Abortion Discussion

Absolam

Deleted User wrote: »

The irrelevancy (or perhaps over-generality) is of your follow on, not of Boylan's statement.

And still, being general doesn't make it irrelevant.

Deleted User wrote: »

If you take it in an extreme general context perhaps. But given that he was being utterly specific then yes it's quite important.

Are you aware of any statement made by an obstetrician involved in the investigation into Ms Halappanavar's death which said that an abortion would have given her the best chance of surviving?

Deleted User wrote: »

The importance of the first analogy was to discuss the idea that 'big general' approaches don't apply when considered in the specific. The second analogy was with the idea of an extremely bleak prognosis for the limb, one such that though it might not be the sought after path, the best course of action would have been to remove it.

I guess neither version of your analogy worked out the way you intended so.

Deleted User wrote: »

No it's analogous in showing that state interference with best practice in medicine can be barbarous. Of course some best practice is certainly blunted by law. Consider siamese twins and the balancing of rights in separation. How does that work?

Your analogy referenced universally recommended treatment though, not best practice. Did you choose the wrong analogy again?

Deleted User wrote: »

Is the UN the source of best practice? Are the 67% of states modern developed states? Argumentum ad populum surely?

As far as I know, no, the UN is not the source of best practice. But yes, if you're arguing that it is true that States should permit abortion where there is a threat to a mothers health because many States permit abortion where there is a threat to a mothers health, then that would certainly be argumentum ad populum.

Deleted User wrote: »

Correct. How did she develop sepsis?

I'm not a clinician, so I can't offer a definitive opinion. I can say that sepsis can develop in a pregnant woman as the result of one of many complications, illnesses, or procedures, including abortion. Urinary tract infection and chorioamnionitis are common infections associated with septic shock in pregnant patients, so it seems most likely Ms Halappanavar developed sepsis as a result of chorioamnionitis, which we know she had.

Deleted User wrote: »

Would she have developed sepsis if her unviable pregnancy had been ended?

Again, not a clinician, but possibly; she would still have had chorioamnionitis to be managed, and the additional risk of sepsis from the termination. I can't say it seems a worthwhile line of speculation though.

Deleted User wrote: »

Of course. But that's not in question. The analogy presented a case where there was no available treatment for the arm. The patient presented with an un-salvageable limb. Just as there was no solution to save Savita's unborn.

You're somewhat changing your criteria there, you originally said "with a limb that is not immediately posing a threat directly to their life, but which at the time of presentation is extremely likely to be utterly un-salvageable". In such a case, amputation would not be the first choice of treatment. A little more reworking of the analogy might get you closer, but in fairness you are going to end up with the analogy failing in the end purely because a persons limb is not analogous to another persons life.

Deleted User wrote: »

You absolutely did! How else ought one read 'Which doesn't really say a great deal'?

No, you took it as a trivial truism. I don't think there's anything trivial about it.

Deleted User wrote: »

If a termination of the pregnancy had been permissible upon discovery of the bleak prognosis for the fetus, and the pain that it was causing Savita, that would have been highly likely enough to prevent her death.

Which would have been an accidental save; the fact that killing someone might accidentally save someone else's life isn't a good enough reason to kill someone, even if they're dying already.

Two Sheds

volchitsa wrote: »

You're entirely missing the point. It's got nothing to do with being sued, or with improvised intervention without information or equipment in a medical emergency when you are on holiday.

The point is that no-one should be at risk (however small a poster on the internet thinks it) of having a criminal record for doing their job well. Criminal records should be a risk only for those who do their jobs dangerously badly.

These are the Medical Council Guidelines on abortion

Abortion -

21.1 You have an ethical duty to make every reasonable effort to protect
the life and health of pregnant women and their unborn babies.

21.2 During pregnancy, rare complications can arise where a therapeutic
intervention is required which may result in there being little or no
hope of the baby surviving. In these exceptional circumstances, it may
be necessary to terminate the pregnancy to protect the life of the
mother, while making every effort to preserve the life of the baby.

21.3 Abortion is permissible where there is a real and substantial risk to
the life of the woman which cannot be averted by other means.4
This risk, while substantial may not be immediate or inevitable in
all cases. This risk should be assessed in light of current evidence
based best practice.

21.4 With regard to abortion abroad, it is lawful to provide information
in Ireland subject to strict conditions;
however it is not lawful to promote or advocate an abortion in such cases.

