Abortion Discussion

volchitsa

Absolam wrote: »

It is the diagnosis you offered. You said

Not "the public record states" or anything similar, no link to any medical authority stating what 'the primary diagnosis was'.
You made the statement, without any attribution. Until you show us who made the diagnosis, how can we possibly consider it to be anything other than your diagnosis? There's no evidence present of anyone else having made it.
We can decide whether it ought to be in dispute or not once we know it's origin

Does this answer your question?
http://www.irishhealth.com/article.html?id=23953

In Savita's case, chorioamnionitis was linked to her having spontaneous rupture of the membranes the day after she was admitted.

Savita later miscarried spontaneously, a diagnosis of sepsis secondary to chorioamnionitis was eventually made and she was admitted to the high dependency unit. A key controversy in the case was the hospital's reported refusal to accede to Ms Halappanavar's request for a termination from early on in her hospital stay.

The HSE review said the risk of infection and sepsis increased with time following admission and especially following the spontaneous rupture of the membranes.

There are lots of places where you could have found that information btw, because as PrP said, it's a matter of public record.

Absolam

volchitsa wrote: »

She was referring to the explanation which the Halappanavars were given, that the abortion requested would be illegal because "this is a catholic country".

Was she? It was actually the headline of the article, so it's hard to say it was presented in the context of anything said to the Halappanavars.

volchitsa wrote: »

They were told that, so it was a perfectly reasonable comment for Dr Gunter, as a non Irish resident who doesn't claim to know the law here, to make. She took the staff member's comment as exact. Why wouldn't she?

Well, she does speculate in the article as to what Irish law does, and separates Catholic doctrine from Irish law in her speculations, then returns to conflating them into Irish Catholic Law in her summary. I'm not sure you can parlay that kind of deliberate phrasing into a reference to the explanation which the Halappanavars were given; she certainly doesn't offer that as reasoning. It seems more likely to me that she was well aware there was no such thing as Irish Catholic Law and chose a deliberately confrontational headline that would drive hits on her page.

volchitsa wrote: »

Love the speculation based around malpractice vs Malpractice, by the way. Do you have a source for that legal nuance, other than your own head?

Where do you think speculation would come from, other than from ones own head?

Absolam

volchitsa wrote: »

Does this answer your question?
There are lots of places where you could have found that information btw, because as PrP said, it's a matter of public record.

Well, no, it doesn't. I asked who said that the primary diagnosis was chorioamnionitis.
The article says that a diagnosis of sepsis secondary to chorioamnionitis was eventually made. It doesn't say who made the diagnosis, nor does it say that the primary diagnosis was chorioamnionitis (I can see why someone might assume that the primary diagnosis was chorioamnionitis, but that's not what your article says).
I'm sure there were lots of ways to find that out; for instance, the HSE report contains the information that a diagnosis of sepsis secondary to chorioamnionitis was made. It also notes the first (or primary) diagnosis that was noted in the medical records; that of “an inevitable/impending pregnancy loss” (subsequent to a queried diagnosis of symphysis pubis dysfunction). However, since I didn't offer the point, it wasn't (and isn't) up to me to show a source for it.
I imagine ProfessorPlum may want to dispute that "the primary diagnosis" is the first diagnosis, and might prefer it be read as "the inferred primacy of chorioamnionitus in a diagnosis of sepsis secondary to chorioamnionitus", which would be altogether novel and entertaining.

volchitsa

Absolam wrote: »

Well, no, it doesn't. I asked who said that the primary diagnosis was chorioamnionitis.
The article says that a diagnosis of sepsis secondary to chorioamnionitis was eventually made. It doesn't say who made the diagnosis, nor does it say that the primary diagnosis was chorioamnionitis (I can see why someone might assume that the primary diagnosis was chorioamnionitis, but that's not what your article says).
I'm sure there were lots of ways to find that out; for instance, the HSE report contains the information that a diagnosis of sepsis secondary to chorioamnionitis was made. It also notes the first (or primary) diagnosis that was noted in the medical records; that of “an inevitable/impending pregnancy loss” (subsequent to a queried diagnosis of symphysis pubis dysfunction). However, since I didn't offer the point, it wasn't (and isn't) up to me to show a source for it.
I imagine ProfessorPlum may want to dispute that "the primary diagnosis" is the first diagnosis, and might prefer it be read as "the inferred primacy of chorioamnionitus in a diagnosis of sepsis secondary to chorioamnionitus", which would be altogether novel and entertaining.

You're positively hilarious. Which is a strange thing to find myself thinking on a subject as tragic as this - but you really are. You have to be a troll. Nobody sane could believe that level of craziness passes for logiic.

For example : you don't really think Savita Halappanavar died of "an inevitable/impending pregnancy loss" - do you? So why do you mention that as being a relevant "primary" diagnosis? Or symphysis-pubis dysfunction for that matter? How could either of those be the primary diagnosis relevant to her death?? Or are you back to "if only she hadn't got pregnant"?

