au/news-and-views/news-features/would-savitas-plight-have-been-different-in-australia-20121120-29ntw.html

    Posted by Sgaile-beairt | November 20, 2012, 3:43 pm
  8. Dr Jen, I think you’ll appreciate this story – http://www.independent.co.uk/news/world/europe/uturn-for-irish-health-chiefs-as-senior-consultants-are-axed-from-team-leading-probe-into-death-of-savita-halappanavar-8335072.html – where some-one at least is interested in finding out what actually happened. Sad that it has to be bereaved husband who still has his wits about him.

    Posted by Maureen Brian | November 21, 2012, 12:04 am
  9. With utmost respect , take away Ireland in the subject line , and substitute Catholic countries , instead .

    Posted by Jim ( aka@riiibbit ) | November 21, 2012, 12:47 am
  10. ….idiot prolifers on twitter, now asking, again, how abortion can cure septicaemia?? also, wldnt a c-section have been “better’ as not “REALLY’/’ an abortion(!!) …. obviously don’t know JACK abt standard of care, best practices, or gynaecology….

    Posted by Sgaile-beairt | November 21, 2012, 3:49 pm
  11. ….also a sharp clear line between “risk to health” & risk to life, in a miscarriage, “no grey areias’ displaying such ignorance…. whats the name for when u combine ignorance & arrogance, isnt there a syndrome now??

    Posted by Sgaile-beairt | November 21, 2012, 4:10 pm
  12. ” ..whether the delay in Ms. Halappanavar’s care was fear of criminal repercussions….” – please dismiss this out of hand (yeah,I know no chance of that!). NEVER, has any criminal sanction even been CONTEMPLATED OR INITIATED in Ireland in this setting even as Ireland is the most medical litiginous. So,that can be excluded.

    Besides,any Irish physician I have ever known wouldn’t give two F…s for the law if he/she thought it was the ethical responsibility to save the life of the mother. So,nothing comes to mind right now except a deeply disturbed religious perversion but some decency requires waiting for more information and the use of ‘KILL” in the title of an earlier posting by Dr. Gunter is not fair.

    One poster disputes Ireland’s world class status in regard to maternal mortality (eg., UNfpa reports for 1995-2010) suggesting that women who go abroad for pregnancy termination (about 5000/year,mainly to GB) keep the numbers low! Our British friends will surely love to hear that all these Irish women are dying in their care and so make the Irish record so outstanding.

    Posted by s branagh | November 21, 2012, 9:46 pm
    • Given what you say, and towards what I too was veering to after reading (not exhaustively but reasonably) about ground realities in Ireleand, I am sorry I have to say this: The doctor/s did not stress himself/themselves much because the lady in question was not a Catholic and not from Ireland, and perhaps primarily because she was not a White. An Irish citizen, in Savita’s place, would have seen her pregnancy terminated without waiting for the fetal heart beat to stop or at the very least not waiting for as long as 2.5 days.

      If what I say above is indeed true (at least I am forced to think that way given the ground realities) then it does not mean a majority of Irish are racist. Always, in such cases, it is a few bad apples and the doctor/s would be really rotten ones if my above-stated thinking is not wrong. And I will be the first one to acknowledge that here, in India, racism is indeed practised and when Dalits are not being made the victims, the victime can indeed be the white foreigner (particularly when it comes to stealing, extortion and every now and then even sex crimes and offences).

      Posted by Rajesh Gajra | November 22, 2012, 2:00 am
      • Rajesh – I don’t have precise figures but about half the medical professionals in University Hospitals in Ireland are not Irish and a considerable number are from South Asia especially India. The extraordinary response of individuals,members of the Parliament,Prime Minister,President would probably occur nowhere else if it was an Irish person in a similar situation.

        There is NO suggestion by any side especially the many thousands who are protesting (10-16,000 people last Saturday in Dublin) what happened had anything to do with racism but had to do with the lack of clarity in Irish Law.