21.5 You have a duty to provide care, support and follow up for women
who have an abortion

Significantly, the MC refers to the unborn as "the baby".

https://www.medicalcouncil.ie/News-and-Publications/Publications/Information-for-Doctors/Medical-Council-Guide.html

https://www.medicalcouncil.ie/News-and-Publications/Publications/Information-for-Doctors/Guide-to-Professional-Conduct-and-Ethics-for-Registered-Medical-Practitioners.pdf

Overheal

Interesting. But, while the medical council may be government-run and/or funded, that use of the term 'the baby' isn't a legal position. The fact that they used the language doesn't surprise me though, as the country's official stance on abortion is the 8th.

But huge props to them for writing something that wasn't written by some stuffy harvard lawyer with a thesaurus shoved up his ass.

volchitsa

Two Sheds wrote: »

These are the Medical Council Guidelines on abortion Significantly, the MC refers to the unborn as "the baby".

https://www.medicalcouncil.ie/News-and-Publications/Publications/Information-for-Doctors/Medical-Council-Guide.html

https://www.medicalcouncil.ie/News-and-Publications/Publications/Information-for-Doctors/Guide-to-Professional-Conduct-and-Ethics-for-Registered-Medical-Practitioners.pdf

Is that a reply to my post?

Two Sheds

volchitsa wrote: »

Is that a reply to my post?

It clearly shows that doctors have sufficient freedom to do their jobs without fear of prosecution and that any claims of a 'chilling effect' around the 8th are likely to be motivated by more than a worry about breaking the law.

volchitsa

Two Sheds wrote: »

It clearly shows that doctors have sufficient freedom to do their jobs without fear of prosecution and that any claims of a 'chilling effect' around the 8th are likely to be motivated by more than a worry about breaking the law.

No it doesn't.

It shows that theoretically doctors can perform an abortion when the mother's life is at risk. But we knew that anyway. The question is whether there is any risk of a doctor ever finding himself accused of not having tried hard enough to save the fetus as well. Given the way many people reacted to the family whose deceased daughter was being used as a human receptacle last year, it's more likely that a doctor will one day find himself up in court for exactly that than not.

Absolam

volchitsa wrote: »

No it doesn't. It shows that theoretically doctors can perform an abortion when the mother's life is at risk. But we knew that anyway.

Actually, it shows that there are Medical Council guidelines in place for the abortions that Doctors currently perform, nothing theoretical about it.

volchitsa wrote: »

The question is whether there is any risk of a doctor ever finding himself accused of not having tried hard enough to save the fetus as well.

That seems a little at odds with:

volchitsa wrote: »

You're entirely missing the point. It's got nothing to do with being sued.

Though there is obviously a difference between what one can be prosecuted for, and what one can be sued for.
It seems to me that if a Doctor was ever going to be accused of not trying hard enough to save the life of the foetus, they'd not be likely to be at risk of having a criminal record for doing their job well, but for doing their job badly. Still; it's not a criminal offense to inadvertantly, or through negligence or inability allow an unborn human life to be destroyed. The offence is specifically "intentional destruction of unborn human life"; the inclusion of 'intentional' means there must be both actus reus and mens rea. To be convicted it would have to be shown that the Doctor made a decision to bring about the prohibited consequence, or, as it is said, had 'malice aforethought'; not trying hard enough (a difficult enough notion to prove in itself) to save the life, on it's own, does not rise to intentionally destroying it.

volchitsa wrote: »

Given the way many people reacted to the family whose deceased daughter was being used as a human receptacle last year, it's more likely that a doctor will one day find himself up in court for exactly that than not.

I think more likely not to be fair. 'Many people' don't get to prosecute other people for this offense; that's reserved to the DPP (or their appointee). And the DPP tends to have a relatively decent understanding of the law.

MrPudding

Absolam wrote: »

It seemThe offence is specifically "intentional destruction of unborn human life"; the inclusion of 'intentional' means there must be both actus reus and mens rea. To be convicted it would have to be shown that the Doctor made a decision to bring about the prohibited consequence, or, as it is said, had 'malice aforethought'; not trying hard enough (a difficult enough notion to prove in itself) to save the life, on it's own, does not rise to intentionally destroying it.
I think more likely not to be fair. 'Many people' don't get to prosecute other people for this offense; that's reserved to the DPP (or their appointee). And the DPP tends to have a relatively decent understanding of the law.

