The tragic death of 31-year-old Savita Halappanavar in a Galway hospital, apparently after being refused an emergency abortion [2], 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 [3] (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 [4]. 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 [5].

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.