Clinicaly dead pregnant woman on life support

RobertKK · 27-12-2014 11:56am

Bruthal wrote: »

You said the hospital applied law to a dead person. The law was tested with regard to an unborn feotus and right to life.

If it had been a dead non pregnant person, you think your dead person law would have been tested here?

It wouldn't. But the unborn was not going to survive with a dead mother. Keeping her on a life support machine was a violation of her right to a dignified natural death, something we all hope we receive when it is our own time to depart this world.

Shenshen · 27-12-2014 11:56am

RobertKK wrote: »

Required by law to argue. But this was not about abortion. It was a court case taken by the family so their family member could be allowed die naturally and with dignity due to the HSE being wrong in what they did.

The HSE were acting on legal advise. If the situation had been as clear-cut and obvious as you pretend it was, it never would have needed to go to court in the first place. It would not have required a court ruling.

As the law stands at the moment, every similar situation arising will most likely have to be dragged to the courts as well, as no doctor and no hospital in their right minds will risk turning off the machines without the full assurance of a court decision.
The risk of it coming to the courts after mother and foetus are dead and the judge then deciding they should have kept her alive as the foetus may have been viable is just too great.

Bruthal · 27-12-2014 11:57am

RobertKK wrote: »

Required by law to argue. But this was not about abortion. It was a court case taken by the family so their family member could be allowed die naturally and with dignity due to the HSE being wrong in what they did.

In my opinion the HSE were correct to ensure acting within law. Just because judges judged in agreement with your prediction, does not mean you are acting within the law before a judgement is made.

The fault here is with the laws themselves, not those who are unclear as to their position while trying to practice within them.

This decision doesn't really offer perfect clarity for any future cases either.

Bruthal · 27-12-2014 12:05pm

RobertKK wrote: »

It wouldn't. But the unborn was not going to survive with a dead mother. Keeping her on a life support machine was a violation of her right to a dignified natural death, something we all hope we receive when it is our own time to depart this world.

We won't all be pregnant when death comes.

Its easy to say it was a violation. But would you simply switch off a machine in similar situations without question and with unclear legal position? Simple when hypothetically from an armchair I'd imagine.

What if advances in medical practice mean a feotus can survive no problem, what then, switch off anyway?

marienbad · 27-12-2014 12:23pm

RobertKK wrote: »

people are using this case for political means. The family went to the high court to allow their family member to rest in peace given she was dead.

You keep saying that but it is a meaningless statement ,how do you know their motives ? You attribute to them what you need to see to support your view .

Some would say you are the most political poster in this discussion .

Baggy Trousers · 27-12-2014 12:28pm

Call me Al wrote: »

I don't know.... Is it? Were any previous cases brought up in the courtroom the last day?

I heard on the radio that this scenario was known to have happened at least twice before in Ireland but the doctors chose to simply turn off the machines rather than seek legal approval. If I recall correctly, one case was in UCHG.

Call me Al · 27-12-2014 12:29pm

Baggy Trousers wrote: »

I heard on the radio that this scenario was known to have happened at least twice before in Ireland but the doctors chose to simply turn off the machines rather than seek legal approval. If I recall correctly, one case was in UCHG.

Do you have a link? When was it? Were the circumstances identical? Genuinely I don't know.

Baggy Trousers · 27-12-2014 12:32pm

Call me Al wrote: »

Do you have a link? When was it? Were the circumstances identical? Genuinely I don't know.

No link - it was either Newstalk or Radio 1. It was about a week ago.
I think the foetus might have been younger in both cases.

ProfessorPlum · 27-12-2014 12:46pm

Baggy Trousers wrote: »

I heard on the radio that this scenario was known to have happened at least twice before in Ireland but the doctors chose to simply turn off the machines rather than seek legal approval. If I recall correctly, one case was in UCHG.

That case and another on Wsterford was mentioned in the Sunday times last week. The foetus died first, and life support was withdrawn after, for obvious reasons. In the case in Watrford it was reported that the hospital approached the AG for advice, the advice given was that the doctors could make the decision without recourse to the courts. The foetus again died, but it wasn't clear weather this happened before a decision was made.

