Ireland's law and Catholic culture allowed Savita Halappanavar to die

The tragic case of a woman who was miscarrying, who died because doctors wouldn't give her a termination, shows the danger of fetishising the life of the unborn child.

The tragic death of 31-year-old Savita Halappanavar in a Galway hospital, apparently after being refused an emergency abortion, has not surprisingly provoked outrage. Although she was found to be miscarrying after being admitted to hospital suffering from back pain on 21 October, for three days staff declined to remove the foetus on the grounds that it still had a detectable heartbeat. Most shockingly of all, a doctor is said to have told Savita and her husband that there was no question of a termination, because "this is a Catholic country".

Ireland's health executive has already announced an inquiry, but that hasn't stopped demands that the country's strict abortion law be re-written. Demonstrations are taking place in Dublin and at the Irish embassy in London. The case is heartbreaking. The details of Savita's final days, spent in agony before she succumbed to the septicaemia and e.coli she contracted when her cervix had remained dilated for 72 hours, are almost too shocking to contemplate. It seems, on the face of it, inhuman that doctors would have allowed her to suffer out of some misplaced concern for the life of her (clearly unsaveable) foetus, or because of their understanding of Irish law or Catholic doctrine. Surely, many will think, this tragedy gives the lie to arguments that opposition to abortion is founded on a respect for life and human dignity. 

This was no case of an elective abortion. Savita was not trying to get rid of an unwanted pregnancy. She was miscarrying and crying out in pain. The responsibilities of the medical staff seem plain: to facilitate the ending of her medical emergency as quickly and safely as possible. That the foetus could not have survived the procedure cannot be relevant in circumstances where it is already doomed. To expedite the ending of the pregnancy in such circumstances cannot properly be called "abortion" at all. This looks, on the face of it, like a case of medical negligence that has little to do with the abortion debate as such.

It is, for one thing, difficult to square the treatment of Savita Halappanavar with the guidelines contained in Ireland's Guide to Professional Conduct and Ethics for Registered Medical Practitioners (pdf), which provide that:

Rare complications can arise where therapeutic intervention (including termination of a pregnancy) is required at a stage when, due to extreme immaturity of the baby, there may be little or no hope of the baby surviving. In these exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the life of the mother.

Not surprisingly, pro-life voices are already making these points, besides calling for caution and demanding that the case not be used as a political football. Several have taken to Twitter to stress that, however strong their own opposition to abortion as a rule, they would have made an exception in a case such as this where the mother's life was in danger. One told me that he'd "like to think that anyone of any persuasion would be sickened to their stomach."

Nevertheless, the reported facts suggest that Ireland's abortion law, and its Catholic culture, were the context within which these horrific events unfolded. As recently as September, an "international symposium" meeting in Dublin declared that "direct abortion is never medically necessary to save the life of a woman", though it added, confusingly, that "legitimate medical treatment" that resulted in pregnancy termination didn't count as such. The statement claimed that "misinformation abounds in public debate" around this issue. But if it is misinformation, Savita's death suggests that it isn't just the public that is misinformed. Her doctors, too, appear to be labouring under the same delusion.

This is obviously a law that requires urgent clarification. On that, I hope that campaigners on both sides of the abortion debate would agree. Even if this does turn out to be a case of medical negligence, even if (as seems likely) the law as it stands would have allowed doctors to intervene and so save Savita's life, they seem to have have believed differently. And this is what mattered. It is particularly shameful that Irish governments have failed to legislate in the twenty years since the Irish Supreme Court ruled that abortion was legal where the mother's life is in danger.

It would be both simplistic and not particularly helpful to turn Savita Halappanavar into a pro-choice martyr. Her tragic death, whether or not the Irish law caused it, is fairly irrelevant to the more general issue of a woman's right to request a termination where her health is not at risk. It does, though, demonstrate all too vividly the dangers of an extreme anti-abortion position. The mindset that denies women the right to make choices for their own lives and over their own bodies leads all too easily to the fetishising of the unborn child, according it a special sanctity beyond the merely human. The principle of preserving life comes to be more important than life itself. 

An anti abortion protester holds up a placard. Photo: Getty
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Air pollution: 5 steps to vanquishing an invisible killer

A new report looks at the economics of air pollution. 