No, you're a troll. I don't think I'll bother with you any more.

ProfessorPlum

Rather frustrating to put it mildly! Now Absolam, please try to rein in that imagination of yours. While for most people the imagination is a wonderful thing, your's isn't doing you any favours.
I hardly see how it could come as a shock to you, but diagnoses are made by medical teams who look after patients. So to put your mind at rest, I will offer that the diagnosis came from the medical team at UCHG. No doubt you will have some issue or another with that. I suggest you head to Galway county coroners court for a transcript of the evidence, or perhaps request a copy of the death certificate from the registrar general (although that will only tell you the cause of death - primary and secondary causes and contributing factors, and not the name of the person/s who made the diagnosis.)

alaimacerc

Absolam wrote: »

[...] she eschewed the capital M in favour of the lower case, [...]

We going to have a Sovereign Citizen/Freeman on the Land type of discourse on the deep significance of caps, next?

recedite

I'm surprised at the extent of the changes in those new guidelines, post Savita. Considering there was no real change in the law. Alright, the PoLPA had been brought in in 2013, but that was just legislating for the x-case which happened way back in 1992, and which established the legal principle that abortion was legal in Ireland if there was a risk to the mothers life.

The miscarriage guidelines state that women with signs of chorioamnionitis (infection of the fetal membranes due to a bacterial infection) should be commenced on broad spectrum intravenous antibiotics without delay.

I would have thought that goes without saying. But anyway that is the first treatment to be tried, before a termination is considered.

..in cases of second trimester miscarriage where there is evidence of maternal compromise such as sepsis, immediate steps towards delivery may be required.

"Delivery" in this scenario is "termination" or "abortion".

..They state that if the fetal heart is present, it may still be necessary to induce delivery irrespective of gestational age, particularly if there is evidence of infection developing...

..where the membranes have ruptured, the woman should be closely monitored clinically for any signs of infection..

On the Savita case itself the HSE investigation reads like a litany of medical malpractice, but is extremely careful to avoid using that word, presumably to avoid being sued.

The HSE's investigation into Savita Halappanavar's death said inadequate assessment and monitoring of her deteriorating condition was a key causal factor in her death.
It said Savita's deteriorating condition was due to infection linked to a failure to devise and follow a plan of care that was cognisant of the fact that her inevitable miscarriage was caused by infection and the risk of sepsis increased following spontaneous rupture of the membranes, which was linked to chorioamnionitis, the day after she was admitted.
Savita later miscarried spontaneously, a diagnosis of sepsis secondary to chorioamnionitis was eventually made and she was admitted to the high dependency unit.

The HSE review also said the hospital failed to adhere to clinical guidelines on the prompt and effective management of sepsis, severe sepsis and septic shock from when it was first diagnosed in Ms Halappanavar.
Another report on Savita's death, by the safety body HIQA, said a more comprehensive plan of care should have been developed from early in Savita's hospital stay.
It said there was a general lack of provision of basic, fundamental care, a failure to recognise that Savita was at risk of clinical deterioration. and a failure to act or escalate concerns to an appropriately qualified clinician when she was showing signs of clinical deterioration. It said there was insufficient monitoring of Savita's condition, and insufficient identification and management of maternal sepsis.

In spite of all that, it is incredible that so many people still accept Dr Boylan's attempts at the time to pass the blame for this tragedy away from the medical profession and onto Irish law.

"The real problem was the inability to terminate prior to Mrs Halappanavar developing a real or substantive risk to her life," Dr Boylan said.
"By that time it was effectively too late to save her life," he added.

How can somebody in "intensive care" in a high dependency unit not be considered to be "at risk"?
And anyway, when was the last time a doctor in an Irish maternity hospital was prosecuted for terminating/aborting a foetus while trying to protect the mother? Ever?

What all this boils down to is the medical profession, the hospital and the HSE all getting together and changing their procedures, while not admitting there was any malpractice in their previous procedures.
Nobody gets sacked, but at least Ireland will be a safer place for pregnant women in future.
It's also a wake up call that in future the priest who sits on the board of many Irish hospitals can no longer dictate a policy that is closer to Canon law than Irish law. Its a wake up call to supposedly secular hospitals like GUH that they cannot take their cue from the so-called "National Maternity Hospital" of Ireland, when it in turn is taking its cue from an executive committee chaired by a man who spent years studying the Canon law and the theology/mythology of an ancient religious cult, but knows precious little about medicine or real law. Check out the first 9 executives listed...

Dr. Diarmuid Martin (Archbishop of Dublin, Chairman)
Cllr. Christy Burke, Lord Mayor of Dublin (Vice Chairman)
Mr Niall Doyle (Deputy Chairman)
Dr Rhona Mahony (Master)
Mr William Johnston (Honorary Secretary)
Ms Catherine Ghose (Honorary Treasurer)
Very Rev. John Gilligan (Administrator of the Parish of St. Andrew, Westland Row)
Ms Catherine Altman
Dr. Peter Boylan

volchitsa

recedite wrote: »

I would have thought that goes without saying. But anyway that is the first treatment to be tried, before a termination is considered.