Edit: according to an IT article from Dec 23, the foetus in Waterford died, and afterwards the machine was turned off. So both cases were similar to this, but they were resolved by the death of the foetus.

Baggy Trousers · 27-12-2014 1:23pm

ProfessorPlum wrote: »

That case and another on Wsterford was mentioned in the Sunday times last week. The foetus died first, and life support was withdrawn after, for obvious reasons. In the case in Watrford it was reported that the hospital approached the AG for advice, the advice given was that the doctors could make the decision without recourse to the courts. The foetus again died, but it wasn't clear weather this happened before a decision was made.

Edit: according to an IT article from Dec 23, the foetus in Waterford died, and afterwards the machine was turned off. So both cases were similar to this, but they were resolved by the death of the foetus.

Ok they must be different cases because the cases I heard about were not referred to any legal entities. They were simply cases where the mother was pregnant when she died and they turned off the life support machine as per next-of-kin wishes. The suggestion on the radio was that the doctors could have acted illegally depending on the outcome of this latest case (which was unknown at the time of radio broadcast).

Baggy Trousers · 27-12-2014 1:28pm

Re above the point being made was why the doctors chose this case over the other two to challenge a legal standpoint.

Call me Al · 27-12-2014 1:37pm

Baggy Trousers wrote: »

Re above the point being made was why the doctors chose this case over the other two to challenge a legal standpoint.

I don't think the doctors here chose this case to make any legal point. Did you read the evidence given by the medical experts involved in her care? They're not heartless animals without emotions for the lady in question. But they face a jail sentence if they act in contradiction to the Constitution, and their legal advice didnt guarantee them anything

Baggy Trousers · 27-12-2014 1:47pm

Call me Al wrote: »

I don't think the doctors here chose this case to make any legal point. Did you read the evidence given by the medical experts involved in her care? They're not heartless animals without emotions for the lady in question. But they face a jail sentence if they act in contradiction to the Constitution, and their legal advice didnt guarantee them anything

I was asking about the previous cases that never went through the courts where the doctors took matters into their own hands. If people haven't heard about those 2 incidents, then fair enough - I don't wish to be argumentative about this case because the correct decision was made, albeit after a long delay.

By the way, it wasn't me making the point about why the doctors chose this case, it was someone on a radio talk show panel who questioned the timing.

Call me Al · 27-12-2014 1:52pm

Baggy Trousers wrote: »

I was asking about the previous cases that never went through the courts where the doctors took matters into their own hands. If people haven't heard about those 2 incidents, then fair enough - I don't wish to be argumentative about this case because the correct decision was made, albeit after a long delay.

By the way, it wasn't me making the point about why the doctors chose this case, it was someone on a radio talk show panel who questioned the timing.

But you did say a couple of posts back that you felt that the HSE were excessively cruel and you suggested that maybe they were just making a point.

Baggy Trousers · 27-12-2014 1:54pm

Call me Al wrote: »

But you did say a couple of posts back that you felt that the HSE were excessively cruel and you suggested that maybe they were just making a point.

Yes I believe that given what I have heard. I feel the inevitable decision was prolonged and dragged through the courts and media far too long.

Call me Al · 27-12-2014 2:51pm

Baggy Trousers wrote: »

Yes I believe that given what I have heard. I feel the inevitable decision was prolonged and dragged through the courts and media far too long.

Well I'd think the doctors involved would completely agree with you there. I'm sure there is nothing they'd have appreciated more than to have had legal certainty and have been able to act quickly in the best interests of the mother and allow her a dignified death.
Can I ask if you were in their position would you have switched off the machine with legal doubts hanging over your head and a threat of jailtime lurking there in the background. Not to mention the professional and other personal consequences it'd have for you.
They aren't legal professionals with the ability to interpret Constitutional technicalities. They were in uncharted territory legally and as such, even though it was a medical matter, it's not for them to decide how section 8 can be interpreted.

And that's why it ended up the sorry mess that it did.

