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
Belief, disbelief and beyond belief
Richard Burden
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The warnings Bosnian gravestones carry for us in 2016

Xenophobia does not usually lead to Srebrenica. But it can do.

Two weeks ago, I joined a visit to Bosnia organised by Remember Srebrenica. If you have ever seen one of the Commonwealth War Graves cemeteries in Northern France, you will have a sense of what the cemetery in Potocari, near Srebrenica, is like. Row upon row of identical white headstones stretching into the distance. Whereas in France, of course, most of the headstones are marked by the cross, in Potocari they are white obelisks. Overwhelmingly, they mark the graves of Muslims.

In the 1990s, the old battery factory of Potocari was the headquarters of Dutch troops. They had been deployed to uphold the United Nations designation of the enclave as a safe area. Their presence, however, did not stop Serb troops from rounding up around 25,000 people sheltering at the base in July 1995. Once the UN troops stood aside, families were divided. Most of the women and children were loaded and sent west to areas of the country still controlled by the Bosnian government. The men and boys were loaded on to separate trucks. Within days, most of them were systematically shot.

Many other men and boys had already taken to the woods to escape, only to face shells, snipers and ambush on the way. Some, like 19-year-old Hasan Hasanovic, made it through to free territory around Tuzla. Many did not. Those did not die in the woods were either persuaded to give themselves up, or were captured. Like the men and boys who had been taken from outside the UN base at Potocari, most simply disappeared. To this day, their bones are still being found in or near mass graves in eastern Bosnia.

And so, 21 years on, I met Hasan at Potocari. July1995 was the last time he saw his twin brother Hussein, his father Aziz or his uncle, Hasan.

The former UN Secretary General Kofi Annan described the Srebrenica massacre as the worst crime on European soil since the Second World War. Indeed, the word massacre doesn’t convey the enormity of what happened. Earlier this year, the International Criminal Tribunal for the former Yugoslavia found 1990s Bosnian Serb leader Radovan Karadzic guilty of involvement in genocide. The verdict in the trial of military leader Ratko Mladic is expected later this year.

Nobody who visits Potocari can fail to be moved by what you see there. For me, it brought back memories of how, as a new MP back in the 1990s, I was one of those calling for more assertive international action to stop the carnage that was unfolding in Bosnia. It was an unfamiliar position to find myself in. All my political life until that point, I had been amongst those opposing involvement in military action abroad. Now I found myself supporting intervention. For three years before the Srebrenica genocide, people in Sarajevo had been starved of food, medicines and even the means to defend themselves as their city was remorselessly pounded from the hills that surround it. We knew it. We could see it on TV. We also saw that neither Europe nor NATO nor the UN were taking action that could have stopped it.

There were always so many geopolitical reasons not to intervene effectively. I heard them day after day from Ministers in the House of Commons. But that did not help the men, women and children who were dying in Sarajevo, and in 1995 it did not save Hasan’s twin brother, his father, his uncle or the 8,000 others who ended up in the mass graves around Srebrenica.

Since I have returned from Bosnia, two things keep dominating my thinking. The first is about Syria. The political circumstances that have led to the destruction of Aleppo today are not the same as those facing Sarajevo in the 1990s. For people trapped there though, the parallels must feel much more real than the differences. I don’t claim to have an off-the-shelf action plan for what the international community should do today any more than anyone else does. I just keep thinking how in twenty years’ time, people visiting Aleppo - hopefully reconstructed as Sarajevo has been today - will ask: “How could the world have let this happen in 2016?” What will be our answer?

The other thing that dominates my thoughts is that the genocide in Bosnia hit people like me. A man I met, who unexpectedly found himself becoming a soldier in 1992, told me how, before the war, he wore a t-shirt, jeans and an earring. On a good day, he would to listen to the Ramones. On a bad day, it would be the Sex Pistols. I am a bit older than him, but this was still my generation. And it happened In Europe.

What is more, the murders and the ethnic cleansing were not committed by strangers. So often, they were committed by neighbours. These were normal people who had been whipped up to dehumanise those who they were told were “different”. They were told that their way of life was under threat. They internalised it. They believed it. And, down the line, they no longer needed persuading it was “them or us”.

Most of the time, xenophobia does not lead to the horrors that have scarred Srebrenica forever. But it can do. That a lesson for all of us must never forget. So next time you hear someone talking about people living either down the road or across the sea being "them" not "us", don't shrug and walk away. Speak up and speak out instead.

Richard Burden is Labour MP for Birmingham Northfield and a Shadow Transport Minister. He visited Bosnia with the Remembering Srebrenica charity in October 2016. You can find out more about the Remembering Srebrenica charity here.

Richard Burden is MP for Birmingham Northfield. Follow him on Twitter @RichardBurdenMP.