Mems rea could be satisfied through oblique intention, if there was a desire to prosecute.

MrP

Absolam

MrPudding wrote: »

Mems rea could be satisfied through oblique intention, if there was a desire to prosecute.
MrP

The destruction must still be deliberate, per the offense. Oblique intention requires that the consequence be a natural and practically certain result of the action; that's pretty much not inadvertantly, or through negligence or inability allowing an unborn human life to be destroyed. Unless the Doctor is doing their job badly, so still, not at risk of having a criminal record for doing their job well.

recedite

volchitsa wrote: »

No it doesn't.

It shows that theoretically doctors can perform an abortion when the mother's life is at risk. But we knew that anyway. The question is whether there is any risk of a doctor ever finding himself accused of not having tried hard enough to save the fetus as well.

There is also a second question; whether the doctor tries hard enough to save the mothers life.
In this kind of a dilemma scenario, there is virtually no chance of them being sued, convicted, or being struck off for either. Those sanctions can only be made to stick where there is some unambiguous malpractice involved, most likely due to some factor involving laziness or ignorance.

The problem for the patient is that this leaves a lot of latitude for individual doctors and individual hospitals to have their own policies in such situations. As Savita Hal. found out tragically.

Two Sheds

volchitsa wrote: »

No it doesn't.

It shows that theoretically doctors can perform an abortion when the mother's life is at risk. But we knew that anyway. The question is whether there is any risk of a doctor ever finding himself accused of not having tried hard enough to save the fetus as well. Given the way many people reacted to the family whose deceased daughter was being used as a human receptacle last year, it's more likely that a doctor will one day find himself up in court for exactly that than not.

'Many people' is not the justice system. That case should never have happened and you have to wonder why it did. It certainly had no basis in law.

lazygal

Two Sheds wrote: »

'Many people' is not the justice system. That case should never have happened and you have to wonder why it did. It certainly had no basis in law.

Would it have arisen if the eighth amendment wasn't in place?

Absolam

lazygal wrote: »

Would it have arisen if the eighth amendment wasn't in place?

If we were still just operating under the previous legislation, (the Offences against the Person Act 1861) then quite possibly yes, because it would have been an offence to supply or procure poison or instruments for the purpose of criminal abortion. It would depend on whether a Court decided this actually covered the withdrawal of life sustaining technology. More likely we would have had legislative updates to the 1861 Act which could have given clarity to such issues.
The case didn't come about because of the 8th Amendment, but because of advances in medical technology which have put us on the cusp of being able to sustain sufficient life in a dead person to bring the foetus they're carrying to a point of viable delivery.
Volchitsas contention was focused on the way many people reacted to the family whose deceased daughter was artificially sustained, indicating that such people might sue doctors who don't make similar heroic attempts to save the life of nascent (presumably) family members in the future. Which scenario is not at all necessarily contingent on the 8th, only on doctors being obliged to make such an attempt.

volchitsa

Absolam wrote: »

Volchitsas contention was focused on the way many people reacted to the family whose deceased daughter was artificially sustained, indicating that such people might sue doctors who don't make similar heroic attempts to save the life of nascent (presumably) family members in the future. Which scenario is not at all necessarily contingent on the 8th, only on doctors being obliged to make such an attempt.

No, my point was that there was a particular problem, a direct consequence of the 8th, when the doctors' medical advice went one way (that the woman was dead and attempts to maintain the fetus would be inadvisable) but the legal opinion about the fetus' right to life under the 8th went another.

In effect it meant they could not turn off the life support before the fetus had actually been declared dead. Or until there was a court ruling.

And my point about reactions to that case becoming public was that a surprising number of people appeared to feel that the family's wishes (to obey the medical advice) were not paramount, and that keeping the woman on life support was not a barbaric thing to do.

Which clearly indicates that had the life support already been turned off without a court case by the time the case came to light, some pro-life activists would certainly have been prepared to take the medical team, and possibly the grieving family, to court over that.

The doctors were well advised, legally, to put the family through hell purely to protect themselves from a possible criminal action. Medically however it was totally unprofessional of them. But that is the direct result of us allowing lawyers to decide upon suitable medical treatment instead of international medical evidence.