JRant · 27-12-2014 4:27pm

RobertKK wrote: »

I am not changing my opinion to something I don't believe so you can feel you are right.
I believe in what I argue as you do with your argument. I am not asking you to admit you are wrong so I can feel I won some debate.
We both believe what we believe and that is what is allowed in a free society.

A free society? Are you serious?

We live in anything but a free society. Well i suppose it is "free" when you agree with all the restrictions placed on private citizens.
Want an abortion? Tough shïte, get the boat.

What business does the constitution have in interfering in personal medical decisions?

ProfessorPlum · 27-12-2014 4:33pm

Baggy Trousers wrote: »

I was asking about the previous cases that never went through the courts where the doctors took matters into their own hands. If people haven't heard about those 2 incidents, then fair enough - I don't wish to be argumentative about this case because the correct decision was made, albeit after a long delay.

By the way, it wasn't me making the point about why the doctors chose this case, it was someone on a radio talk show panel who questioned the timing.

I can find no mention in the press or anywhere else of these two 'other' cases. Nor were they mentioned in the recent court proceedings, which I find impossible to believe would happen if they actually existed. Would it be fair to suppose that either your self or the panel on the radio show got it wrong and were actually talking about the two know cases that I mentioned and were also mentioned during the court proceedings?

The doctors didn't 'choose' this case. It was the father of the woman involved who brought proceedings.

Baggy Trousers · 27-12-2014 4:38pm

ProfessorPlum wrote: »

I can find no mention in the press or anywhere else of these two 'other' cases. Nor were they mentioned in the recent court proceedings, which I find impossible to believe would happen if they actually existed. Would it be fair to suppose that either your self or the panel on the radio show got it wrong and were actually talking about the two know cases that I mentioned and were also mentioned during the court proceedings?

The doctors didn't 'choose' this case. It was the father of the woman involved who brought proceedings.

The story was just breaking but I know what I heard. I am sure it will come out in due course. It wouldn't be incredible to think that some doctor(s) decided to "do the right thing" rather than go to the courts for some interpretation. One of the cases was in UCH Galway (not Savita) if that helps. For the record, I am not advocating a witch-hunt by any means.

Fair play to the father though, at least this formal decision will prevent pointless heartache in the future. I think most do agree that the law is an ass and needs to be clarified.

lazygal · 27-12-2014 5:15pm

Baggy Trousers wrote: »

The story was just breaking but I know what I heard. I am sure it will come out in due course. It wouldn't be incredible to think that some doctor(s) decided to "do the right thing" rather than go to the courts for some interpretation. One of the cases was in UCH Galway (not Savita) if that helps. For the record, I am not advocating a witch-hunt by any means.

Fair play to the father though, at least this formal decision will prevent pointless heartache in the future. I think most do agree that the law is an ass and needs to be clarified.

This judgment very much takes only the precise circumstances of the situation into.consideration. I very much doubt this judgment will prevent similar but not identical cases coming before the courts. In fact, after this doctors may be even more cautious about how pregnant women are treated in case they end up in the high court. Why should they have to interpret the constitution when practicing medicine? The eighth amendment has to go.

Grayson · 27-12-2014 6:00pm

lazygal wrote: »

This judgment very much takes only the precise circumstances of the situation into.consideration. I very much doubt this judgment will prevent similar but not identical cases coming before the courts. In fact, after this doctors may be even more cautious about how pregnant women are treated in case they end up in the high court. Why should they have to interpret the constitution when practicing medicine? The eighth amendment has to go.

I've heard the decision described as "landmark". I guess in some ways it is but it's a very narrow judgement. These cases are very rare.

However as we've found there are lots of very rare cases. Savita, this one, Miss Y, etc... All rare cases. And there will be more.

lazygal · 27-12-2014 7:24pm

Grayson wrote: »

I've heard the decision described as "landmark". I guess in some ways it is but it's a very narrow judgement. These cases are very rare.

However as we've found there are lots of very rare cases. Savita, this one, Miss Y, etc... All rare cases. And there will me more.

I think its only landmark in the sense that once again the eighth amendment is shown to affect clinical judgment and has doctors puzzling and worrying about constitutional law rather than medical matters.

conorh91 · 27-12-2014 8:14pm

MrPudding wrote: »

You will find several references in the judgement to 'allowing the woman to die'.

