Consultant 'refused abortion plea'

opinion guy

Grayson wrote: »

It was incompetence that caused the misdiagnoses. I seriously hope someone loses their license and goes to jail for it.

This does not automatically follow. For one thing I like to know how busy the staff were during those days. How many patients did the nurses attend to and how many nurses ? How many patients did the doctors have to see in how many locations ? Its possible understaffing/overwork was a factor - which if it was comes down to management.

Shint0

opinion guy wrote: »

This does not automatically follow. For one thing I like to know how busy the staff were during those days. How many patients did the nurses attend to and how many nurses ? How many patients did the doctors have to see in how many locations ? Its possible understaffing/overwork was a factor - which if it was comes down to management.

This indeed may also have been a contributory factor. However, it has been reported that her vital signs were not checked on one occasion when her symptoms would have warranted further investigation.
I'm not really interested in the pro life/pro choice debate per se. I'm more interested in the facts. Can the inquest decide definitively or with a high degree of certainty that Savita would not have died had she received earlier intervention which may have included a termination?

drkpower

Shint0 wrote: »

Can the inquest decide definitively or with a high degree of certainty that Savita would not have died had she received earlier intervention which may have included a termination?

No, not really. The inquest determines the factual circumstances, the 'what happened'. It doesn't determine the 'what ifs' or 'what might have been'.

Of course, any witness might comment on what might have been, and the coroner might give his view on the matter when summing up, but those views have no legal weight or effect. A civil court, on a different day, could come to a completely different view.

Shint0

drkpower wrote: »

No, not really. The inquest determines the factual circumstances, the 'what happened'. It doesn't determine the 'what ifs' or 'what might have been'.

Of course, any witness might comment on what might have been, and the coroner might give his view on the matter when summing up, but those views have no legal weight or effect. A civil court, on a different day, could come to a completely different view.

I'm curious to know how does a coroner arrive at a conclusion e.g. misadventure, accidental, unless there is some degree of interpretation of the facts. I'm not entirely familiar with the process.

GCU Flexible Demeanour

Flier wrote: »

Once again, a lot of waffle, no substance. I rest my case.

I'm afraid your case was found wanting, many posts ago.

Grayson wrote: »

If they had proceeded with a termination anyway, she probably would have survived.

I think we have to distinguish possibility from reality. Another poster earlier in the thread, getting rather carried away by the moment, asserted that she'd have had a better chance of survival in India. In actual fact, death from sepsis following abortion is a significant cause of maternal death in India for married women.

A mismanaged termination could also have involved infection and death. We have to get beyond the possibility that, through happenstance, termination might have solved the problem if no other complications were ignored.

drkpower

Shint0 wrote: »

I'm curious to know how does a coroner arrive at a conclusion e.g. misadventure, accidental, unless there is some degree of interpretation of the facts. I'm not entirely familiar with the process.

the coroner does interpret the facts, that's the whole point of the process. But it doesn't/shouldn't (usually) get into speculation as to what might have been. It also cannot explicitly attribute blame, but of course in determining the facts of what occurred, where fault lies can be implicit.

The verdict follows from the facts. Each verdict has its own meaning in law. For instance, misadventure is an in intended consequence of an intended act (ie. a complication (unintended) of a surgical procedure (intended act). Misadventure, contrary to widespread misconception, does not mean that there was negligence or fault.

Happenstance, surprisingly, is not a verdict open to the jury....;)

Grayson

GCU Flexible Demeanour wrote: »

I'm afraid your case was found wanting, many posts ago.I think we have to distinguish possibility from reality. Another poster earlier in the thread, getting rather carried away by the moment, asserted that she'd have had a better chance of survival in India. In actual fact, death from sepsis following abortion is a significant cause of maternal death in India for married women.

A mismanaged termination could also have involved infection and death. We have to get beyond the possibility that, through happenstance, termination might have solved the problem if no other complications were ignored.

But it is known that being in the condition she was in heightens the risk of sepsis. yes, there's still a chance that it could have happened anyway. But it's like saying that there's no difference between flying ryanair and flying a 50 year prop driven aeroflot plane that's being piloted by a 14 year old. One is slightly risky as is all air or road travel, one is reckless.

