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Dublin: 6 °C Thursday 23 May, 2013

Leaked Savita death report backs government’s decision to legislate – Rabbitte

The Evening Herald has obtained a draft HSE report into the death of the Indian woman at University Hospital Galway last October.

COMMUNICATIONS MINISTER PAT Rabbitte has said that a leaked report into the death of Savita Halappanavar appears to support the government’s decision to legislate for the X Case on abortion.

The Evening Herald today reports details of a draft report by the Health Service Executive into the death of the Indian woman at University Hospital Galway last October, days after her family claim she had asked for but was denied an abortion.

According to reporter Fiona Hynes the draft report is said to state that hospital staff should have considered offering Savita an abortion days before her death as her unborn child had no possibility of surviving.

The clinical review also reportedly details a litany of medical failures and says that a blood infection, from which Savita is suspected of having died, went undiagnosed for days.

Speaking on Newstalk Breakfast this morning, Rabbitte said: “The suggestion seems to be that medical negligence was a contributory factor but that in addition there are no clear guidelines here and that doctors felt that their hands were tied.

“Now that seems to me to be more tangible, hard evidence than we might have expected to support the measures embarked on by government in respect of legislating for the X Case.”

He said there was an obligation on TDs and senators to bring “legal clarity” to what he said was a “hugely complex issue”.

Health Minister James Reilly said he would not comment until the report has been published. The HSE said it would not be commenting on a draft report.

TheJournal.ie understands that the review, chaired by Sir Prof Sabaratnam Arulkumaran, was concluded over six weeks ago but that drafts of the report are currently being circulated to affected parties for review ahead of publication.

Separately a Health Information and Quality Authority review of the safety, quality and standards of services provided by the HSE to patients, including pregnant women, at risk of clinical deterioration, at University Hospital Galway is ongoing.

It is understood to be some way off completion and is not expected to be published in the near future.

Read: Savita solicitor: We released details slowly to keep media interest

Read: Preliminary inquest into Savita Halappanavar’s death takes place

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Comments (92 Comments)

  • I really hope this never happens to anyone again the poor woman.

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  • macca 13/02/13 #

    Any woman whose life is at risk should be liable for an abortion! if my gf was pregnant and I knew her life was in danger I’d tell them terminate! It really is common sense

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  • We have waited to long for legislation. People are buying abortion pills online. And ending up having medical treatment for botched abortion. Legislate, this NOW

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  • The report vindicates what Savita’s husband said.

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    • Her husband’s words about an abortion request was never really in doubt. People made a point of questioning it to highlight the lack of information and the danger of prejudging without solid evidence.

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    • Fergal — Yes. Some essentially accused a grieving husband of lying about the circumstances of his wife’s death. Classy.

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    • Yes, the anti choice site about it (what was it called again, Savita truth or Savita facts? Youth Defence were advertising it) clearly stated that she never requested an abortion and that Praveen was lying. Even when it was proven he was not by the medical records, they didn’t amend the website to tell the actual truth.. Gotta love the level of sociopathic disrespect some people have shown this grieving man and their families..

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    • Zoe Daly 13/02/13 #

      The leaking of an incomplete report to the media, before he had first seen it, – is also disrespectful to Mr Halapanavaar.

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    • Agreed Zoe.
      However, the leakage of an official report, which was based upon evidence, is not nearly as disrespectful as this:
      http://savitafacts.com/the-truth/

      Here, a website that claims it has “the facts” and “the truth” peddles blatant lies. This website was all over youth defences Facebook page (and other “pro life” pages, twitter etc), several “pro life” commenters here over the course of the story also posted this link.

      This website flies in the face of what we now know as actual fact; an abortion was requested (and noted) and it was denied. To a woman who’s baby was miscarrying anyway. I will never be able to get my head around that, it seems so needless. Such a waste. Regardless of why, when the baby is dying anyway what is the hold up when the woman’s health is deteriorating? In any other developed nation it would have been considered best practice to abort, I look forward to finding out the true reason why these doctors did not take this course of action.