Good heavens, why would you think it would "go without saying"? This is before there is any measurable risk to the mother's life. So what exactly is the reason for having a constitutional amendment giving equal rights to the fetus if medical practice is expected to ignore the amendment "without saying"? Sounds like hypocrisy to me - the country wants to pretend it accords equal recognition to the rights of the fetus, but isn't prepared to take the consequences of its "moral" stance, and wants to claim it can provide the same level of care for pregnant women as countries that don't try to claim some imaginary moral high ground as Ireland does.

But perhaps you don't realize that many broad spectrum antibiotics can be very dangerous for the fetus? They are associated for example with a higher rate of cerebral palsy in the resulting child.

So isn't giving them systematically before the mother's life is at "substantive" risk a bit of a contradiction wrt the 8th amendment?

What all this boils down to is the medical profession, the hospital and the HSE all getting together and changing their procedures, while not admitting there was any malpractice in their previous procedures.
Nobody gets sacked, but at least Ireland will be a safer place for pregnant women in future.

Except that isn't true, is it? There was a report recently that said that even in GUH many of the required changes had snot yet been implemented and didn't even appear to be under preparation.

It's also a wake up call that in future the priest who sits on the board of many Irish hospitals can no longer dictate a policy that is closer to Canon law than Irish law. Its a wake up call to supposedly secular hospitals like GUH that they cannot take their cue from the so-called "National Maternity Hospital" of Ireland, when it in turn is taking its cue from an executive committee chaired by a man who spent years studying the Canon law and the theology/mythology of an ancient religious cult, but knows precious little about medicine or real law. Check out the first 9 executives listed...

Well, this is the funny thing, if it can be called funny - for daring to say that the law could be an issue for doctors, Boylan has been called pro-abortion! It's crazy, given his past history. Though it's an interesting illustration of how little loyalty any doctors can expect from the pro-life movement - the minute they stop obeying they can expect their reputation to be torn to shreds by their erstwhile allies. Or even just when it becomes expedient to do so apparently.

alaimacerc

volchitsa wrote: »

Good heavens, why would you think it would "go without saying"? This is before there is any measurable risk to the mother's life. So what exactly is the reason for having a constitutional amendment giving equal rights to the fetus if medical practice is expected to ignore the amendment "without saying"?

I'm not sure that it's quite right to say the risk isn't "measurable". Is it "substantial"? Well, who the heck knows what that means, anyway?

Sounds like hypocrisy to me - the country wants to pretend it accords equal recognition to the rights of the fetus, but isn't prepared to take the consequences of its "moral" stance, and wants to claim it can provide the same level of care for pregnant women as countries that don't try to claim some imaginary moral high ground as Ireland does.

You might think that. I couldn't possibly comment.

But perhaps you don't realize that many broad spectrum antibiotics can be very dangerous for the fetus? They are associated for example with a higher rate of cerebral palsy in the resulting child.

Wouldn't follow from a foetal right to life, as such. Were one to infer the 8th had established full-blown foetal personhood, one might argue that there are competing rights to "health", here. As far as I know, no court has ever found such a thing.

Absolam

volchitsa wrote: »

You're positively hilarious. Which is a strange thing to find myself thinking on a subject as tragic as this - but you really are. You have to be a troll. Nobody sane could believe that level of craziness passes for logiic.

That's a very well reasoned rebuttal

volchitsa wrote: »

For example : you don't really think Savita Halappanavar died of "an inevitable/impending pregnancy loss" - do you?

You know, I don't? But I do think it was the first diagnosis made and entered in the medical records according to the HSE report. And I don't recall ProfessorPlum mentioning a diagnosis of what Ms Halappanavar died of, do you? Just "the primary diagnosis was chorioamnionitis". Of course, if it were the cause of death we were talking about, we'd be talking about Fulminant septic shock from E. coli bacteremia, with ascending genital tract sepsis, and miscarriage at 17 weeks gestation associated with chorioamnionitis. So it seems "the primary diagnosis" doesn't match that either...

volchitsa wrote: »

So why do you mention that as being a relevant "primary" diagnosis? Or symphysis-pubis dysfunction for that matter?

Because it was the first (primary) diagnosis entered on her medical report (and symphysis-pubis dysfunction was the first recorded queried diagnosis). I'm sure I mentioned that in my post... oh wait, yes I did, you can read it there.

volchitsa wrote: »

How could either of those be the primary diagnosis relevant to her death?? Or are you back to "if only she hadn't got pregnant"?

I'm afraid you'll have to point out where 'the primary diagnosis' was changed to 'the primary diagnosis relevant to her death'. I've checked back over the thread myself, and it just doesn't seem to have occurred. Would you consider trying to change the scope of the statement without drawing any attention to it to be deliberately misleading?