The earlier the procedure is done, the far less the risk is. And it's stupid that anyones life would be risked for the sake of a stupid law. This isn't about being pro-life or pro-choice. This is about legislating to save lives.

GCU Flexible Demeanour

Grayson wrote: »

<...> it's like saying that there's no difference between flying ryanair and flying a 50 year prop driven aeroflot plane that's being piloted by a 14 year old<..>

Not really, as fatalities in either situation are rare here. If systems broke down so much as to allow a fatality in this case, there's no reason to have confidence that they'd have functioned in other circumstances.

Grayson wrote: »

<...> This is about legislating to save lives.

I'm not sure this case is about a need for legislation at all, and I'd be worried that this is effort misplaced when we should probably be asking about the organisation of our hospital services, instead. For instance, medical professionals advise that in Ireland we spread our resources too thinly, by trying to offer 24/7 services out of too many locations. I'd suspect that some of what we see in this case reflects that.

At the same time, I think by 'legislating' you need to be clear in saying what you're advocating is a referendum proposing Constitutional change.

opinion guy

Expert opinion:

Dr Peter Boylan said that if Ms Halappanavar had been given a termination on the Monday or Tuesday, one or two days after she was admitted last October 21st, she would “on the balance of probabilities”, still be alive.
"It is highly likely she would not have died" if she had been given a termination earlier, he added.
However, terminating her pregnancy was not a practical proposition for the doctors treating her at this time because of the legal situation in Ireland, he said.

and

Dr Boylan said that in his view the deficiencies in her care would not have made any difference to Ms Halappanavar’s survival. He said none of the deficiencies in her care was, on its own, likely to result in her death. However their cumulative effect was to delay treatment, and the effect of this was to increase the risk of mortality. Every hour in delay in treating sepsis increases the risk of mortality by 6 per cent.
The real problem was the inability of doctors to terminate her pregnancy at an earlier stage, Dr Boylan said. By the time her condition worsened and this became possible, it was too late to save her life.

Full article:
http://www.irishtimes.com/news/highly-likely-halappanavar-would-be-alive-if-termination-given-inquest-told-1.1363125




So there you have it.

positron

In other news water is wet etc!

I really wish people would start looking at the bigger picture and see things as they really are as compared to splitting hair and try and find faults to justify something just because they are used to it.

Cody Pomeray

opinion guy wrote: »

Expert opinion:





and





Full article:
http://www.irishtimes.com/news/highly-likely-halappanavar-would-be-alive-if-termination-given-inquest-told-1.1363125




So there you have it.

wow, wasn't expecting that.

I think most people were expecting an expert opinion relating to systems failures and maybe misadventure, but a lot still depends on whether the Doctors in question were unable to act despite the risk of danger to the woman's life, or whether they just thought they could not act.

It's not for Dr Boylan to decide that, but the justice system.

PlainP

So its official, will people now realise that it is the law which is flawed and needs to be amended. If Savita had not died the eejits in the Dail would still be sitting on their hands regarding the abortion issuse.
What a waste of a life. This country really needs a good kick up the hole.

jjn2

PlainP wrote: »

So its official, will people now realise that it is the law which is flawed and needs to be amended.

From the bits I've read, it seems like this is likely to be true, but I don't think Peter Boylan's statement settles things? If she'd had a termination 2 weeks earlier, it probably would have saved her life, given subsequent events, but it wouldn't automatically mean that the law is flawed. What will establish that the law is flawed is if the conclusion is that in a situation like sepsis there is a danger to the life of the mother, but that (at least one) doctor doesn't feel legally sure that it's "real and substantial", and therefore can't provide a needed termination.

Steve O

It sounds overhyped!!!!!1111 :rolleyes:

Senseless death followed by accusations that the husband was "milking it for all its worth". Hope ya feel proud out there, all you lovely people.

Steve O

I'd also like to say that this wasn't a result of protest from people to change the system or any kind of public outcry, the man was told to shut up and accept it. Thanks to his perseverance and relentless pursuit of the truth and justice, he can finally mourn his wife.

