Consultant 'refused abortion plea'

mikom

Pompey Magnus wrote: »

Why should that be an exception?

It's not an exception, it's a question.

Stark

Pompey Magnus wrote:

Why should that be an exception?

You think forcing heroin addicts to become parents to (probably profoundly disabled) children is a good idea?

drkpower

wolfpawnat wrote: »

Yes, at the end of a working shift or just before the patient is released. I know this personally. But never after a death unless something important is remembered, like perhaps a request for more medication, etc. .

No; not just at the end of a shift. And yes; even after a death. Once they are identified clearly as retrospective and the reasons given for their addition, retrospective notes are entirely appropriate and even best practice.

wolfpawnat wrote: »

My stepmother was given anti-biotics while pregnant that were going to kill the already dying foetus. Her life was seen as I dunno would you call it suitably at risk, but at risk enough for them to think it the best plan of action, and yes, then the foetus was as you say evacuated. I have said in many of my posts that this should have been done for Savita too. Whatever drugs necessary to deal with her infection, make her comfortable and bring her deteriorating health somewhat under control, then deal with the dead/dying foetus. And then allow her to make full recovery. As I have also stated, the failure of the medical parties involved to read/obtain her blood test results is what failed in this situation.

While your interpretation of your stepmother's experience is clearly relevant and important information, antibiotics do not kill the foetus (at least not at the speed that would be required in the context of chorioamnionitis) and treatment for chorioamnionitis is antibiotics and evacuation of the uterus, not one or the other, nor one followed by the other.

wolfpawnat wrote: »

As you have stated too, with the correct information, her doctor would have been able to make a better call and more than likely Savita would still be alive today.

I didnt say that; because we dont know that.

Pompey Magnus

mikom wrote: »

It's not an exception, it's a question.

Yes, but why do you feel the need to ask eireannBEAR if you don't think it worthy of an exception to his already quite clear criteria?

eireannBEAR

heroin addicts are not of sound mind and body so they would not be allowed an abortion even in the uk! disgraceful question by the way.

mikom

Pompey Magnus wrote: »

Yes, but why do you feel the need to ask eireannBEAR if you don't think it worthy of an exception to his already quite clear criteria?

He is a self confessed ex-addict.
I presume he knows what coming off certain substances is like.
I also presume he will know how incapable of caring for a child many addicts can be.

eireannBEAR wrote: »

heroin addicts are not of sound mind and body so they would not be allowed an abortion even in the uk! disgraceful question by the way.

It's a perfectly valid question.
Not disgraceful at all.

Spontaneous abortion is one of the many side effects of heroin addiction.
This is enabled by the addicts "choice" to continue using.

Avoiding this, then you will have the birth of a heroin addicted baby to a parent incapable of caring for it.

Pompey Magnus

Stark wrote: »

You think forcing heroin addicts to become parents to (probably profoundly disabled) children is a good idea?

Firstly I don't discriminate between a child who is disabled and one who is not, that aspect of your question is irrelevant as far as I am concerned. In answer to the rest of your question though I feel the State should ensure the child is adequately cared for after birth and if the mother is not able to do so then the State should intervene.

eireannBEAR

mikom wrote: »

He is a self confessed ex-addict.
I presume he knows what coming off certain substances is like.
I also presume he will know how incapable of caring for a child many addicts can be.

how would that give me any insight in to the mind of a HEROIN addict???

Seachmall

eireannBEAR wrote: »

the only exceptions should be if the birth puts the mothers life at high risk. after all why should both mother and child die. in those circumstance you are not protecting the child by allowing his/hers mother to die along with him/her.

Well there's no moral dilemma there so the answer is clear but what about a case where you only have two options,

1. Abort the child, let the mother survive.
2. Birth the child, let the mother die.

Not in a "save one or both die" situation but in a "pick one or the other" situation?

Is abortion justified?

Gatling

anybody huffing and puffing on here Actually got medical qualifications .
Or medically versed in emergency maternity medicine,

wolfpawnat

drkpower wrote: »

No; not just at the end of a shift. And yes; even after a death. Once they are identified clearly as retrospective and the reasons given for their addition, retrospective notes are entirely appropriate and even best practice.

I was a trainee nurse, we were not allowed many retrospective notes after death unless essential. Only notes at the time (you could imagine the size of the paperwork load some of us left for the actual nurses to tidy up). But we were not left do too much damage. I am only going on what I did myself.

drkpower wrote: »

While your interpretation of your stepmother's experience is clearly relevant and important information, please be asured that antibiotics do not kill the foetus (at least not at the speed that would be required in the context of chorioamnionitis).