You will also find in the judgment references to the woman as having already died.

I am aware that Ireland does not have a legal definition of death, nevertheless I feel that the judgment was unhelpfully ambiguous in this regard. Either the woman is dead or she is not. Either she possesses personal rights, or she does not.

This is a side-issue and not central to the Court's decision, but since you asked me, yes I feel the Court was ambiguous on whether or not the woman is dead.

You find it odd that the court would listen to experts in a particular area and use their opinion, or evidence as it is frequently called, to inform their judgement???

No. I have no problem with medical doctors scientific evidence, nor their personal experience of obstetrics, gynecology and internal medicine being used in the judgment. I do find it surprising that they should be called upon as ethicists. Ethical judgment was for the Court alone, perhaps after having consulted a philosopher, as has happened in other high-profile cases.

I also found it strange that Dr Boylan claimed that this wouldn't happen in any other country in the world. That's a legal question, not one for a medical expert to answer. I'm not sure how well-acquainted Dr Boylan is with comparative constitutional law, but even if he considers himself qualified to speak in this way, evidence from medical doctors should be restricted to the practice of medicine directly.

volchitsa · 27-12-2014 8:34pm

conorh91 wrote: »

I also found it strange that Dr Boylan claimed that this wouldn't happen in any other country in the world. That's a legal question, not one for a medical expert to answer. I'm not sure how well-acquainted Dr Boylan is with comparative constitutional law, but even if he considers himself qualified to speak in this way, evidence from medical doctors should be restricted to the practice of medicine directly.

I'm fairly certain it could only happen in places where the fetus is the subject of personhood laws. I don't know if there are any countries where this is the case, but there are states in the USA with some version of these laws.

Without being a legal expert, it wouldn't be surprising for Peter Boylan to take a certain interest in whether obstetricians in other countries operate under similar constraints to himself and his colleagues, so he may have some idea about it, I'd have thought.

lazygal · 27-12-2014 9:09pm

volchitsa wrote: »

I'm fairly certain it could only happen in places where the fetus is the subject of personhood laws. I don't know if there are any countries where this is the case, but there are states in the USA with some version of these laws.

Without being a legal expert, it wouldn't be surprising for Peter Boylan to take a certain interest in whether obstetricians in other countries operate under similar constraints to himself and his colleagues, so he may have some idea about it, I'd have thought.

Many Irish doctors will also have done some work or training abroad. One of the reasons I chose my obstetrician when I was pregnant was the fact they had done some training outside the Irish state. I didn't want to be in a situation where I was being treated by someone who had never operated within a system where abortion was a normal part of clinical practice during pregnancy. I would also have serious reservations about some of the consultants in the same hospital and refused treatment from one of them during my last pregnancy for various reasons. If I'm pregnant again I plan on returning to my previous consultant and requesting in writing not to be treated by the other consultant, even in an emergency situation.

conorh91 · 27-12-2014 9:40pm

volchitsa wrote: »

Without being a legal expert, it wouldn't be surprising for Peter Boylan to take a certain interest in whether obstetricians in other countries operate under similar constraints to himself and his colleagues, so he may have some idea about it, I'd have thought.

Yes, he may have "some idea" about it, just as some amateur boardsie with a library card may have "some idea" of obstetrics.

Even an academic constitutional lawyer is unlikely to be able to make such a statement with certainty as Dr. Boylan made.

In Dr. Boylan's case, he would appear to be incorrect. There is a broad spectrum of rights ascribed to the unborn across the European Union, from almost zero to moderately strong legal protection. Even the European Court of Human Rights is on-the-fence regarding foetal rights. It seems perfectly plausible that such a case could occur internationally, and may have done so for all I know.

All I am saying is that expert witnesses should stick to their realm of practice. I would hope people would see that as a rational expectation.

volchitsa · 27-12-2014 9:50pm

conorh91 wrote: »

Yes, he may have "some idea" about it, just as some amateur boardsie with a library card may have "some idea" of obstetrics.

Even an academic constitutional lawyer is unlikely to be able to make such a statement with certainty as Dr. Boylan made.