Absolutely boils my blood this fcuking sh*t.

Morag

PlainP wrote: »

So its official, will people now realise that it is the law which is flawed and needs to be amended. If Savita had not died the eejits in the Dail would still be sitting on their hands regarding the abortion issuse.
What a waste of a life. This country really needs a good kick up the hole.

Unfortunately the Constitution will have to be amended before the risk to the health of a woman is reason enough for an abortion.

Steve O

Again, how can anyone look at themselves in the mirror after this? For all the values that religion teaches surely morality is one? How could you watch someone die ffs?!

GCU Flexible Demeanour

jjn2 wrote: »

From the bits I've read, it seems like this is likely to be true, but I don't think Peter Boylan's statement settles things? If she'd had a termination 2 weeks earlier, it probably would have saved her life, given subsequent events, but it wouldn't automatically mean that the law is flawed. What will establish that the law is flawed is if the conclusion is that in a situation like sepsis there is a danger to the life of the mother, but that (at least one) doctor doesn't feel legally sure that it's "real and substantial", and therefore can't provide a needed termination.

I think that's about the size of it. For abortion to be lawful in circumstances that Peter Boylan envisages, the law would need to state that abortion is allowed where the continuance of the pregnancy would involve risk to the life or health of the pregnant woman, greater than if the pregnancy were terminated.

Which is what the UK abortion law says, and amounts to making abortion lawful in any situation. I doubt that's politically feasible.

Morag

We know that the 'pro life' amendment, the 8th amendment in conjunction with the 1861 act has a body count, so far there are 3 women that we know of, Sheila Hodgers, Michelle Harte and Savita Halappanavar.

It needs to be scraped so that the 'unborn' is not given the equal right to life as the woman esp when miscarriage is inevitable or when a woman need chemo.

GCU Flexible Demeanour

Morag wrote: »

We know that the 'pro life' amendment, the 8th amendment has a body count, so far there are 3 women that we know of, Sheila Hodgers <....>

I suspect change is necessary, and the issue is around creating a political consensus. But the first step is to be clear-eyed about the issues, and to only make statements that can be supported.

http://www.ifpa.ie/node/506

Sheila Hodgers died <...> on 19 March 1983

http://en.wikipedia.org/wiki/Eighth_Amendment_of_the_Constitution_of_Ireland

<...> the Eighth Amendment of the Constitution <...> was approved by referendum on 7 September 1983 and signed into law on the 7 October of the same year.

Morag

The cite I have has different dates but I will check it, her death was still complicated by the 1861 act which is till enforce today.

opinion guy

Cody Pomeray wrote: »

wow, wasn't expecting that.

I think most people were expecting an expert opinion relating to systems failures and maybe misadventure, but a lot still depends on whether the Doctors in question were unable to act despite the risk of danger to the woman's life, or whether they just thought they could not act.

It's not for Dr Boylan to decide that, but the justice system.

In his expert opinion the hesitation about carrying out the abortion was more important to the outcome than the sum of all the small failures. It is absolutely for Dr Boylan to state that if that is his honest opinion given the sum total of his training and experience. Its his job as the expert witness to state that.

VEN

aidan24326 wrote: »

It's unlikely a consultant would say such a thing in a situation like this. Isn't it? Surely? Or are we still living in 1950?

The consultant denies saying "this is a catholic country"

you'd be surprised what choice of words they use when no one else is around.
denial... ah the great denial.

i'd believe him, its possible. i've had similar experiences with out of order remarks by these people we're all suppose to trust.
the mid-wife was honest, thumbs up, now lets all be honest shall we? or would a consultants high paid job be on the line to as much as be honest?

iphone recorders are great, now i always bring it to meetings.

Cody Pomeray

opinion guy wrote: »

In his expert opinion the hesitation about carrying out the abortion was more important to the outcome than the sum of all the small failures.

That's not the part of his testimony to which I'm referring.