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    • Shanti, that site just tells what the pro abortion journalist Kitty Holland says in an interview with Marc Coleman it is not yd’s. Also why is everyone so silent about this lady that died horrifically After her abortion in December. http://www.lifenews.com/2012/09/28/teen-dies-from-abortion-contracted-superbug-from-abortion-drug/

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  • Clutching at straws, the ‘pro-life’ lobby will now shout ‘medical negligence’ and talk about guidelines etc. It’s crap.

    In almost every situation they meet doctors can, without hesitation, treat what is presented to them based entirely on medical assessment. In our abnormal world, once the case involves a pregnant woman, they cannot. They have to stop and consider whether any decision they make tosses them into a legal grey area, guidelines or no guidelines. That sort of thinking will inevitably lead to poorer decisions, maybe not every time but often enough for it to be a problem.

    Almost everywhere except Ireland Savita would not even have had to ask for an abortion, much less be refused one. In the situation she was in it would have been offered as a matter of course, in fact almost certainly it would have been recommended as her best option.

    We are a sick society when we let this kind of thing happen, and sicker if knowing it does we do not do everything in our power to prevent it from happening again.

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    • You really need to reread what has been leaked this morning. The medical failures included:

      * Tests showing possible blood infection on the day Savita was admitted were never followed up by staff. A lack of clarity among key staff about who was responsible for acting on blood tests.

      * Doctors were often too busy caring for other patients to deal immediately with the mum-to-be, whose condition grew progressively worse as time went on.

      * To prevent the spread of infection, staff should have considered inducing – even before the couple requested it.

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    • Fergal do you think one wrong negates the other?

      We wait for the report, but I think all of us have our suspicions about the hospital failing to adequately care for Savita during her time there, I’d be more surprised if this report absolves them of error to be honest. But that doesn’t mean that the lack of legislation isn’t also a problem and didn’t contribute to what happened here. You accuse Gilmore of spin in a separate comment on this article, I’d ask you not to do likewise.

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    • Niall,

      On the basis of what has been leaked do you really think its acceptable to refer to the medical negligence as “clutching at straws or crap”. That pro-abortion claptrap has too challenged and show to be what it is.

      The question is why wasn’t a standard Irish medical procedure carried out. I look forward to seeing the full text.

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    • Fergal I do think it is claptrap to even begin to believe that whatever is in this report should influence legislation. The likes of YD and Iona will attempt to spin this as medical negligence on one doctor’s part and say that it is a basis for not introducing legislation.

      This will fail to look at other aspects of the report, fail to look at the recent hearings on legislation where lawyers and medics both said legal clarity is needed and also fail to acknowledge that the Irish people have voted on introducing legislation on more than one occasion.

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    • Your being disingenuous presenting the abortion referenda results as a mandate for abortion. You know very well in those votes the Pro Life movement were equally divided behind yes and no. During the hearings there was ample lawyers and medics disagreeing with Enda’s proposals. Enough red herrings please.

      You already acknowledge her death is behind Enda’s proposals. It is extraordinary that you say an IT article on a death can influence legislation but a properly conducted report into it must not.

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    • Fergal every group that has ever lost an election or a referendum has any amount of excuses as to why that happened. That still doesn’t allow for governments to ignore the results however. Do you not see how not legislating is actually an attack on democracy?

      As for the expert witnesses at the hearings on the pro-life side, they all came from Iona, YD and their ilk, who again have been discredited so often it doesn’t even bear repeating.

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    • Niall, despite opinion polls conducted by newspapers, – there still is alot of people out there, who have some form of ‘Pro Life’ views.
      Not necessarily all come from Iona institute, or YD – many just ordinary people, all over the country. I still think its important that people who have reservations, – be free to express them. We need to proceed very carefully with Legislation. The experience of other countries, especially the UK, has shown us this.

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    • I see this “some form of ‘Pro Life’ views” as the latest line recently when pro-life groups try to explain away opinion polls that state that an overwhelming majority of Irish people want X legislated for, want abortion legalised in the case of foetal abnormalities and want abortion available in the case of rape & incest.

