The 8th amendment(Mod warning in op)

threescompany

....... wrote: »

Indeed - so do you prefer to be part of a society where women do not have full bodily autonomy and where their maternity treatment is not best practice because of the 8th Amendment and where women who do seek abortions are forced to do so in an unsafe manner by flying to a different jurisdiction or not?

There is not one positive outcome of the 8th Amendment. It doesnt even stop abortions (which some people might see as positive) because all the studies show that abortion bans dont stop abortions, they just make women seek unsafe abortions or force poorer women to carry to term and have unwanted children.

Do I prefer to live in a society where Women don’t have full bodily autonomy? Of course not! Full bodily autonomy is full responsibility for ones body, right?? That’s just it, I’m completely in favor of taking responsibility of ones body and making good choices.
It is other people that are not taking responsibility for their bodies & making poor choices when it comes to contraception, with a result of unwanted pregnancy? Please answer this as it would help me in understanding, but if full bodily autonomy is so important, why are people not using contraception with the result of an unwanted pregnancy? ( obviously I’m referring only to pregnancies that result from failed / no contraception).

Also, you say “their maternity treatment is not best practice”. I find this a vague sweeping statement.

SusieBlue

drkpower wrote: »

I am pro-choice and have written and lectured on the circumstances where the 8th has an impact on obstetric care.

But the above is simply incorrect, assuming the tablet you are talking about is methotrexate. There is nothing illegal about methotrexate and it is used for early ectopics in Ireland. It is part of numerous hospital guidelines on the management of ectopic pregnancy available online (including the Coombe and HSE hospitals). It is absolutely or relatively contraindicated in certain clinical scenarios, sure, so it certainly isn't used in all ectopic pregnancies. But that applies to its use in any jurisdiction.

The circumstances were the 8th impinges on obstetric care are all too real, but they are limited. Broad brush statements like 'in any circumstances, whatever a doctor decides to do or not do, a woman doesn't have the power to consent or withdraw consent' are both false and dangerous. And that type of approach will only be counter-productive in the debate that gathers pace over the next few months.

Genuine apologies if i picked you up wrong or misinterpreted something in that post.

As far as I'm aware, and in purely personal experience, methotrexate wasn't offered or advised to 2 women I know (CUMH).
Both had the surgery rather than the tablet. Using the methotrexate is shaky ground because it technically terminates the pregnancy, which goes against the 8th, and could have the medical staff facing prosecution.
I've genuinely never heard of anyone being offered it or advised to use it to treat an ectopic pregnancy, but would be interested in seeing stats of it being used for sure.

As for the consent part, I stand by it. Permission isn't sought for breaking waters, performing sweeps, the list goes on...In my own experience, my opinion wasn't asked for regarding how I wanted to deliver. While the medical staff I dealt with were absolutely lovely, I have no doubt if I had refused something they would have done it anyway.

SusieBlue

threescompany wrote: »

Do I prefer to live in a society where Women don’t have full bodily autonomy? Of course not! Full bodily autonomy is full responsibility for ones body, right?? That’s just it, I’m completely in favor of taking responsibility of ones body and making good choices.
It is other people that are not taking responsibility for their bodies & making poor choices when it comes to contraception, with a result of unwanted pregnancy? Please answer this as it would help me in understanding, but if full bodily autonomy is so important, why are people not using contraception with the result of an unwanted pregnancy? ( obviously I’m referring only to pregnancies that result from failed / no contraception).

Also, you say “their maternity treatment is not best practice”. I find this a vague sweeping statement.

This one is very simple. People are silly, people think they can beat the odds, people think they'll be grand, it'll never happen to them.

Of course they should take responsibility for their bodily autonomy, but we as humans make mistakes and misjudge situations every day.

Of course they should use contraception, but there'll always be the few with the "be grand" attitude.

nozzferrahhtoo

threescompany wrote: »

( obviously I’m referring only to pregnancies that result from failed / no contraception).

I think you mistyped there? I assume you are NOT talking about pregnancies from FAILED contraception. Because in those cases people did take full cautionary measures, but they failed on them. They can hardly be blamed for that.

There is two main problems with moral high horsing in this fashion however that are worthy of your consideration.

1) The first is we do not do this anywhere else. We do not stand over someone injured on the football field screaming at them that they brought it on themselves with their choice to play football, or their choice not to wear the correct protective gear, or that their protective gear was not used properly or failed them. We do not refuse medical help to those who did not put their seat belt on in the car. We help people FIRST and offer condemnation LATER.

2) Like what I wrote to you earlier about rape....... differentiating between people who did not bother to use contraception.... and those that did but were failed by it.......... is not really workable in practice. When a woman shows up seeking abortion, how do you propose to tell the difference between the two retrospectively?

People make mistakes in this world. I think the best approach is to work to minimize mistakes, rather than deny them options having made their mistakes.

