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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There's nothing Luddite about banning zero-hours contracts

The TUC general secretary responds to the Taylor Review. 

Unions have been criticised over the past week for our lukewarm response to the Taylor Review. According to the report’s author we were wrong to expect “quick fixes”, when “gradual change” is the order of the day. “Why aren’t you celebrating the new ‘flexibility’ the gig economy has unleashed?” others have complained.

Our response to these arguments is clear. Unions are not Luddites, and we recognise that the world of work is changing. But to understand these changes, we need to recognise that we’ve seen shifts in the balance of power in the workplace that go well beyond the replacement of a paper schedule with an app.

Years of attacks on trade unions have reduced workers’ bargaining power. This is key to understanding today’s world of work. Economic theory says that the near full employment rates should enable workers to ask for higher pay – but we’re still in the middle of the longest pay squeeze for 150 years.

And while fears of mass unemployment didn’t materialise after the economic crisis, we saw working people increasingly forced to accept jobs with less security, be it zero-hours contracts, agency work, or low-paid self-employment.

The key test for us is not whether new laws respond to new technology. It’s whether they harness it to make the world of work better, and give working people the confidence they need to negotiate better rights.

Don’t get me wrong. Matthew Taylor’s review is not without merit. We support his call for the abolishment of the Swedish Derogation – a loophole that has allowed employers to get away with paying agency workers less, even when they are doing the same job as their permanent colleagues.

Guaranteeing all workers the right to sick pay would make a real difference, as would asking employers to pay a higher rate for non-contracted hours. Payment for when shifts are cancelled at the last minute, as is now increasingly the case in the United States, was a key ask in our submission to the review.

But where the report falls short is not taking power seriously. 

The proposed new "dependent contractor status" carries real risks of downgrading people’s ability to receive a fair day’s pay for a fair day’s work. Here new technology isn’t creating new risks – it’s exacerbating old ones that we have fought to eradicate.

It’s no surprise that we are nervous about the return of "piece rates" or payment for tasks completed, rather than hours worked. Our experience of these has been in sectors like contract cleaning and hotels, where they’re used to set unreasonable targets, and drive down pay. Forgive us for being sceptical about Uber’s record of following the letter of the law.

Taylor’s proposals on zero-hours contracts also miss the point. Those on zero hours contracts – working in low paid sectors like hospitality, caring, and retail - are dependent on their boss for the hours they need to pay their bills. A "right to request" guaranteed hours from an exploitative boss is no right at all for many workers. Those in insecure jobs are in constant fear of having their hours cut if they speak up at work. Will the "right to request" really change this?

Tilting the balance of power back towards workers is what the trade union movement exists for. But it’s also vital to delivering the better productivity and growth Britain so sorely needs.

There is plenty of evidence from across the UK and the wider world that workplaces with good terms and conditions, pay and worker voice are more productive. That’s why the OECD (hardly a left-wing mouth piece) has called for a new debate about how collective bargaining can deliver more equality, more inclusion and better jobs all round.

We know as a union movement that we have to up our game. And part of that thinking must include how trade unions can take advantage of new technologies to organise workers.

We are ready for this challenge. Our role isn’t to stop changes in technology. It’s to make sure technology is used to make working people’s lives better, and to make sure any gains are fairly shared.

Frances O'Grady is the General Secretary of the TUC.