Two Sheds

volchitsa wrote: »

No, my point was that there was a particular problem, a direct consequence of the 8th, when the doctors' medical advice went one way (that the woman was dead and attempts to maintain the fetus would be inadvisable) but the legal opinion about the fetus' right to life under the 8th went another.

In effect it meant they could not turn off the life support before the fetus had actually been declared dead. Or until there was a court ruling.

And my point about reactions to that case becoming public was that a surprising number of people appeared to feel that the family's wishes (to obey the medical advice) were not paramount, and that keeping the woman on life support was not a barbaric thing to do.

Which clearly indicates that had the life support already been turned off without a court case by the time the case came to light, some pro-life activists would certainly have been prepared to take the medical team, and possibly the grieving family, to court over that.

The doctors were well advised, legally, to put the family through hell purely to protect themselves from a possible criminal action. Medically however it was totally unprofessional of them. But that is the direct result of us allowing lawyers to decide upon suitable medical treatment instead of international medical evidence.

Nonsense! Have you any evidence for that? Any?

"there is never an obligation to employ extraordinary means."

Pro-Life Campaign

Two Sheds

As predicted, it now appears that those calling for abortion in the case of fatal foetal impairment have extended their demand to include the disabled.

Amnesty International has, yet again, been given a media soap box to espouse its attack on those judged unworthy of life, while wrongly claiming that access to abortion is a human right -

severe.. impairment is a serious medical condition, not a disability.

http://www.irishtimes.com/opinion/head-to-head-colm-o-gorman-argues-in-favour-of-repealing-the-eighth-amendment-1.2277875

AMNESTY MUST CLARIFY ITS COMMENTS REGARDING ABORTION AND DISABLED PEOPLE, SAYS PLC

Delirium

Two Sheds wrote: »

As predicted, it now appears that those calling for abortion in the case of fatal foetal impairment have extended their demand to include the disabled.

Amnesty International has, yet again, been given a media soap box to espouse its attack on those judged unworthy of life, while wrongly claiming that access to abortion is a human right -

http://www.irishtimes.com/opinion/head-to-head-colm-o-gorman-argues-in-favour-of-repealing-the-eighth-amendment-1.2277875

AMNESTY MUST CLARIFY ITS COMMENTS REGARDING ABORTION AND DISABLED PEOPLE, SAYS PLC

The opinion piece says the opposite of what your quote mining presents.

Those who oppose abortion must be prepared honestly and respectfully to debate the issues here in Ireland.

[...]
They must not suggest that international human rights law demands access to abortion where the foetus has a disability – severe and fatal impairment is a serious medical condition, not a disability.

Two Sheds

Delirium wrote: »

The opinion piece says the opposite of what your quote mining presents.

It's hardly quote mining when I presented the relevant text and a link to the original. You may wish to read it again.

It's clear there's an attempt to portray a severely disabled unborn child as an illness or disease for the expectant mother - a claim that is medical nonsense.

If such reasoning is accepted then subjective terms such as 'severe' and 'disability' become all important and can be easily expanded to include any and every disability.

Many conditions such as Down Syndrome and cystic-fibrosis can be diagnosed in the womb and could fall under the heading of “severe foetal impairment” referred to by Mr. O’Gorman. It is deeply worrying that Amnesty now seems to be slipping further towards supporting abortion for disability in the womb.

Fred Swanson

This post has been deleted.

Two Sheds

Fred Swanson wrote: »

This post has been deleted.

People like Stephen Hawking perhaps? -

It is now possible to test for the presence of mutations in the SOD1, TDP43, FUS and C9ORF72 genes in a person diagnosed with familial MND. ....
Unborn children can be tested to determine if they have inherited the mutation known in the family.

Motor Neurone Disease (MND)

recedite

volchitsa wrote: »

Which clearly indicates that had the life support already been turned off without a court case by the time the case came to light, some pro-life activists would certainly have been prepared to take the medical team, and possibly the grieving family, to court over that.

Even if this speculation were true, the actual judgement which was subsequently delivered gave the instruction to switch off life support because it was a distressing and futile endeavour. This proves without any doubt that your hypothetical pro-lifers would have lost their case.

Hence the following is a non-sequitur...

volchitsa wrote: »

The doctors were well advised, legally, to put the family through hell purely to protect themselves from a possible criminal action. Medically however it was totally unprofessional of them. But that is the direct result of us allowing lawyers to decide upon suitable medical treatment instead of international medical evidence.