Sexual ignorance is one example of this. We need better and more comprehensive and EARLIER sexual education in our schools for example. Despite people (well just one on this thread really) suggesting that education has no effect outside the classroom..... it has actually been shown to be one of (or even THE?) most effective factor in reducing unwanted pregnancy and abortion in a society.

drkpower

WhiteRoses wrote: »

As far as I'm aware, and in purely personal experience, methotrexate wasn't offered or advised to 2 women I know (CUMH).
Both had the surgery rather than the tablet. Using the methotrexate is shaky ground because it technically terminates the pregnancy, which goes against the 8th, and could have the medical staff facing prosecution.
I've genuinely never heard of anyone being offered it or advised to use it to treat an ectopic pregnancy, but would be interested in seeing stats of it being used for sure.

As for the consent part, I stand by it. Permission isn't sought for breaking waters, performing sweeps, the list goes on...In my own experience, my opinion wasn't asked for regarding how I wanted to deliver. While the medical staff I dealt with were absolutely lovely, I have no doubt if I had refused something they would have done it anyway.

That 2 people you know didnt get methotrexate doesn't mean that it is illegal. The more obvious reason is that methotrexate was absolutely or relatively contraindicated in the scenario. Surgery ends a pregnancy as much as methotrexate does. Propogating what you are saying is dangerous. And irresponsible. Spreading irresponsible misinformation will do nothing to get this referendum to pass. Genuinely, go and look at the publically available guidelines on this issue. Its the least you should do.

As for the consent issue, it doesnt even make logical sense. How on earth would the breaking of waters (or not) touch upon the 8th? It is simply a procedure to advance the progress of labour. It has zero effect on the life of the foetus. I am not doubting, by the way, whether you were asked or not (you clearly should have been). Im simply saying that if you were not, it had zero to do with the 8th.

For what its worth, i was asked (well, my wife was) and we said yes.

.......

This post has been deleted.

SusieBlue

....... wrote: »

This post has been deleted.

One of the people I know wasn't even told it could be medically managed by taking a tablet, as far as they were aware at the time of procedure, surgery was the only option.

drkpower

....... wrote: »

This post has been deleted.

Someone i know who someone else told in the pub kindof thing....? You need to weigh up that kind of evidence against the other, you know, actual evidence out there.

What did the case in the newspaper report and what relevance does it have?

drkpower

WhiteRoses wrote: »

One of the people I know wasn't even told it could be medically managed by taking a tablet, as far as they were aware at the time of procedure, surgery was the only option.

That makes complete sense; methotrextae is medically contraindicated in certain scenarios, particularly as foetal size increases. Nothing to do with the law.

.......

This post has been deleted.

.......

This post has been deleted.

rainbow kirby

threescompany wrote: »

Also, you say “their maternity treatment is not best practice”. I find this a vague sweeping statement.

When antenatal screening is either not being performed at all or performed at the wrong time (for example, the anomaly scan according to NICE guidelines in the UK should be performed between 18+0 and 21+6 weeks but is often performed later in Ireland or not at all) that is not best practice.

Most of the techniques of Active Management of Labour (amniotomy/instant augmentation with synthetic oxytocin etc) as brought to the world by Holles Street are not considered best practice. The expectation that labour must follow a nice partogram graph is a bit ridiculous.

The fact that very few of the hospitals in Ireland make use of community midwives and satellite clinics is not best practice - it has been shown that it is better for low-risk women to be cared for in community settings by midwives, freeing up obstetricians for medium and high risk cases.

The fact that a woman's informed consent can be overruled simply because she is pregnant (see the Mother B case: hospital brought her to court on due date to force a CS rather than "allowing" a VBA3C attempt) is absolutely nuts and is a direct result of the 8th.

SusieBlue

drkpower wrote: »

That 2 people you know didnt get methotrexate doesn't mean that it is illegal. The more obvious reason is that methotrexate was absolutely or relatively contraindicated in the scenario. Surgery ends a pregnancy as much as methotrexate does. Propogating what you are saying is dangerous. And irresponsible. Spreading irresponsible misinformation will do nothing to get this referendum to pass. Genuinely, go and look at the publically available guidelines on this issue. Its the least you should do.

As for the consent issue, it doesnt even make logical sense. How on earth would the breaking of waters (or not) touch upon the 8th? It is simply a procedure to advance the progress of labour. It has zero effect on the life of the foetus. I am not doubting, by the way, whether you were asked or not (you clearly should have been). Im simply saying that if you were not, it had zero to do with the 8th.

For what its worth, i was asked (well, my wife was) and we said yes.

Well maybe I should have worded it better, a better way of saying it would have been that the legality of the use of it to manage ectopic pregnancies is a grey area due to the wording of the 8th, some will take the risk, some will not.