        In the county that is next to Galway,Moosajee Bhamjee,an Indian physician (via South Africa) was elected to the Irish Parlaiment in 1992 even though there were only a few Indians in the entire county at that time.

        The racism situation is being monitored fairly carefully for member countries of the European Union and Ireland ranks quite well at all levels but Irish Society at all levels are working to do much better.

        Posted by s branagh | November 22, 2012, 3:27 pm
    • >Rajesh – I don’t have precise figures but about half the medical professionals in University Hospitals in Ireland >are not Irish and a considerable number are from South Asia especially India. The extraordinary response of >individuals,members of the Parliament,Prime Minister,President would probably occur nowhere else if it was an >Irish person in a similar situation.

      Yes, absolutely. The response was very big and very encouraging, and I will say I was pleasantly stunned (and not because the victim was an Indian but on the issue’s own merit). Further, I have not doubt that on the streets among lay Irish men and women there will not be any reason to fear racism (although I personally have gone through one subtle racist incident when on a major shopping area street in London in 2009 when I was there on a 4-day trip; but that was London and not Ireland).

      Yet, I am nagged by a doubt that at the level of doctors, particularly senior doctors, there is a possibility of racial bias. This is assuming that the deciding doctor/s at Galway hospital where Savita was admitted did not include any Indian/South Asian. I will be happy to be proved wrong on this. It will be nice to have a reasonable confirmation of the fact that no Savita-like emergency situation (where mother’s condition was as bad as Savita’s was) ever occurred in the last 2 decades in Ireland or if it did it whether it resulted in the same “Sorry, we are a Catholic country and can’t abort till the fetal heart is beating” response from the doctor. If indeed a Savita-like case has occurred in the past with an Irish woman and doctors have aborted immediately without the “Catholic country” response then why did they not do the abortion immediately in Savita’s case?

      Posted by Rajesh Gajra | November 23, 2012, 5:30 am
  13. I’m afraid another story has emerged, Rajesh.

    http://www.secularism.org.uk/news/2012/11/another-irish-abortion-scandal-emerges – an Irish woman this time but the same reasoning (sic) on display.

    Posted by Maureen Brian | November 23, 2012, 11:23 am
    • Thanks, Maureen, for the link and I see at least one other newspaper to have picked it up. But the details of this case are not comprehensive and from whatever details are there it appears to me the situation at the time when the hospital doctors told her they can’t carry out an abortion on her child was not dire (as it was in Savita’s case). I say this not to to underplay the danger to the woman’s health and that case also sickens one.

      In Savita’s case, there is that possibility that the senior doctors (not the junior-level consultants and nurses) tended to be cavalier in their judgement of the danger to Savita’s life perhaps because they did not connect emotionally with her as she was not a Catholic and not an Irish-born woman.

      Of course, I could be wrong in all this. But are we to blindly assume that racism is just not possible (although I will not assume that in India and will be the first one to admit racial bias where I sense one) among Irish doctors?

      Posted by Rajesh Gajra | November 27, 2012, 1:30 am
      • I’m not for a minute ruling out the possibility of racism. It has been proved, usually after great effort, to be an unacknowledged factor in other hospital deaths.

        You say though, Rajesh, that the second case does not show such clearcut danger to life. I would disagree with you. Where chemotherapy is the appropriate treatment for a cancer there is, surely, a window of opportunity during which it should be started to achieve the best possible outcome – usually as soon as possible.

        I am not a medic but am very aware of this from the story of my late sister. She had had ovarian cancer, was in remission but was having regular blood tests. As soon as they showed the CA125 was up it was straight to the hospital and another round of chemo to start in a couple of days. Then she got a slight cold – one which in a well person would barely be noticed – the treatment was delayed for just a week and when it was performed it was ineffectual. It was not certain it would work but the delay tipped the odds, as the doctors acknowledged.