No, anti-biotics do not actively kill a foetus, but they weaken it, like us adults, and if the foetus is already dying, it may speed up the already inevitable. Getting her infection under control was paramount to her survival, the foetus as you clearly seem to know yourself, would/should be second to that.

drkpower wrote: »

I didnt say that; because we dont know that.

Hence why I said more than likely rather than swearing blindly she would be. We have no guarantees. Medicine is not perfect, and people will always die, this is fact. But with the correct information and course of action, her chances of survival would have been a hell of a lot higher.

Stark

Gatling wrote: »

anybody huffing and puffing on here Actually got medical qualifications .
Or medically versed in emergency maternity medicine,

Do you?

HondaSami

Seachmall wrote: »

What about a case where the mother will likely die during birth but the child could be saved or the child could be aborted and the mother saved.

Not in a "save one or both die" situation but in a "pick one or the other" situation?

Is abortion justified?

This is the only time i am in favour of it, save the mother always imo.

I'm for it in rape/incest cases also, just to be clear but never on demand.

eireannBEAR

rape/incest case are dodgy but i would side with termination due to it would be carried out near instantly and most rape cases could be resolved with the pill.

Gatling

Stark wrote: »

Do you?

No but my partner has been through 2 difficult labour's

Seems a lot of view's on medical issues with little or no actual knowledge of either medicine or maternity in general

mikom

eireannBEAR wrote: »

how would that give me any insight in to the mind of a HEROIN addict???

Don't say it was cannabis you were addicted to, or else I will fall off my seat.

eireannBEAR

mikom wrote: »

Don't say it was cannabis you were addicted to, or else I will fall off my seat.

flagged

wolfpawnat

eireannBEAR wrote: »

rape/incest case are dodgy but i would side with termination due to it would be carried out near instantly and most rape cases could be resolved with the pill.

Not wanting to drag this off Savita and the discussion at hand too much. But this is very true, these days with the MAP being available over the counter, it has countered the rape suggestion, hence the vote my the IMO against it in their recent meeting.

Then there are the terrified/nasty women who will claim rape to get the abortion and innocent men may end up imprisoned for something that was consensual.

Incest is a whole different kettle of fish though!

Seachmall

[Post is irrelevant given mod warning below.]

mikom

mikom wrote: »

Don't say it was cannabis you were addicted to, or else I will fall off my seat.

eireannBEAR wrote: »

flagged

It was?

Good Jaysus.
As bad as being in the grips of a video game addiction.

LizT

Mod

This is it guys, last warning. This thread is for discussion of the case at hand, it's not a pro/anti abortion thread.

Any more off topic posts will be infracted from here on out, fair warning.

wolfpawnat

I can find toss all new information online from the second half of today's inquest hearing. Seriously need to find a good news site. Anything else come to light?

Flier

Uriel. wrote: »

Yeah we are all discussing this from the "comfort of our computer screens" so get over yourself. If you don't want to discuss something then fine.

I'm not having a go at you - you're right, there's a lot of armchair doctors and lawyers stating as fact what should or shouldn't have been done. However, the staff in UCHG were working in real time, and made the best decision they could with the information they had at the time. And the coroner (who is actually qualified) is waiting to hear all the evidence before he decides to rule on the case.

Uriel. wrote: »

But it would appear to me, that the Dr. in question is suggesting that had she had more accurate medical information, which would have been available had policy and procedure matters she would have been able to carry out an abortion in line with the Constitution some 5 hours earlier at least. Would that have saved the poor woman... I don't know, but perhaps.

5 hours is a very fine line in a rapidly deteriorating situation. I wouldn't like my life to depend on it.

Morag

https://twitter.com/FergalBowers

He is the Health Correspondent for RTE News and has been live tweeting the inquest.

drkpower

wolfpawnat wrote: »

I was a trainee nurse, we were not allowed many retrospective notes after death unless essential. Only notes at the time (you could imagine the size of the paperwork load some of us left for the actual nurses to tidy up). But we were not left do too much damage. I am only going on what I did myself. .

Just because it was what you did as a trainee nurse doesnt mean that you were doing it right. Google MPS; retrospective notes and you wil find very quickly what best practice is considered to be.

wolfpawnat wrote: »

No, anti-biotics do not actively kill a foetus, but they weaken it, like us adults, and if the foetus is already dying, it may speed up the already inevitable. Getting her infection under control was paramount to her survival, the foetus as you clearly seem to know yourself, would/should be second to that. .