Absolam

ProfessorPlum wrote: »

Rather frustrating to put it mildly! Now Absolam, please try to rein in that imagination of yours. While for most people the imagination is a wonderful thing, your's isn't doing you any favours.

I imagine you mean well by instructing me on how to post, but I think I can manage, thanks. Though it's odd that I'm providing links and sources for everything I attribute to someone else, but you haven't managed even one. I think if we were to worry about someone's imagination not doing them any favours, it's probably yours...

ProfessorPlum wrote: »

I hardly see how it could come as a shock to you, but diagnoses are made by medical teams who look after patients.

I can't recall saying I thought such a thing would be shocking; you may have imagined it? Anyway, I'm sure you'll be pointing out where the medical team who concluded "the primary diagnosis was chorioamnionitis" said so, and we won't need to wonder who else might make a diagnosis.
Though, I seem to recall Volchitsas Dr Gunter offered a diagnosis as well, yet she wasn't a part of the medical team looking after the patient. How odd.
It does sound rather like you're trying to distance yourself from the diagnosis you offered, yet you're not giving us a link to anyone else offering that diagnosis. Again... odd.

ProfessorPlum wrote: »

So to put your mind at rest, I will offer that the diagnosis came from the medical team at UCHG. No doubt you will have some issue or another with that.

Well, you've attributed it, so now all you have to do is show the attribution is accurate, which shouldn't be hard, it's not likely they came and told you their diagnosis, and you hardly took someone elses word that they made the diagnosis (they might have been in need of reining in their imagination, after all), so you must have checked...

ProfessorPlum wrote: »

I suggest you head to Galway county coroners court for a transcript of the evidence, or perhaps request a copy of the death certificate from the registrar general (although that will only tell you the cause of death - primary and secondary causes and contributing factors, and not the name of the person/s who made the diagnosis.)

Ah well.. bit of a problem there. I didn't make the assertion, you did. I'm hardly going to try and prove it for you; you can either make your point stand up or not. That's up to you really. To be fair, I can see why you wouldn't bother; it's not like it introduced anything significant on the thread anyway, but it's obviously entirely your call.

recedite

volchitsa wrote: »

Good heavens, why would you think it would "go without saying"? ...
But perhaps you don't realize that many broad spectrum antibiotics can be very dangerous for the fetus? They are associated for example with a higher rate of cerebral palsy in the resulting child.

I suppose you are against vaccinating kids as well, on the basis that a tiny proportion of them may suffer some adverse side effect.

In the specific scenario mentioned in the guidelines, ie suspected miscarriage and confirmed chorioamnionitis, it is highly unlikely that the foetus will be born at all, so worrying about possible future side effects at age 7 years old seems ridiculous.
Here's a reasonably balanced article on the subject.

volchitsa wrote: »

Well, this is the funny thing, if it can be called funny - for daring to say that the law could be an issue for doctors, Boylan has been called pro-abortion! It's crazy, given his past history. Though it's an interesting illustration of how little loyalty any doctors can expect from the pro-life movement - the minute they stop obeying they can expect their reputation to be torn to shreds by their erstwhile allies. Or even just when it becomes expedient to do so apparently.

If you stopped pigeonholing everyone into these two opposing camps (pro-life and pro-choice) for a minute you might see whats really going on. All that fiddling with the charts and blaming the law was to protect "the system" from being blamed. Institutionalised malpractice perpetrated over many years, with hospital committees ignoring the implications of the x-case judgement.

I think you'll find the new HSE guidelines are being followed.To go against them now is to be wide open to a malpractice lawsuit.

volchitsa

recedite wrote: »

I suppose you are against vaccinating kids as well, on the basis that a tiny proportion of them may suffer some adverse side effect.

Vaccination, like all medical treatment, is a benefit-risk equation. It's ethical only as long as the individual can expect to get greater benefit from it than any risk of harm - that's why for a long time only girls were vaccinated against Rubella, not boys - or the risk is now so tiny that it can be discounted (the added risk of the Rubella when given within the MMR cocktail is so tiny that boys can ethically be given it even though there's no risk of them having a disabled child later). So your little crack at me is a bit silly, isn't it?

And I'd certainly be against a law that threatened doctors with years in prison for vaccinating kids, or for not vaccinating them as a general rule and not according to the individual's medical history. And I'd also have issues with a vaccination policy that removed the family's right to seek or to refuse specific vaccinations based on legal criteria rather than what is best for that individual from a medical point of view.

In the specific scenario mentioned in the guidelines, ie suspected miscarriage and confirmed chorioamnionitis, it is highly unlikely that the foetus will be born at all, so worrying about possible future side effects at age 7 years old seems ridiculous.

Umm. In that case, why not allow the woman to have a termination when she requested it? The experts involved (Boylan but also the chairman brought in from the UK, Prof Arulkumaran (sp.?)) said that would have been the usual course elsewhere, and would have prevented the situation spiraling out of control - something antibiotics alone would not have been able to achieve.)

Oh yeah, there's that slight problem with the law, which doesn't take into account the dismal prognosis for the fetus - remember? Presumably that same problem exists ref antibiotic prescription too.

