Monday, September 15, 2014

THE HSE has said that some of the commentary surrounding the case of a woman who underwent a caesarean section after being denied an abortion has been “inaccurate”. It hopes that a report, due to be completed and published by the end of next month, will end such reporting. The HSE said its director general had requested a report to be completed that “establishes all of the facts surrounding the care given to a woman who had her pregnancy ended pursuant to the Protection of Life During Pregnancy Act, 2013.
“That act was a triumph for political cowardice and legislative minimalism,” said well-known Irish pro-life activist Dr Seán Ó Domhnaill in an article that was recently published in the Irish Independent.
“The guidelines on the new abortion law have opened up an appalling vista. Overstretched practitioners on the frontline of medicine know that cases involving complications in pregnancy can be difficult and complex to manage. That’s why we always seek to follow evidence-based medicine and best international guidelines. It’s to the eternal shame of this government, then, that it did not listen to the evidence presented to two separate Oireachtas hearings on abortion and suicidality. That evidence was ignored to such an extent that it prompted a member of the Oireachtas committee, Mattie McGrath, to describe the whole thing as a ‘total charade’.”
The abortion guidelines state that there are no term limits for terminating a pregnancy in certain circumstances. They also state, however, that doctors are obliged to protect the baby’s life where the unborn child has reached viability at the time an abortion is sought.
Where does this leave an obstetrician who has been asked to end a pregnancy after 24 weeks’ gestation, for example, because a woman claims that continuing with her pregnancy is causing her to consider suicide? Where the outcome of that termination is a living child, does that mean the threat of suicide has not been sufficiently dealt with? In Britain, the answer has been that unborn children who have survived abortion have been left to die – a human genocide, accepted in a civilised society.
Is the doctor liable if the woman self-harms because she sought an abortion but the baby’s life was not ended?
To add to the lack of clarity, the guidelines say this may not be a termination under the legislation, since a human life is not ‘ended’, but that throws up even more problems for doctors.
What will happen to the child who has been purposely burdened with all the possibly serious complications of prematurity, which include cerebral palsy, blindness and brain damage? Will the doctors – and the state – also be liable to be sued by that child in later years?
This law is being implemented at a time when health services in Ireland are under enormous strain, and the use of the abortion act as outlined above will only add to the strain on neonatal intensive-care units and to the already-creaking maternity services, an issue flagged by Dr Sam Coulter Smith during the Oireachtas hearings.
Added to this appalling vista is the inescapable fact that we now have a situation in Ireland where a doctor can end the life of an unborn child, despite the overwhelming evidence that abortion is not a treatment for suicidal tendencies in pregnancy. These guidelines seek to force doctors to practise non-evidence-based medicine – a travesty in modern practice.
Abortion was legalised in Ireland in the aftermath of the tragic death of Savita Halappanavar, despite the fact that subsequent investigations found that her death was due to mismanagement of a resistant e-coli infection that arose in pregnancy and occurred in an over-stretched maternity unit. In fact, it became crystal clear at the Oireachtas hearings on abortion that Ireland’s ban was not putting women’s lives at risk, and the experts testified that they knew of no cases where a woman had died because doctors felt constrained by the law on abortion.
They also pointed out that they had often intervened to save mothers’ lives in pregnancy, even where this meant the child’s life was unfortunately lost.
There is a deep and cynical hypocrisy in this government’s claim that it legalised abortion to protect women, while the same government is actually putting women and their babies in danger by seeking to close maternity units and inflicting dangerous cuts on health spending. This cynicism has not been lost on medical practitioners, nor on the Irish public.
Dr Mark Murphy, writing on these guidelines recently, also in the Irish Independent, claimed that international guidance should prompt the provision of abortion as a matter of choice. No such international guidance for medical professionals exists, though, conversely, the Dublin Declaration on Maternal Health Care, which affirms that abortion is not medically necessary, has now been supported by more than 900 medical professionals globally.
There is very little public or professional support for the position of Doctors for Choice, who favour legalising abortion-on-demand and who afford the unborn child no human rights. This is a political position, not a medical one.
Best maternal healthcare is provided when doctors can work to protect mother and baby and follow evidence-based medicine. These new guidelines force doctors to practise non-evidence-based medicine and require them to end an unborn baby’s life when no medical necessity exists.

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By Fr Paddy Byrne
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