110, 150, 520... These chilling statistics are the number of deaths attributable to particulate air pollution for the cities of Southampton, Nottingham and Birmingham in 2010 respectively. Or how about 40,000 - that is the total number of UK deaths per year that are attributable the combined effects of particulate matter (PM2.5) and Nitrogen Oxides (NOx).

This situation sucks, to say the very least. But while there are no dramatic images to stir up action, these deaths are preventable and we know their cause. Road traffic is the worst culprit. Traffic is responsible for 80 per cent of NOx on high pollution roads, with diesel engines contributing the bulk of the problem.

Now a new report by ResPublica has compiled a list of ways that city councils around the UK can help. The report argues that: “The onus is on cities to create plans that can meet the health and economic challenge within a short time-frame, and identify what they need from national government to do so.”

This is a diplomatic way of saying that current government action on the subject does not go far enough – and that cities must help prod them into gear. That includes poking holes in the government’s proposed plans for new “Clean Air Zones”.

Here are just five of the ways the report suggests letting the light in and the pollution out:

1. Clean up the draft Clean Air Zones framework

Last October, the government set out its draft plans for new Clean Air Zones in the UK’s five most polluted cities, Birmingham, Derby, Leeds, Nottingham and Southampton (excluding London - where other plans are afoot). These zones will charge “polluting” vehicles to enter and can be implemented with varying levels of intensity, with three options that include cars and one that does not.

But the report argues that there is still too much potential for polluters to play dirty with the rules. Car-charging zones must be mandatory for all cities that breach the current EU standards, the report argues (not just the suggested five). Otherwise national operators who own fleets of vehicles could simply relocate outdated buses or taxis to places where they don’t have to pay.  

Different vehicles should fall under the same rules, the report added. Otherwise, taking your car rather than the bus could suddenly seem like the cost-saving option.

2. Vouchers to vouch-safe the project’s success

The government is exploring a scrappage scheme for diesel cars, to help get the worst and oldest polluting vehicles off the road. But as the report points out, blanket scrappage could simply put a whole load of new fossil-fuel cars on the road.

Instead, ResPublica suggests using the revenue from the Clean Air Zone charges, plus hiked vehicle registration fees, to create “Pollution Reduction Vouchers”.

Low-income households with older cars, that would be liable to charging, could then use the vouchers to help secure alternative transport, buy a new and compliant car, or retrofit their existing vehicle with new technology.

3. Extend Vehicle Excise Duty

Vehicle Excise Duty is currently only tiered by how much CO2 pollution a car creates for the first year. After that it becomes a flat rate for all cars under £40,000. The report suggests changing this so that the most polluting vehicles for CO2, NOx and PM2.5 continue to pay higher rates throughout their life span.

For ClientEarth CEO James Thornton, changes to vehicle excise duty are key to moving people onto cleaner modes of transport: “We need a network of clean air zones to keep the most polluting diesel vehicles from the most polluted parts of our towns and cities and incentives such as a targeted scrappage scheme and changes to vehicle excise duty to move people onto cleaner modes of transport.”

4. Repurposed car parks

You would think city bosses would want less cars in the centre of town. But while less cars is good news for oxygen-breathers, it is bad news for city budgets reliant on parking charges. But using car parks to tap into new revenue from property development and joint ventures could help cities reverse this thinking.

5. Prioritise public awareness

Charge zones can be understandably unpopular. In 2008, a referendum in Manchester defeated the idea of congestion charging. So a big effort is needed to raise public awareness of the health crisis our roads have caused. Metro mayors should outline pollution plans in their manifestos, the report suggests. And cities can take advantage of their existing assets. For example in London there are plans to use electronics in the Underground to update travellers on the air pollution levels.

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Change is already in the air. Southampton has used money from the Local Sustainable Travel Fund to run a successful messaging campaign. And in 2011 Nottingham City Council became the first city to implement a Workplace Parking levy – a scheme which has raised £35.3m to help extend its tram system, upgrade the station and purchase electric buses.

But many more “air necessities” are needed before we can forget about pollution’s worry and its strife.  

 

India Bourke is an environment writer and editorial assistant at the New Statesman.