In Dr. Boylan's case, he would appear to be incorrect. There is a broad spectrum of rights ascribed to the unborn across the European Union, from almost zero to moderately strong legal protection. Even the European Court of Human Rights is on-the-fence regarding foetal rights. It seems perfectly plausible that such a case could occur internationally, and may have done so for all I know.

All I am saying is that expert witnesses should stick to their realm of practice. I would hope people would see that as a rational expectation.

Isn't that exactly the problem though? The doctors in this case had a medical opinion, but felt they were incompetent to decide on the legal situation?

As an aside, could you tell us which, if any, European countries would have a similar level of protection of fetal life that might entail forcibly keeping a woman on one support against the next of kin's wishes? It's my understanding that there are some with bans on abortion, but that is different from a more general protection for the unborn.

lazygal · 27-12-2014 9:55pm

volchitsa wrote: »

Isn't that exactly the problem though? The doctors in this case had a medical opinion, but felt they were incompetent to decide on the legal situation?

As an aside, could you tell us which, if any, European countries would have a similar level of protection of fetal life that might entail forcibly keeping a woman on one support against the next of kin's wishes? It's my understanding that there are some with bans on abortion, but that is different from a more general protection for the unborn.

Possibly Malta, which has a similar near total ban on abortion to Ireland. I understand the laws in Poland are also very restrictive.
I wonder what would happen if a woman expressed a wish (especially after this case) that her wish was to remain on life support as long as possible, but her next of kin wanted to do otherwise. Would a living will or otherwise expressed wish be respected by a court? Would it interfere with the right of the foetus in a case like this?
Once again, rather than tidying up the abortion debate forevermore, the eighth amendment raises ever more questions.

ETA: Map below. Ireland stands alongside Malta, but I'm not overly sure of the exact laws in Poland and Spain.
http://news.bbc.co.uk/2/hi/europe/6235557.stm

conorh91 · 27-12-2014 10:01pm

volchitsa wrote: »

Isn't that exactly the problem though? The doctors in this case had a medical opinion, but felt they were incompetent to decide on the legal situation?

Doctors take legal advice all the time. The HSE's legal bill is extraordinary. Medical law is thriving. It is no bad thing that doctors should show caution in the course of their practice, including seeking legal opinions from time to time. This is in patients' best interests.

I'm not sure where the idea came from that the law should not be a factor in medical practice, but it seems to me like a bizarre statement. Ignoring the law in the past has resulted in issues like symphysiotomy. Am I likening this case to symphysiotomy? Never. But I am simply pointing out that the law often operates to keep doctors in check and vindicate patients' rights.

As an aside, could you tell us which, if any, European countries would have a similar level of protection of fetal life that might entail forcibly keeping a woman on one support against the next of kin's wishes?

None have a similar leval of protection as far as I am aware.

But some, such as Greece, offer limited legal protection to the unborn. In cases where the mother is clinically dead as thus has no rights, the threshold for protection would be very low in order for the foetus to be maintained, all else being equal.

According to the Irish Times, Denmark, Spain and Portugal also grant limited legal rights to the unborn. I am not certain of the nature of that protection, but I would reiterate that the threshold would appear to be low, in circumstances where the mother is dead. As we know, some US states are more forthright in their foetal protection.

lazygal · 27-12-2014 10:04pm

conorh91 wrote: »

Doctors take legal advice all the time. The HSE's legal bill is extraordinary. Medical law is thriving. It is no bad thing that doctors should show caution in the course of their practice, including seeking legal opinions from time to time. This is in patients' best interests.

Really, doctors take legal advice all the time? Do you have evidence of this? What other area of medical practice requires doctors to dig out the constitution to check whether they are operating within the law?
When I am pregnant, the very last thing I'm interested in is the constitution. I'm interested in doctors practicing what they are trained to do and what they should be allowed to do without worrying about ending up in the high court. When a woman is in labour and the foetus is in distress and emergency intervention is required and decisions have to be made within minutes, do you really think its appropriate that a constitutional legal team is on standby just in case?

Clinicaly dead pregnant woman on life support

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