Or does the law only apply when it suits you?

If you stopped pigeonholing everyone into these two opposing camps (pro-life and pro-choice) for a minute you might see whats really going on. All that fiddling with the charts and blaming the law was to protect "the system" from being blamed. Institutionalised malpractice perpetrated over many years, with hospital committees ignoring the implications of the x-case judgement.

I think you'll find the new HSE guidelines are being followed.To go against them now is to be wide open to a malpractice lawsuit.

Any evidence of that? Only there have been articles recently saying that HSE guidelines are either not in place or not implemented, including in GUH. I haven't time to look them out now - but since you're the one making the assertion, it's fair enough to ask you to back it up. I'm certain you're wrong.

I won't get into speculation about a cover up, if you don't mind.

ProfessorPlum

Absolam wrote: »

I imagine you mean well by instructing me on how to post, but I think I can manage, thanks. Though it's odd that I'm providing links and sources for everything I attribute to someone else, but you haven't managed even one. I think if we were to worry about someone's imagination not doing them any favours, it's probably yours...
I can't recall saying I thought such a thing would be shocking; you may have imagined it? Anyway, I'm sure you'll be pointing out where the medical team who concluded "the primary diagnosis was chorioamnionitis" said so, and we won't need to wonder who else might make a diagnosis.
Though, I seem to recall Volchitsas Dr Gunter offered a diagnosis as well, yet she wasn't a part of the medical team looking after the patient. How odd.
It does sound rather like you're trying to distance yourself from the diagnosis you offered, yet you're not giving us a link to anyone else offering that diagnosis. Again... odd.
Well, you've attributed it, so now all you have to do is show the attribution is accurate, which shouldn't be hard, it's not likely they came and told you their diagnosis, and you hardly took someone elses word that they made the diagnosis (they might have been in need of reining in their imagination, after all), so you must have checked...

Ah well.. bit of a problem there. I didn't make the assertion, you did. I'm hardly going to try and prove it for you; you can either make your point stand up or not. That's up to you really. To be fair, I can see why you wouldn't bother; it's not like it introduced anything significant on the thread anyway, but it's obviously entirely your call.

As far as I know, transcripts of the coroners court are not digitalised, and a patient's personal medical records are, well personal, so it's hard to see how I could post a link for you here. However, I have given you a link - it just involves a little leg work on your part and a trip to Galway. Unless you are happy to believe the many second hand accounts of the evidence (including the various reports), but it would appear that you are not. I'm struggling to understand your issue though. But that's hardly surprising since you're really not making very much sense at all.

recedite

volchitsa wrote: »

And I'd certainly be against a law that threatened doctors with years in prison for vaccinating kids, or for not vaccinating them as a general rule and not according to the individual's medical history. And I'd also have issues with a vaccination policy that removed the family's right to seek or to refuse specific vaccinations based on legal criteria rather than what is best for that individual from a medical point of view.

Just as well you added that last bit in, because there is actually a constitutional "right to bodily integrity" which makes it illegal to dose people with inappropriate drugs. It was called upon by the anti-flouridation of water brigade, but they failed to prove that flouridation had an overrall harmful effect.
At the end of the day, its a medical decision whether flouridation, or a vaccination, or an antibiotic presents an inappropriate risk. It only becomes malpractice if medical guidelines are ignored. And then the law will step in to prosecute the perpetratrors of that malpractice.
The same principle applies to abortions. If they are carried out in good faith, ie only when necessary to protect the life of the mother, there is no danger of prosecution. Any doctor staying within the medical guidelines need not worry.

The change in the situation post Savita is not any change in the balance of rights between the unborn and its mother. The difference now is that the HSE has issued medical guidelines which are different to the policies formerly imposed by the committees of certain hospitals. The hospitals and staff in question must therefore re-align their in-house procedures or leave themselves open to malpractice lawsuits. There may be other hospitals who have never been influenced by Canon Law, such as the Rotunda, whose policies were already aligned with the actual legal position, and who don't have to change their policies.

volchitsa

recedite wrote: »

Just as well you added that last bit in, because there is actually a constitutional "right to bodily integrity" which makes it illegal to dose people with inappropriate drugs. It was called upon by the anti-flouridation of water brigade, but they failed to prove that flouridation had an overrall harmful effect.
At the end of the day, its a medical decision whether flouridation, or a vaccination, or an antibiotic presents an inappropriate risk. It only becomes malpractice if medical guidelines are ignored. And then the law will step in to prosecute the perpetratrors of that malpractice.
The same principle applies to abortions. If they are carried out in good faith, ie only when necessary to protect the life of the mother, there is no danger of prosecution. Any doctor staying within the medical guidelines need not worry.

The change in the situation post Savita is not any change in the balance of rights between the unborn and its mother. The difference now is that the HSE has issued medical guidelines which are different to the policies formerly imposed by the committees of certain hospitals. The hospitals and staff in question must therefore re-align their in-house procedures or leave themselves open to malpractice lawsuits. There may be other hospitals who have never been influenced by Canon Law, such as the Rotunda, whose policies were already aligned with the actual legal position, and who don't have to change their policies.