        I don’t think any of use, even the most highly qualified, which I am not, can judge the odds or predict the precise moment of someone’s death. Nor should we!

        We can only use the knowledge we have to say “this significantly increases the risk” and take the best action we know to preserve life. Which makes the two cases the same in all essentials.

        Posted by Maureen Brian | November 27, 2012, 2:30 am
  14. ….here is the relevant guidelines, from the irish medical coundil….see p21….no health exceptn only life….not allowed to refer or ‘encourge” patient to have abortion….all very vague….not sure how binding tehse guidlines are, since we know women who go to england dont get help @ home after….

    http://www.medicalcouncil.ie/News-and-Publications/Publications/Professional-Conduct-Ethics/Guide-to-Professional-Conduct-and-Behaviour-for-Registered-Medical-Practitioners-pdf.pdf

    http://www.irishstatutebook.ie/1995/en/act/pub/0005/index.html

    Posted by Sgaile-beairt | November 24, 2012, 8:17 am
  15. ….also did you see Yvonne nolan, posted this??

    http://twitpic.com/bfp2nc

    Posted by Sgaile-beairt | November 24, 2012, 9:35 am
  16. http://www.irishtimes.com/newspaper/ireland/2012/1124/1224327042133.html

    Timeline of Sativa’s death as reported by her husband.

    Posted by Oubli | November 26, 2012, 1:00 pm
  17. Rajesh, you might be interested in this – http://www.guardian.co.uk/world/2010/apr/04/martin-jacques-racism-justice-hongkong – as I know the author slightly and know for certain he can be trusted, would I deny racism? Even if I wasn’t onto it long before this happened?

    Posted by Maureen Brian | November 27, 2012, 2:41 am
    • Yes, Maureen, while the news of Hari’s husband winning the case in Hong Kong courts (the link that you shared) is something I was not aware of (thanks for sharing the link), I became aware of Hari’s case a couple of years back itself. I was deeply moved by the facts of the case.

      Hong Kong is notorious for this kind of racism, and a subtle form of it was experienced by me as well when I was there on a 2-day official trip 3 years ago (its a long story that needs a separate comment by itself). In fact, I came across Hari’s case after returning from my Hong Kong trip, when I was googling instances of racism in Hong Kong.

      It is indeed some relief that the Hong Kong courts have given justice to Hari’s husband, whom you know slightly, and Hari’s son, although the ideal thing would have been for Hari to be alive and with her husband and son.

      Posted by Rajesh Gajra | November 27, 2012, 3:22 am
  18. >>I’m not for a minute ruling out the possibility of racism. It has been proved, usually after great effort, to be an unacknowledged factor in other hospital deaths.

    Yep, Maureen. True.

    >> I don’t think any of use, even the most highly qualified, which I am not, can judge the odds or predict the precise moment of someone’s death. Nor should we!
    >>We can only use the knowledge we have to say “this significantly increases the risk” and take the best action we know to preserve life. Which makes the two cases the same in all essentials.

    It is possible I am emotionally biased but I was really hamstrung to be sensitive about that woman’s case due to the lack of elaborate details in the newsreports. And I am really trying to go beyond my Indian-ness to see whether Savita’s case really was not more bad than the other case. But so far, and even I am not a medical expert, my basic intelligence tells me that Savita’s case required the most urgent intervention which it did not get.

    Posted by Rajesh Gajra | November 27, 2012, 3:36 am

Trackbacks/Pingbacks

  1. Pingback: Not just Ireland | Butterflies and Wheels - November 20, 2012

  2. Pingback: Can Georgia law force a woman to have a c-section for a non viable, premature fetus? « Dr. Jen Gunter - January 8, 2013

  3. Pingback: Woman dies in Galway Hospital after being refused termination - Page 761 - February 16, 2013

  4. Pingback: ACLU should sue the doctors as well as bishops over denied medically indicated abortion | Dr. Jen Gunter - December 4, 2013

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