      The idea is that pro-life can pretend that they are the majority as the recent poll show 37% in favour of full choice rights for a woman, although, oddly enough, 6 out of 10 people in that poll agreed with the statement “abortion is a woman’s right to chose”, but that weirdly wasn’t reported in many of the supposedly pro-choice, Leftie media outlets (I didn’t even hear about that myself until I went looking for the amount of people who said ‘Don’t Know’ as opposed to ‘No’ for the initial question, still looking if anyone can point me in its direction).

      It’s clear the only last line for the Irish people is whether we allow full choice rights for woman. Suicide, rape, X & foetal abnormalities should be legislated for this year and we should look to hold another referendum in the next two years where the question is simple, ‘Do you believe that a woman should be given freedom of choice in regards to abortion?’, Yes or No.

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    • Well you have got to be commending for admitting this proposal is a stepping stone for abortion on demand. Few abortion advocates will admit this. Lesser support organising referenda for abortion.

      Obviously you didn’t even watch the hearings though. Not all came from YD or Iona.

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    • I know there were other doctors from the likes of Life Institute and Family & Life there Fergal, but the difference between those Christian Fundamentalists and YD & Iona’s Christian Fundamentalists isn’t really clear to me

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    • Give the name calling a break. “Fundamentalism” has no bearing in this debate. Its a term for a movement which formed as a sub-sect of American protestants in the early 20th cen but is nearly always misused.

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    • @Fergal None of what you say takes away from the fact that in almost every other country Savita would have been offered an abortion EVEN in the absence of signs of infection once it was known she had begun a miscarriage. In fact it would have been recommended, as a matter of course and best practice, that an abortion was the next step/

      The issue of whether or not the foetus was alive would have been a **complete non-issue** and irrelevant to that recommendation, because it was not going to ever be born, ever. The presence or absence of infection would have been a **complete non-issue**, because an abortion at that point could only have a positive and preventative effect on the potential for development of infection.

      However that is NOT the routine recommendation in Ireland, because legally the medics are forced to consider the non-viable life while it still has some limited and certain to end form of life and cannot recommend abortion at that early stage because there is no certainty that a threat to the mother’s life will occur.

      So the legal position is no red herring. It is the central issue here.

      Whether there was negligence or not (and their probably was) this stark difference between how miscarrying women are treated here and elsewhere remains, to our shame.

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    • “Fundamentalism is the demand for a strict adherence to specific theological doctrines”

      It’s hardly name calling when the groups are saying we should all live by their religious standard as outlined in the Bible now is it? Unless they’re the type of Christians who pick and choose what they wish to believe, which they have never come across as to me to be fair

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    • Fergal’s implication that the only reason pro-choice campaigners are calling for x case legislation is to get abortion on request as opposed to wanting something trifling like legislation to save women’s lives is insulting, disingenuous, deceptive and wrong.

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    • But if a woman dies in a similar way after abortion pro aborts say “it was her choice” because you dont really care about women , just about getting abortion in. Did you know that women die having so called safe legal abortion in India all the time, it is never mentioned here.

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  • As most sensible people had predicated. Legislation is needed to protect women and save lives. The pro “guideliners” just want to leave the situation as is. Legislate now.

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  • See? See? Now – what are all you anti-abortion supporters going to argue now that a report FINDs that an abortion should have been offered? You said it wouldnt happen and it has. So what’s your excuse now?

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    • I think most know that legislation for this has to come in (and welcome it) but we also know that that will never be enough for you.

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    • Absolute rubbish as usual James. When have I ever stated that I support abortion on demand? Never. Yet another weak argument from you lot. I have had two miscarriages. Thankfully not life-threatening. I think for the sake of my two beautiful children its in their best interests that I stay alive. But then you don’t care about actual children. More concerned with unviable foetuses .

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    • Did you not read my comment or are you just going on auto-pilot? I’m in favour of it but just not in the way liberals want the UK model.

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    • Yes James I read it and responded to exactly what you wrote ‘but that will never be enough for you’.