A lot of assertions/speculation there, based on nothing afaict. When you post up some evidence to back any of it up, I'll be prepared to look at it, until then, it's just your own opinion apparently.

BTW, I didn't just "add that last bit in" it is absolutely fundamental. The problem with the law on abortion is that it removes medical decisions from doctors and puts them in the hands of lawyers. There is no other medical procedure where that is the case afaiaa. For example, it would normally be murder to rip someone's heart out, but yet there is no legal requirement for doctors to fulfill before they can perform a heart transplant on them, only medical requirements. Benefit-risk again, like vaccinations.

IMO, it should be the same for pregnancy terminations - doctors should not have to make medical decisions using legal criteria. Good medicine just cannot be done that way.

Even if you are right about there being a medical coverup in GUH, I don't believe that involving lawyers in the decision-making process can possibky help (and indeed it didn't) - the point at which lawyers become useful is only when they come in as independent arbiters afterwards, in case of problems.

If they are involved in the decision itself, who is then left to uncover any possible wrong doing?

Absolam

ProfessorPlum wrote: »

As far as I know, transcripts of the coroners court are not digitalised, and a patient's personal medical records are, well personal, so it's hard to see how I could post a link for you here. However, I have given you a link - it just involves a little leg work on your part and a trip to Galway.

So.... have you seen a statement from the medical team that treated Ms Halappanavar which specified that "the primary diagnosis was chorioamnionitis"?

ProfessorPlum wrote: »

Unless you are happy to believe the many second hand accounts of the evidence (including the various reports), but it would appear that you are not.

Well, I haven't seen any of those either, and you haven't offered any for consideration so it's hard to say if I'd be happy to believe them.

ProfessorPlum wrote: »

I'm struggling to understand your issue though. But that's hardly surprising since you're really not making very much sense at all.

Well, it's not really my issue; you're the one who introduced the subject, remember?
You asserted that the primary diagnosis was chorioamnionitis.
You then attributed your assertion to the medical team at UCHG.
Then you told us that the only way to ascertain this is to go to Galway and look for the statement in the transcripts of the coroners court.
From my point of view, that pretty much wraps it up.

volchitsa

Absolam wrote: »

So.... have you seen a statement from the medical team that treated Ms Halappanavar which specified that "the primary diagnosis was chorioamnionitis"?
Well, I haven't seen any of those either, and you haven't offered any for consideration so it's hard to say if I'd be happy to believe them.

Well, it's not really my issue; you're the one who introduced the subject, remember?
You asserted that the primary diagnosis was chorioamnionitis.
You then attributed your assertion to the medical team at UCHG.
Then you told us that the only way to ascertain this is to go to Galway and look for the statement in the transcripts of the coroners court.
From my point of view, that pretty much wraps it up.

Not sure what it wraps up tbh. Other than that we aren't writing theses or great literature here, and not many of us bother to get a proof reader before posting.
What conclusion do you draw from it? That Professor Plum probably isn't a professor? That's probably true, but isn't very relevant to the actual subject of the discussion. What about the actual subject,rather than the poster, do you have anything to conclude about that, from this "primary diagnosis" fixation you have going? That might be a little bit interesting.

It's a bit like your ding dong with whoever it was (Satori Rae?) about whether or not she'd used a particular word - you were right, she had - but so what?? It didn't make the slightest difference to your point or to hers - and really, it often looks as though you don't have a point, just a need to make multiple postings over some pointless detail.

That's why I said you aren't worth bothering about. You don't ever make any actual points or arguments yourself. And this particular "reply" of yours just sums up the general inanity of your posts, which is why I decided to point it out.

That's all really. I don't think there's any ignore possibility on here, so unfortunately I won't be able to help reading some at least of your posts, but no more than I can help.

ProfessorPlum

Absolam wrote: »

So.... have you seen a statement from the medical team that treated Ms Halappanavar which specified that "the primary diagnosis was chorioamnionitis"?
Well, I haven't seen any of those either, and you haven't offered any for consideration so it's hard to say if I'd be happy to believe them.

Well, it's not really my issue; you're the one who introduced the subject, remember?
You asserted that the primary diagnosis was chorioamnionitis.
You then attributed your assertion to the medical team at UCHG.
Then you told us that the only way to ascertain this is to go to Galway and look for the statement in the transcripts of the coroners court.
From my point of view, that pretty much wraps it up.

Do you like to run around in circles chasing your tail?
This really has become a fixation for you!
To remind you, the only reason I mentioned the diagnosis of chorioamnionitis was to demonstrate to you that your assertion that another poster implied that the foetus was the source of infection was untrue, and demonstrated your lack of medical knowledge. Which is fair enough, you're obviously not a medical professional. Yet you like to imply that you know what you're taking about!
Many patients have multiple pathologies and multiple diagnoses. Doctors don't have to stick to one. And often what looks to be the case on day one, may not in fact be - which is why doctors will have a number of differential diagnoses, or might change their mind completely depending on the evolution of the patient's condition.
I still find it confusing that you don't seem to believe that Savita had chorioamnionitis!