The foetus is the source of the infection (or more accurately the connection between the foetus and mother is the source); as a former trainee nurse, I hope you were thought that removing the source of an infection is even more important in most cases than antibiotic therapy. Removing the source of infection is most definitely not 'second to' antibiotic therapy.

wolfpawnat wrote: »

Hence why I said more than likely rather than swearing blindly she would be. We have no guarantees. Medicine is not perfect, and people will always die, this is fact. But with the correct information and course of action, her chances of survival would have been a hell of a lot higher.

Saying she 'more than likely' would have survived is still wrong.

positron

This week my faith in humanity has been restored by the actions of Midwife Manager Ann Maria Burke, who had the courage and decenty to stick to her values and principles and agree that she did indeed mention the widely reported 'catholic country' remark, and I am sure she knows full well how much damage that has done and how many are going to look down at her for that. And for Praveen to straight away come out and express that he understands her and does not feel anything against her and still want to thank all the staff who tried to help - that was equally heartwarming. Good people on both sides. I am sure this won't get as much media coverage as the original news item, which is a shame, but that's how it is.

On the other hand, I still can't stop thinking that Savita would have been alive today if this happened in India, or another country. That is, based on everything that was discussed, I personally feel Dr Astbury (sp?) was hindered by the legal situation from taking a more proactive decision - like any doctor would have in India for example. It's a shame really. And the fact that there are many people out there who are try to split hair on the minute details trying to find fault elsewhere etc.. is a bit worrying..!

GCU Flexible Demeanour

positron wrote: »

<...> the widely reported 'catholic country' remark<...>

As many have said, it's only stating facts to say that the main reason abortion is banned by the Constitution is because of the influence of Catholicism.

positron wrote: »

<...> I still can't stop thinking that Savita would have been alive today if this happened in India<...>

http://www.unfpa.org/public/home/news/pid/10730

Disparity exists within and across countries and regions. One third of all maternal deaths occur in just two countries – in 2010, almost 20 per cent of deaths (56,000) were in India and 14 per cent (40,000) were in Nigeria.

http://www.ncbi.nlm.nih.gov/pubmed/15814392

The present study was undertaken at a rural medical institute in India to analyse the trends in maternal mortality due to sepsis and the factors associated with change, if any. <...> the percentage contribution of septic abortion has remained the same. <...> Most of the women who had died due to septic abortion were married (65%). <...>

positron wrote: »

<...> I personally feel Dr Astbury (sp?) was hindered by the legal situation from taking a more proactive decision <...>

Grand, but have you any actual basis for saying that? The issue, so far, seems to be about infection going undetected. Hasn't the doctor you're referring to said that she'd have acted sooner if she'd known the full picture?

drkpower

GCU Flexible Demeanour wrote: »

Hasn't the doctor you're referring to said that she'd have acted sooner if she'd known the full picture?

she has said that she may have acted sooner had she been aware of some indicators of infection earlier (foul vaginal discharge, white cell count).

She has said that she did, in fact, feel constrained from acting due to Irish law.


There is a notable difference there, I think.

GCU Flexible Demeanour

drkpower wrote: »

she has said that she may have acted sooner had she been aware of some indicators of infection earlier (foul vaginal discharge, white cell count).

She has said that she did, in fact, feel constrained from acting due to Irish law.


There is a notable difference there, I think.

There's a difference between those two statements, but the emerging picture suggests that (similar to the reported outcome of the HSE inquiry) the law wasn't the pivotal issue. The pivotal issue was the condition was undiagnosed (or, at least, that would seem to be what's coming out the testimony.)

positron

The figure of 56000 might look big, but when they say India they are talking about over 1.2 billion people, so it might be really tiny in percentage terms.

Dr Astbury also said she felt constrained by the Irish law to giving an abortion as soon as she knew the fetus was not viable. I am sure everyone would agree there is no point prolonging the agony and risking death in such a case, and it is shocking really that in this day and age a knowledgeable medical team with armed with the right skillset, knowledge, medical equipment and test results, can't proactively act to help someone, due to some conditions setup by a society under the influence of a religious order with no knowledge of the medical procedures, threats or benefits just because they feel they are the guardians of some sort of moral value and feels the need to inflict that upon everyone else irrespective of their own personal belief or the lack of.