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    • If Savita had the abortion and still died from an infection that it seems she came in with, would any of the pro choice camp care? No because they say if you die after having an abortion it is your choice. That is the truth.

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    • Hi Mairead

      Perhaps you could point out exactly where on this thread a member of a pro-choice community said that they ‘didn’t care’ about the death in the UK? Otherwise, kindly stop trolling the same posts and silly accusations.

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  • Can ANYONE argue that if abortion had not been a loaded issue here, the issue would’ve been crystal clear from the start- i.e. human has sepsis, treat infection before she dies?

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  • Graham 13/02/13 #

    Even if the report said in big block capitals that an abortion would of saved her the pro life loons would still not accept it. You can not argue with such a closed minded cult.

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  • Legislate NOW!

    Guidlines KILL!!

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    • Incompetence and delay also kills and judging by this report there was both in abundance in this sorry episode. The good for nothing politicians who have delayed this vital legislation for decades need to get on with it, this could happen again any day and to any woman so it’s long past the time for talking about it it needs action, NOW!

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  • Since the beginning of this case, it seems to me that the facts are misinterpreted and a lot of people think that the core issue here is the topic of abortion and the lack of guidelines and legislation. What happened was indeed outrageous and should have never happened. From my point of view, the medical staff totally neglected what was going on, like the fact the baby was never going to be born alive, and that the mother was acquiring serious infection. The staff neglected these clear facts and didn’t act at all, which is mind boggling. This is the core of this unfortunate case. It goes down to the medical treatment itself in the first place, the guidelines on that, I would think, are present as is the legislation. There is nothing wrong on discussing the topic of abortion of course, but the core of this case was not abortion at all. It was the way how the staff approached this case medically.

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    • i agree with your point, but as someone who works in front line service, and often makes decisions under pressure, then reviews/reflects after, I have found repeatedly that my prior experience in terms of what I had been praised and/or punished for, plus my own values, ultimately played a part in any decision when there was any ambiguity in terms of guidelines. I do not for one second believe the lack of clarity here did not pay a part in several decisions and/or failure to act, even if that cannot be scientifically proven and no one has recordings of peoples thoughts, or lack of same!
      In my field, failures on my part are not life-threatening, and I have learned now to identify in advance any situation in which I am unclear, so as to give myself immediate and clear reference when a high pressure situation presents.
      Fire-drills are carried out so that people do not have to think too hard when in a panic. They help put in place clear, quick reference, and thus people are saved by habit when all hell breaks loose. Medical decisions often must be made under similar pressure, and thus the habits/ training of the doctors and nurses are what comes into play. We all know all hospital services are under extreme pressure and demand nowadays. Thus, the lack of crystal clear guidelines can kill.

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    • “like the fact the baby was never going to be born alive”

      Doctors in Ireland are NOT permitted to carry out abortions for that reason. It is the sole reason why the standard treatment for a woman presenting with an inevitable miscarriage is not recommended for immediate abortion here – as they would be anywhere else.

      This complicates the medical decision making, leading to a situation where here there is a wait and see approach to infection, elsewhere there are immediate and positive steps taken to prevent it.

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    • Katie,

      They certainly are if it would otherwise create a dangerous situation. There are many reasons against inducing being an automatic procedure for apparent miscarriages. Thus medics don’t consider it an automatic procedure.

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    • No Fergal, they are not.

      You introduced an ‘if’ – ” if it would otherwise create a dangerous situation”.

      But even taking the ‘if’ on board, you are still wrong. It cannot just create a dangerous situation, it must create one which is an immediate risk to life.

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    • No Katie your adding the word ‘immediate’. In our bodies everything is interlinked. Minor things can escalate into life threatening situations very quickly. In contrast a ‘threat to health’ could mean just about anything. Doctors are always going to error on the side of caution to protect life. Trust me the DPP is not looking over their shoulders, waiting to pounce if the threat had not not clearly manifest yet.