What exactly is your point?!!

Absolam

ProfessorPlum wrote: »

Do you like to run around in circles chasing your tail? This really has become a fixation for you!

Not really, it was a single, direct question, no need for any tail chasing in fairness. It may have been your own meanderings in avoiding answering that made you feel you were going in circles....

ProfessorPlum wrote: »

To remind you, the only reason I mentioned the diagnosis of chorioamnionitis was to demonstrate to you that your assertion that another poster implied that the foetus was the source of infection was untrue, and demonstrated your lack of medical knowledge.

Ah.... I thought you mentioned it to show how you 'got' me 'on a bit of a technicality', though since the technicalities overtook you I can see how you'd change your point of view. But I sure am glad I pointed out my own lack of medical knowledge before I had the nerve to question what drkpower meant, or I'd be worried you were trying to pretend otherwise

ProfessorPlum wrote: »

Which is fair enough, you're obviously not a medical professional. Yet you like to imply that you know what you're taking about!

It was me saying "I'm not a clinician" that gave it away, wasn't it? I knew it would...... But anyway, I certainly like to know what I'm talking about; I like to know if others do to. That's why I say they seem to be saying something, if I'm not sure they are (and ask them to back it up), or, if for instance they make a straightforward, presented as a fact assertion, I ask for their source. Sound familiar?

ProfessorPlum wrote: »

Many patients have multiple pathologies and multiple diagnoses. Doctors don't have to stick to one. And often what looks to be the case on day one, may not in fact be - which is why doctors will have a number of differential diagnoses, or might change their mind completely depending on the evolution of the patient's condition.
I still find it confusing that you don't seem to believe that Savita had chorioamnionitis!

I see why you're so confused so; I never said I didn't believe Ms Halvannapar had chorioamnionitis. I'm quite aware that quite a number of diagnoses were made, and of the fact that in the course of events Ms Halvannapar was diagnosed as having chorioamnionitis, but that's not what you said is it? You said "the primary diagnosis was chorioamnionitis".

ProfessorPlum wrote: »

What exactly is your point?!!

I was asking you for a source for your statement 'the primary diagnosis was chorioamnionitis'. So far your reply has (eventually, after some prevarication) been it was the medical team, without specifying which member, and that this can only be verified by a physical examination of the records of Galway County Coroners Court, an examination which you have declined to specify you have yourself undertaken.

Absolam

volchitsa wrote: »

Not sure what it wraps up tbh. Other than that we aren't writing theses or great literature here, and not many of us bother to get a proof reader before posting.

Not sure about all that; from my point of view it wrapped up the question whether ProfPlums assertion had any great merit to it or not.

volchitsa wrote: »

What conclusion do you draw from it? That Professor Plum probably isn't a professor? That's probably true, but isn't very relevant to the actual subject of the discussion. What about the actual subject,rather than the poster, do you have anything to conclude about that, from this "primary diagnosis" fixation you have going? That might be a little bit interesting.

The only conclusion I drew was it would be wise to check the foundation of any factual statement by ProfPlum before accepting it as fact; it looks like you drew your own.

volchitsa wrote: »

It's a bit like your ding dong with whoever it was (Satori Rae?) about whether or not she'd used a particular word - you were right, she had - but so what?? It didn't make the slightest difference to your point or to hers - and really, it often looks as though you don't have a point, just a need to make multiple postings over some pointless detail.

I suppose you could look at it that way, though in fairness I mentioned her use of the word in passing and she chose to make an issue of it, so it was hardly my 'ding dong', and ProfPlum is not likely to ever say he didn't say "the primary diagnosis was chlorioamnionitis", so there are dissimiliarities...

volchitsa wrote: »

That's why I said you aren't worth bothering about. You don't ever make any actual points or arguments yourself..And this particular "reply" of yours just sums up the general inanity of your posts, which is why I decided to point it out.

I think you may be confusing 'not having any actual points or arguments' with 'not having any actual points or arguments that you've successfully disputed'. But they're not the same.

volchitsa wrote: »

That's all really. I don't think there's any ignore possibility on here, so unfortunately I won't be able to help reading some at least of your posts, but no more than I can help.

It's good to see that once again after a moments consideration you discovered that something else you said wasn't true, but this time you did it without my assistance!

MrPudding

Absolam wrote: »

I wonder will they take it to the Supreme Court.

Doesn't look like they will.

MrP

alaimacerc

MrPudding wrote: »

Doesn't look like they will.

Or more precisely, that they can't. "Permission to appeal was refused because an arguable point of law was not raised, the Supreme Court said."

MrPudding

alaimacerc wrote: »

Or more precisely, that they can't. "Permission to appeal was refused because an arguable point of law was not raised, the Supreme Court said."