I never suggested that the consent one was a matter of life or death.
There's just a stark difference between regular medical care, where approval is needed to pretty much everything, and maternity care, where if you were to say no, they can potentially do it anyway.
I don't doubt that most maternity medical staff DO seek permission, but I also don't doubt that many simply don't at all.

NuMarvel

drkpower wrote: »

That makes complete sense; methotrextae is medically contraindicated in certain scenarios, particularly as foetal size increases. Nothing to do with the law.

Is the presence of a foetal heartbeat one of these scenarios?

drkpower

....... wrote: »

This post has been deleted.

Are you sure about that? I havent seen the report but this seems like a straightforward case where methotrexate was either absolutely or medically contraindicated.

SusieBlue

drkpower wrote: »

Are you sure about that? I havent seen the report but this seems like a straightforward case where methotrexate was either absolutely or medically contraindicated.

Here is a link.

drkpower

WhiteRoses wrote: »

Well maybe I should have worded it better, a better way of saying it would have been that the legality of the use of it to manage ectopic pregnancies is a grey area due to the wording of the 8th, some will take the risk, some will not.

Its not a grey area at all, legally. Clinically, you could say it is, but that applies in any other country.

WhiteRoses wrote: »

I never suggested that the consent one was a matter of life or death.
There's just a stark difference between regular medical care, where approval is needed to pretty much everything, and maternity care, where if you were to say no, they can potentially do it anyway.
I don't doubt that most maternity medical staff DO seek permission, but I also don't doubt that many simply don't at all.

Approval to do just about everything is needed in medical care and obstetric care; that is Medical Law 101.

The only possible exception caused by the 8th relates to very rare scenarios where a maternal choice will result in death of the foetus (refusal of caesarean section in certain unusual circumstances); and even the legal position on that is in debate.

Medical staff not seeking (or perhaps more usually, assuming) consent does happen, but it has nothing to do with the 8th.

drkpower

NuMarvel wrote: »

Is the presence of a foetal heartbeat one of these scenarios?

I think so; as it is in the UK and every other jurisdiction.

.......

This post has been deleted.

.......

This post has been deleted.

drkpower

It's disappointing that you ommitted the key part of s.7.7.1 of the HSE consent policy. In all seriousness, it is this type of disingenous approach that will risk losing this referendum. There are many many reasons for repeal of the 8th; there is no need to make ones up.

7.7.1 Refusal of treatment in pregnancy The consent of a pregnant woman is required for all health and social care interventions. However, because of the constitutional provisions on the right to life of the “unborn”12, there is significant legal uncertainty regarding the extent of a pregnant woman's right to refuse treatment in circumstances in which the refusal would put the life of a viable foetus at serious risk. In such circumstances, legal advice should be sought as to whether an application to the High Court is necessary.

http://www.hse.ie/eng/about/Who/QID/Other-Quality-Improvement-Programmes/Consent/National-Consent-Policy-August-2017.pdf

.......

This post has been deleted.

drkpower

The one from a few posts above, which you said 'wrong' to.

Approval to do just about everything is needed in medical care and obstetric care; that is Medical Law 101.

The only possible exception caused by the 8th relates to very rare scenarios where a maternal choice will result in death of the foetus (refusal of caesarean section in certain unusual circumstances); and even the legal position on that is in debate.

Medical staff not seeking (or perhaps more usually, assuming) consent does happen, but it has nothing to do with the 8th.

Can you really not see the key way in which you(or perhaps AIMS) sought to mischaracterise s.7.7.1 of the consent policy? Genuinely?

.......

This post has been deleted.

Annasopra

I hear Micheal Martin just came out in favour of repeal just now

seamus

Joeytheparrot wrote: »

I hear Micheal Martin just came out in favour of repeal just now

Ooh, that's ... unexpected.

https://www.rte.ie/news/2018/0118/934135-eighth-amendment/

That puts him at odds with the FF Ard Fheis and is sure to put the cat amongst the pigeons.

FF are making a push for the younger voters; the ones who weren't really impacted by the recession, but even if this is a solo run by Martin, there's a huge grassroots vote in the rural Catholics who won't be impressed by this.

Or maybe they will, and they'll follow his lead.

.......

This post has been deleted.

Loafing Oaf

seamus wrote: »

there's a huge grassroots vote in the rural Catholics who won't be impressed by this.

Probably not, but the salient question from his POV is, are they going to shift their vote away from FF in any numbers. If not, there's no real downside to this move for him.

Hector Bellend

The 8th amendment will not be televised

Edward M

Loafing Oaf wrote: »

Probably not, but the salient question from his POV is, are they going to shift their vote away from FF in any numbers. If not, there's no real downside to this move for him.

I think its great for the debate.
Let's face it, he has a personal point of view on ethical issues and shouldnt suffer consequences for voicing them, despite his party's stance.
http://www.thejournal.ie/fianna-fail-protect-rights-of-unborn-3646886-Oct2017/