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Dear Ireland, the answer to allowing medical necessary abortion isn’t an inquisition

The coroner and jury in the inquest into the death of Savita Halappanavar arrived at the same conclusions that I have long held: that the prohibitive Irish abortion law played a role.

Ms. Halappanavar needed her uterus evacuated before Wednesday (preferably on the Monday), but under current Irish law a woman apparently has be waiting in death’s antechamber to get a termination. To evacuate a uterus so a women doesn’t get gravely ill is simply not an option. 

The coroner and jury recommended that the Irish Medical Council lay out guidelines to decide when exactly a doctor can intervene to save the life of the mother. What has apparently been proposed is a panel of six doctors to review each case

Canada used to have a panel of 3 doctors although that was never for medical necessary terminations, it was for elective cases. Women had to prostrate themselves, begging for mercy. This was deemed unconstitutional along with all abortion laws, and so now in Canada abortion is not legal or illegal, it is simply a medical procedure.

An abortion panel, especially one where the procedure is part of the medical care, is ludicrous and, as Dr. Anthony McCarthy an Irish psychiatrist has so eloquently stated, is “abusive to women.” Panels are a terrible idea. The concept is degrading. Women shouldn’t have to beg for health care (and if you are gravely ill, do you leave your hospital bed to petition for your life or does the panel come to you?). And what if the panel members disagree? If 2 say, “Yes, abortion is needed,” and 4 say, “Well, no it isn’t,” does the minority report not count for anything? If 1/3 of the doctors think you have a real and substantial risk of death, wouldn’t that count for something? And how will personal neutrality of the physicians be assured? 

A woman shouldn’t have to prove that she is sick enough or suicidal enough or whatever enough, there should just be recommended treatment options for medical conditions.  

The Irish medical council needs to put on their big boy and girl panties and recommend the following: 

A) List conditions where termination is an accepted part of the medical therapy. For example, they could state (like the American Congress of OB/GYN) that the treatment for chorioamnionitis is delivery, regardless of gestational age. 

B) State that abortion should be allowed when an OB/GYN or appropriate specialist considers that there is medical evidence to suggest that continuing the pregnancy either  increases a woman’s risk of death above the Irish baseline of 8/100,000 live births OR when continuation of the pregnancy could reasonably be considered to have a serious and deleterious effect on the health. While not dying is a worthy goal, we must not forget women whose medical conditions get worse during pregnancy often with permanent consequences. An example might be a diabetic with renal disease that is progressing during pregnancy. Renal failure can be treated with dialysis, but the better option is to prevent that situation rom occurring. Abortion must be allowed for both the life and health of a woman. 

The big “fear” is that if abortion were allowed in Ireland for medical reasons that women would flock to their doctors and claim that they will commit suicide if they don’t get a termination, but that whole construct is insulting to women. That isn’t what happens. Women don’t feign or claim mental illness to get abortion. 

The best answer, of course, is to simply leave the decision for a termination for medical reasons to be a private one between a woman and her physician, which is of course the statement that I’d really like to see from the Irish Medical Council.   

 

 

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Discussion

11 thoughts on “Dear Ireland, the answer to allowing medical necessary abortion isn’t an inquisition

  1. 100% agree with you, Dr. Gunter. As OB-GYN doctor, I know doctors who have the knowledge, judgment and training to make decision what is good for patients. It is a time sensitive issue. Delaying treatment could kill patient’s life. The case is ridiculous. The stupid law should be responsible for her death!

    Posted by Renjie Chang | April 24, 2013, 8:39 am
  2. You might enjoy this article:

    “If she is unable to get on a plane or procure herself the necessary pills over the internet, then she is very likely to be in the throes of a major crisis. The first rule suggested by organisations such as the Samaritans for dealing with someone in a mental health crisis is that if they indicate they are suicidal, you take them seriously….
    What you don’t do is suggest to them that you don’t believe them when they say they’re feeling suicidal; the very last thing you do is pressure them to prove they’re serious….

    any woman who is together enough to fake feeling suicidal will have long ago booked herself a plane ticket or ordered those pills from the internet.

