THERE has been a near collective rush to judgment, some of it
bordering on near hysteria based on ill-founded comment, as the country
engulfs itself in another abortion paroxysm.
While acknowledging
at the outset the terrible heartbreak of Savita Halappanavar's husband,
following the tragic death of his wife, it is crucial that basic natural
justice applies to all the medical and other staff involved in this
case.
The presumption of innocence until proven guilty surely
applies in a matter literally of life and death.
Some very serious, and
very simplistic allegations are being made, about a medical predicament
which involves finely tuned and potentially high-risk decision-making by
the medics involved.
Central to the current controversy is
whether the cause of death can be directly and unequivocally linked to
existing guidelines on abortion, as these are applied in practice by the
medical profession.
It will be up to the inquiry now under way to answer this crucial question.
On
a broader level, there is wide disagreement as to what kind of abortion
regime should apply in both the Galway case and similar instances,
which involve life-threatening health choices for a pregnant mother.
There
are those who feel the immediate challenge is to introduce legislation
to give legal effect to the the current reality on the ground, which of
course does allow for abortion in certain circumstances, depending on
the ruling of the doctors concerned.
But there are also those for whom such legislation is not enough.
They
want to introduce "no-fault" abortion on demand, as for example exists
in Britain.
Under such a regime the fundamental decision as to whether a
pregnancy should be terminated would essentially rest with the mother
rather than the doctor.
In the meantime, while acknowledging
legislation would provide better legal protection for doctors, and
presumably widen the ambit of their decision making, it should be noted
that despite the fallout from the Galway tragedy, existing Irish Medical
Council guidelines are fairly clear-cut.
Doctors are told
abortion is allowed where there is a real and substantial risk to the
life – as distinct from the health – of the mother. And in what doctors
deem to be exceptional medical circumstances termination of pregnancy is
allowed to protect the mother's life, providing every effort is also
made to preserve the life of the baby.
Proposed legislation may
well bring further clarity to the implementation of these guidelines.
But it won't change the bottom line. The mother will remain subject to
the judgment of her doctor, as to whether an abortion is necessary to
save her life.
One of the more insightful comments made this week
came from a senior consultant, who said he currently sees no evidence
that doctors are confused when deciding if a woman whose life may be at
risk can have an abortion.
However, Dr Sam Coulter-Smith, Master
of Dublin's Rotunda Hospital, did acknowledge it would be preferable to
have legislation to bring more clarity to the existing guidelines.
But
it is important to note he has not seen confusion among doctors when
they have to decide if a woman is entitled to an abortion on clinical
grounds. "Not in relation to where a mother's health is at risk," he
said.
Could legislation giving legal effect to abortion on these
existing limited medical grounds get through the Dail, despite the
reservations of Taoiseach Enda Kenny, and some of the more socially
conservative members of Fine Gael?
The answer is probably yes, in
that the Government is essentially being asked to legislate for what is
already constitutionally agreed, and more importantly for what has now
become common medical practice.
But on the other hand any proposal
to legislate for what can broadly be described as abortion on demand,
based on the British model, is certain to convulse the entire political
system.
The truth is that all the political parties would be
deeply divided on any proposal of this nature, particularly Fine Gael
and Fianna Fail, and in addition sharp divisions remain among the
electorate at large.
The history of a particular kind of social
legislation in Ireland has been a traumatic one, although the relentless
march of time has created its own momentum. The Mother and Child
scheme, which at one point the Catholic Church would have us believe was
creeping communism, because it was "socialised medical care for the
lower orders" is but a distant memory.
And when the one-time twin evils of contraception and divorce were introduced to Catholic Ireland the world didn't end.
Abortion
is the last big issue in this area, but it's the most contentious and
emotive of them all; there is nothing like a national consensus,
politically or otherwise, as to what should be done.
In the past
there was the opportunity to hide behind the old "Irish solution to an
Irish problem" approach, and kick the can down the road, in the hope
that time and tide would bring their own kind of resolution.
But when it comes to the singular issue of life and death – this may no longer be an option.