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
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The Prevent strategy needs a rethink, not a rebrand

A bad policy by any other name is still a bad policy.

Yesterday the Home Affairs Select Committee published its report on radicalization in the UK. While the focus of the coverage has been on its claim that social media companies like Facebook, Twitter and YouTube are “consciously failing” to combat the promotion of terrorism and extremism, it also reported on Prevent. The report rightly engages with criticism of Prevent, acknowledging how it has affected the Muslim community and calling for it to become more transparent:

“The concerns about Prevent amongst the communities most affected by it must be addressed. Otherwise it will continue to be viewed with suspicion by many, and by some as “toxic”… The government must be more transparent about what it is doing on the Prevent strategy, including by publicising its engagement activities, and providing updates on outcomes, through an easily accessible online portal.”

While this acknowledgement is good news, it is hard to see how real change will occur. As I have written previously, as Prevent has become more entrenched in British society, it has also become more secretive. For example, in August 2013, I lodged FOI requests to designated Prevent priority areas, asking for the most up-to-date Prevent funding information, including what projects received funding and details of any project engaging specifically with far-right extremism. I lodged almost identical requests between 2008 and 2009, all of which were successful. All but one of the 2013 requests were denied.

This denial is significant. Before the 2011 review, the Prevent strategy distributed money to help local authorities fight violent extremism and in doing so identified priority areas based solely on demographics. Any local authority with a Muslim population of at least five per cent was automatically given Prevent funding. The 2011 review pledged to end this. It further promised to expand Prevent to include far-right extremism and stop its use in community cohesion projects. Through these FOI requests I was trying to find out whether or not the 2011 pledges had been met. But with the blanket denial of information, I was left in the dark.

It is telling that the report’s concerns with Prevent are not new and have in fact been highlighted in several reports by the same Home Affairs Select Committee, as well as numerous reports by NGOs. But nothing has changed. In fact, the only change proposed by the report is to give Prevent a new name: Engage. But the problem was never the name. Prevent relies on the premise that terrorism and extremism are inherently connected with Islam, and until this is changed, it will continue to be at best counter-productive, and at worst, deeply discriminatory.

In his evidence to the committee, David Anderson, the independent ombudsman of terrorism legislation, has called for an independent review of the Prevent strategy. This would be a start. However, more is required. What is needed is a radical new approach to counter-terrorism and counter-extremism, one that targets all forms of extremism and that does not stigmatise or stereotype those affected.

Such an approach has been pioneered in the Danish town of Aarhus. Faced with increased numbers of youngsters leaving Aarhus for Syria, police officers made it clear that those who had travelled to Syria were welcome to come home, where they would receive help with going back to school, finding a place to live and whatever else was necessary for them to find their way back to Danish society.  Known as the ‘Aarhus model’, this approach focuses on inclusion, mentorship and non-criminalisation. It is the opposite of Prevent, which has from its very start framed British Muslims as a particularly deviant suspect community.

We need to change the narrative of counter-terrorism in the UK, but a narrative is not changed by a new title. Just as a rose by any other name would smell as sweet, a bad policy by any other name is still a bad policy. While the Home Affairs Select Committee concern about Prevent is welcomed, real action is needed. This will involve actually engaging with the Muslim community, listening to their concerns and not dismissing them as misunderstandings. It will require serious investigation of the damages caused by new Prevent statutory duty, something which the report does acknowledge as a concern.  Finally, real action on Prevent in particular, but extremism in general, will require developing a wide-ranging counter-extremism strategy that directly engages with far-right extremism. This has been notably absent from today’s report, even though far-right extremism is on the rise. After all, far-right extremists make up half of all counter-radicalization referrals in Yorkshire, and 30 per cent of the caseload in the east Midlands.

It will also require changing the way we think about those who are radicalized. The Aarhus model proves that such a change is possible. Radicalization is indeed a real problem, one imagines it will be even more so considering the country’s flagship counter-radicalization strategy remains problematic and ineffective. In the end, Prevent may be renamed a thousand times, but unless real effort is put in actually changing the strategy, it will remain toxic. 

Dr Maria Norris works at London School of Economics and Political Science. She tweets as @MariaWNorris.