    But reality doesn’t come into this discussion. If we were dealing with reality, we’d accept that abortion already exists in this country in all senses but the geographical.”

    http://www.irishtimes.com/life-and-style/people/forcing-suicidal-pregnant-women-to-prove-they-are-serious-is-cruel-and-dangerous-1.1370025

    Unfortunately the Irish medical council cannot update their guidelines to include risks to a woman’s health. That would be illegal under the terms of the X-Case judgement. Though I would certainly like to see them campaign for it.

    There is the organisation Doctors for Choice which campaigns for decriminisalisation.

    Posted by QoB | April 24, 2013, 8:40 am
  3. Ireland is still totally under the control of the church of Roma and its patriarchal ways.

    Roman rules control every dept in Ireland still from courts to medicine to school to religion etc.

    Members of the church of Roma are not supposed to question anything and especially wombmen and children.

    It all goes back to Eve ill Eve and how all women are here to suffer for Eve’s sin, because poor Adam was not expected to avoid temptation.lol Poor fella.

    So ever since women and children have been the scapegoats- the Evil ones, who tempt these poor men and get themselves pregnant and need to be punished in every way possible…like the Magdalene’s,Unlike the holy Mary’s who had sex and did not get caught out.

    “they determined that women had intelligence which was less evolved than that of men and in particular, poor women.”

    https://www.adoptionhealing.com/Mother%27s_Without_Their_Children.html

    The feeble minded stigma is still placed on all Irish women in family law in 2013.

    There are still secret Inquisition courts where women dare not speak about or go to jail- its the law you know.

    The Inquisition never ended in Ireland but lives on daily in secret and few people outside of Ireland know our secret.

    Thanks to those like you, we now speak our truth as women and we make it so that women in Ireland are no longer second class breeders for the patriarchal system ,

    Posted by ladyportia27 | April 24, 2013, 9:31 am
  4. It all boils down to the catholic church saying ‘ no ‘ to abortions .

    Posted by Jim | April 24, 2013, 12:06 pm
  5. I’m afraid you’ve misread the proposed law. Nobody is suggesting a panel of six doctors for medical interventions.

    Posted by Meeja | April 25, 2013, 7:42 am
  6. Dr Gunter has got two separate issues muddled into one here and its confusing and very misleading. its not proposed that a sick woman has to put her case to six doctors.

    First issue is in relation to legislating for X case to allow abortion in cases where a woman is suicidal – this has the prospect of up to 6 docs needing to ‘sign off’ on it.

    Second issue is the outcome of Savita’s inquest where abortion may be needed when a mothers health is at risk..not just ‘life at risk’ as by the time this happened it was already too late to save Savita. Clarification is to be made regarding which health circumstances would abortion be ok.

    I hope we go to the vote and get it in for whomever requests it.

    Posted by JK | April 25, 2013, 2:24 pm
  7. Dr j you’ve got the facts here mixed up again. The legislation is for 1 obstetrician to make the decision in an emergency; 2 obstetricians in a non emergency, many example of which you give above cancer, cardiac stuff etc (I’m sure the medical council can contact you when they need help drawing up a list); 2 psychiatrists plus 1 obstetrician in cases of suicidal ideation. If a woman is refused a termination they can appeal to a panel of 3 – this would hold in non-emergencies only and in practice for suicidal ideation only. Many psychiatrists on both sides of the abortion argument are very unhappy about it.
    Your comment about the medical councils panties is hard to understand because you should know that they can not issue guidance outside of the law – people would have to vote for a change first or at the very least the gov would have to pass compatible legislation – same as anywhere else

    Posted by Roedole | May 5, 2013, 9:10 am
  8. I’ve no doubt your misapprehensions about this were genuine, but it’s disappointing that you’ve moved on without offering any correction. It’s poor form to tackle such a contentious issue and leave it more confused than before. These things matter.

    Posted by Meeja | May 5, 2013, 10:01 am
  9. Please blog about Beatriz in El Salvador, she’s quickly gonna become another Savita.

    Posted by Oubli | May 30, 2013, 12:03 am

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