Yes. Not sure how it works in Ireland, but in the UK one can only appeal on a point of law, that the lower court got the law wrong, as it were. Points of fact, or indeed anything else are not valid grounds for appeal.

MrP

drkpower

Dr Boylan, the coroner's independent expert witness stated that savita had chorioamnionitis following his review of her medical records. Removal of the source of that infection could only be achieved by a termination.

All of this is accepted fact so the debate over the past few pages is puzzling.

There is a debate over the extent of that chorioamnionitis, the extent of the threat it posed to savitas life and whether (and when) a termination was legally permissible according to the x case test.

Dr boylan's view, for what it's worth ( and I think it is worth a lot) is that on the Tuesday, a termination was not legally permissible yet (because there was not sufficient threat to her life) by the Wednesday, it was (because there was a threat to her life).

It seems clear to me that the legal position imposes an unacceptable form of brinkmanship on doctors in terms of when they are legally entitled to terminate. That is a view shared by a number of other obstetricians (notably Rhona Mahoney, master of nmh) as expressed to the oireachtas committee. Where the foetus is destined to die imminently (as in savitas case) I cannot see what (or who) this form of brinksmanship serves.

recedite

drkpower wrote: »

Dr boylan's view, for what it's worth ( and I think it is worth a lot) is that on the Tuesday, a termination was not legally permissible yet (because there was not sufficient threat to her life) by the Wednesday, it was (because there was a threat to her life).

Even if that was his view, 24 hours is a long, long time in that situation.
Its hard to believe that it went from "there's no real threat" to "its too late to save her now anyway" without anyone noticing.

drkpower wrote: »

It seems clear to me that the legal position imposes an unacceptable form of brinkmanship on doctors in terms of when they are legally entitled to terminate. That is a view shared by a number of other obstetricians (notably Rhona Mahoney, master of nmh) as expressed to the oireachtas committee. Where the foetus is destined to die imminently (as in savitas case) I cannot see what (or who) this form of brinksmanship serves.

Surely an element of brinksmanship is common enough in medicine. A decision to remove a brain tumour or operate on the spine would not be taken until the prognosis for the patient was even worse if nothing were to be done.
The difference in an abortion situation, of course, is that the doctor is asked by the law to balance the chances and the rights of two individuals, not just one. People who personally only recognise the rights of one, would resent that, obviously.

It became clear in a more recent case, involving the brain dead woman, that where a person or foetus is destined to die anyway, and in the absence of any competing rights, their death should not be prolonged, but cannot be actively accelerated either.
But if the mother was still alive and needed some treatment, it would be reasonable to conclude that the balance of rights had tilted completely towards her. So it would be difficult to imagine any sort of repercussions against a doctor for disregarding the interests of the foetus in that situation. Basically you would be saying that the "right to life" is now defunct and without any real meaning because of the unique situation.
Its a pity we don't yet have some legislation or case law clarifying that. The 8th amendment would not necessarily stand in the way, providing it was clear that it applied equally to the born and the unborn. It could have implications for euthanasia though, which might be allowed where the objective was to hasten an already imminent death, in order to reduce suffering.

drkpower

Brinksmanship is certainly an unavoidable occupational hazard where you have to balance treatment with something tangible (ie. a significant risk of the treatment itself).

Brinksmanship for the purposes of nothing at all (ie. a foetus that will imminently die) is pointless, and serves no one and nothing, and should be completely avoidable.

recedite

drkpower wrote: »

Brinksmanship for the purposes of nothing at all (ie. a foetus that will imminently die) is pointless, and serves no one and nothing, and should be completely avoidable.

Yes, I agree totally.
I suppose the pertinent question would be;
Was extreme brinksmanship actually required by the law, or was it just a hospital policy, or was it just a case of things going too far due to a lack of monitoring.

drkpower

recedite wrote: »

Yes, I agree totally.
I suppose the pertinent question would be;
Was extreme brinksmanship actually required by the law, or was it just a hospital policy, or was it just a case of things going too far due to a lack of monitoring.

Probably a combination of 1 and 3.

The interface between possible threat to life - substantial threat to life - imminent threat to life, can be very hard to judge in real life clinical practice. So brinksmanship is and was required by law. I can accept that difficulty where the foetus is actually viable (even though I don't agree with the 8th amendment). But where the foetus is not viable, or is destined to die, I,can't accept that difficulty as it serves no one.

In savitas case, the first difficulty was complicated further by the failure in monitoring which made this decision making even more challenging.

volchitsa

drkpower wrote: »

Probably a combination of 1 and 3.
...

In savitas case, the first difficulty was complicated further by the failure in monitoring which made this decision making even more challenging.

The thing I just can't understand wrt your point 3 though is that it simply isn't true that there was no monitoring : the fetal heartbeat was repeatedly and intensively monitored. What on earth was that about, and doesn't that fact alone make it impossible to believe that the failure to terminate was "just" negligence?