I'm referring to that part of the evidence where Peter Boyland said "Terminating her pregnancy was not a practical proposition for the doctors treating her." Presumably practical means the magnitude of the risk to Halapanavar's life was deemed to be inadequate. If so, that's a legal opinion, not strictly a medical one. It's quite possible that the law is more liberal than Peter Boylan thinks.

opinion guy

Cody Pomeray wrote: »

That's not the part of his testimony to which I'm referring.

I'm referring to that part of the evidence where Peter Boyland said "Terminating her pregnancy was not a practical proposition for the doctors treating her." Presumably practical means the magnitude of the risk to Halapanavar's life was deemed to be inadequate. If so, that's a legal opinion, not strictly a medical one. It's quite possible that the law is more liberal than Peter Boylan thinks.

The quote is:

However, terminating her pregnancy was not a practical proposition for the doctors treating her at this time because of the legal situation in Ireland, he said.

I think that's fairly clear. I think trying to make an argument that the law is more liberal than they think is facetious. That is what Dr Astbury thought. This is what Dr Boylan thinks. They are the experts practising the field. If the law is not clear to them then it is not clear enough. Simple as. A doctor should not have to obtain a legal opinion in deciding how to treat a common condition.

Morag

This action to email your TD to demand they legislate for the X case asap is finishing on Friday, if you haven't gotten around to used it please consider doing so now.
http://www.nwci.ie/takeaction/show-your-support-for-legislate-for-x/

GCU Flexible Demeanour

Morag wrote: »

The cite I have has different dates but I will check it, her death was still complicated by the 1861 act which is till enforce today.

That would be helpful - and, obviously, I'll completely accept any verifiable facts you produce. However, I have found the dates I've provided in several sources, which means her death could not possibly relate to the 8th Amendment. I'd suspect a pro-lifer could even argue that the 8th Amendment would have extended specific Constitutional protection for maternal life that was previously absent.

The date issue is obviously just an open-and-shut fact. But I'd wonder if you can be quite so positive in citing the other cases. Did the HSE pay compensation to Michelle Harte? To be clear, I'm not suggesting that financial compensation is a solution (as I expect some will try to avoid the point by pretending that's the point). It would just be unusual, I'd expect, for the HSE to pay compensation unless they felt a case could be made that they'd denied someone a legal entitlement. If that's so, clearly the issue wouldn't be the 8th Amendment, but how folk are applying it (or failing to apply it).

On the Savita Halappanavar case, the issue seems to hinge on Peter Boylan's expert testimony. Again, the issue seems to be about whether aborting when requested would, through happenstance, have avoided death. The pro-life argument in defence of the 8th Amendment will presumably be that, if medical opinion is that circumstances exist which will very likely result in maternal death, abortion is already possible and it's just a case of clarifying that. If, genuinely, he means that no circumstances existed on (say) the Monday to suggest a substantial risk to maternal life, then there's no way of legally defining an exception - other than to say a woman can request an abortion at any time, with medical opinion of risk being irrelevant.

Cody Pomeray

opinion guy wrote: »

The quote is:



I think that's fairly clear. I think trying to make an argument that the law is more liberal than they think is facetious. That is what Dr Astbury thought. This is what Dr Boylan thinks. They are the experts practising the field. If the law is not clear to them then it is not clear enough. Simple as. A doctor should not have to obtain a legal opinion in deciding how to treat a common condition.

I think you're misunderstanding my post.

I am not an anti abortion nutter. I do think that we need to legislate. If it were up to me we would go a lot further in the legislation.

However, from what I have read of the inquest, it appears either premature or inappropriate for Peter Boylan to say that an abortion was not a practical proposition, because it may be the case that the law is more liberal than he is giving it credit for.

Which is why, I agree, we need legislation - to clarify the law.

Ash.J.Williams

Should a doc even be thinking about law in a life saving situation?

Loafing Oaf

Ash.J.Williams wrote: »

Should a doc even be thinking about law in a life saving situation?

She didn't realise it was a life-saving situation until it was too late but even so, surely we shouldn't be putting our medical professionals in a situation where doing something that is standard practice in other countries is placing them in even theoretical legal jeopardy...