So even though the hospital lawyers can claim they didn't know at the time how it would turn out legally, certainly they know now that any fears of prosecution were unfounded and totally exaggerated.
Therefore it could never happen again.

lazygal

recedite wrote: »

Even if this speculation were true, the actual judgement which was subsequently delivered gave the instruction to switch off life support because it was a distressing and futile endeavour. This proves without any doubt that your hypothetical pro-lifers would have lost their case.

Hence the following is a non-sequitur...

So even though the hospital lawyers can claim they didn't know at the time how it would turn out legally, certainly they know now that any fears of prosecution were unfounded and totally exaggerated.
Therefore it could never happen again.

The judgment also stated it was specific to the facts of the case. This scenario could arise again, possibly where a foetus is closer to viability than in the NP case.

recedite

Fred Swanson wrote: »

This post has been deleted.

I agree. Given that the fairly widespread pro-choice position is generally to allow the abortion of any unborn baby/foetus, including completely healthy ones, then I can't see too many people becoming concerned about the abortion of those with severe or fatal abnormalities.

recedite

lazygal wrote: »

The judgment also stated it was specific to the facts of the case. This scenario could arise again, possibly where a foetus is closer to viability than in the NP case.

I suppose every judgement is specific to the facts of the case. But technically you are correct, there is still a virtually zero chance of prosecution to worry about.

lazygal

recedite wrote: »

I agree. Given that the fairly widespread pro-choice position is generally to allow the abortion of any unborn baby/foetus, including completely healthy ones, then I can't see too many people becoming concerned about the abortion of those with severe or fatal abnormalities.

Given that those who oppose abortion in Ireland don't seem too worried about the unborn brought elsewhere to be aborted at a rate of 12 a day, I can't see how they'd oppose women being able to access abortion because of possible severe or fatal abnormalities in other jurisdictions. As long as they can continue to.ensure such pregnancies are dealt with elsewhere, that's the main thing.

lazygal

recedite wrote: »

I suppose every judgement is specific to the facts of the case. But technically you are correct, there is still a virtually zero chance of prosecution to worry about.

A foetus at 22 weeks gestation might lead to a very different judgement. Such a case might compel medics to continue to gestate said foetus regardless of the condition of a woman. Of course a sentient woman whose not a corpse and can travel can abort a pregnancy elsewhere.

recedite

lazygal wrote: »

A foetus at 22 weeks gestation might lead to a very different judgement. Such a case might compel medics to continue to gestate said foetus regardless of the condition of a woman.

It would all depend on whether said gestation was considered futile or not, which is a medical decision not a legal one.
If it looked like the foetus was going to die, then the same precedent set by the previous judgement would apply.
If it looked like a healthy baby could be delivered after a short extra period of gestation, then that would be a completely different situation, and the previous judgement would not apply.

If there was going to be any realistic chance of a prosecution, the doctor would have to have decided that keeping the foetus going was futile, and have switched off the machine. Then afterwards the prosecution would have to find another doctor willing to testify that the foetus actually had a good chance of survival. All very unlikely.

lazygal

recedite wrote: »

It would all depend on whether said gestation was considered futile or not, which is a medical decision not a legal one.
If it looked like the foetus was going to die, then the same precedent set by the previous judgement would apply.
If it looked like a healthy baby could be delivered after a short extra period of gestation, then that would be a completely different situation, and the previous judgement would not apply.

If there was going to be any realistic chance of a prosecution, the doctor would have to have decided that keeping the foetus going was futile, and have switched off the machine. Then afterwards the prosecution would have to find another doctor willing to testify that the foetus actually had a good chance of survival. All very unlikely.

Unlikely, but not impossible. Of course women who can travel to avail of abortion services won't be at risk of being used to gestate a foetus even when brain dead.

recedite

True, but then brain dead people are unlikely to travel anyway.
The unfortunate woman in that case had no intention of availing of any abortion service in any jurisdiction before she died.

lazygal

recedite wrote: »

True, but then brain dead people are unlikely to travel anyway.
The unfortunate woman in that case had no intention of availing of any abortion service in any jurisdiction before she died.

Meaning that a brain dead pregnant woman has fewer rights than a living pregnant woman. In no other circumstances would a woman be kept alive solely to ensure someone else has his or her right to life vindicated.