      Katie if this was not the case why has no doctor ever been charged under the 1861 Act. There are Obstetricians who have said they never heard of peers who felt threatened by the 1861 Act. The legal threat to doctors is an utter phantom.

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    • Ok, let me rephase that so (though I don’t know why I bother):

      It must present a threat to the life (as opposed to the health) of the mother.

      One of the main reason doctors are not in danger of prosecution here is that we have the escape hatch that is England, where women with non-viable pregnancies regularly go because they cannot, due to our laws, have the treatment they need in their own country. For that very reason – there is no threat to their lives, ‘only’ to their health and mental well-being.

      There may be obstetricians who feel as you say, others have clearly stated that they feel constrained by the law.

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    • Katie,

      You are missing the point entirely. This lady died from an infection which was identified and ignored. That is why she died. If this happened in the UK and she received an induced labour/abortion when she asked the chances are Savita still would have died; as by the time she asked the her condition was much more severe. Remember when her condition was clearly life and death they still did not induce labour and they just waited for her to naturally miscarry.

      The option of UK abortions would have absolutely zero effect or relevance to Savita like cases. There is not a shred of evidence that the UK is a ‘safely valve’. Even cases like the late Ms Harte fail to show that. Abortion for ‘health’ as opposed to life would offer no advantage to Irish healthcare. As health is a vague and meaningless concept. All it would do is open a floodgate.

      Finally non-viable pregnancies are no more dangerous statistically to women than viable pregnancies.

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  • bombacho 13/02/13 #

    It looks like there is a gross negligence and incompetence on part of the hosp staff.

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  • Best way for the abortion to be settled is a woman’s only referendum limited to women of child bearing age only.Since it effects women’s health let the women decide.
    People might argue that’s restrictive but since woman can only have children they should make the decision and as free from religious and middle aged politicians we have in Leinster house.

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  • Whoever leaked selective parts of this report should be ashamed also the rush to print and Air from our media is equally repulsive.Then again I expect nothing less from the Indo stable of trash

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  • i hope the HSE don’t leak my medical history if the Herald is looking for some headlines. What gives with the prolific rate of leaked information?
    Is it that we Irish drink too much and end up babbling away down the pub about every confidential issue at the office? Can people not be trusted to be professional?

    The leaker needs to be fired.

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    • totally agree Arbitrasure, – I can’t understand why the details of such an important report, are being leaked to the Media.
      Can we not just wait until the full official report comes out, & then make a fair & rational decison, based upon that?
      The media is playing a huge role in this debate, – it is the ‘engine’ that is driving the pro choice lobby.
      I would prefer to wait & see the official report, – instead of just selectively leaked details with the usual accompanying Media headlines & spin.

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    • And it’s a delay tactic by the pro-life lobby to complain about such leaks so they don’t have to face the damning facts that Savita died because she was refused an abortion.

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    • To want to wait & see the full & official report is not a delay tactic, – I would prefer to make a judgement based upon that, – than a media leak.

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    • zedabelzer,

      Certainly damming but on the basis of the released information damming on the part of the staff in Galway who had no legal restriction to do what they probably needed to do.

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    • With all due respect without a whistleblower in the Doctor o Leary case how many more women would have had their womb removed which the whistleblower was ostracised for.

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    • @Zoe “Her unborn child had no possibility of surviving”. I think your very unlikely to find a contradictory statement in the final research paper, because this statement is so conclusive. We can discuss and rationalize whenever we want, and now is as good a time as any.

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    • George, – fully agree that the final report is likely to come to that conclusion.
      All the same, I think to wait for the final medical report, – rather than documents leaked to the media, for me personally would be the best way to make a judgement.
      I think that would, ultimately, would be the most objective & fair.

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    • No legal restriction Fergal? The inarguable fact is that there are no clear guidelines. Legislation will prevent that. Why are you so against it? What are you afraid of? If pro-lifers are saying that abortions are already taking place and there is no need for legislation, then why are you so against supporting it with legislation?

      @zoe. Fair enough. Wait. But the result will be the same.

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    • Zoe Daly 13/02/13 #

      Just saw where Mr Hapapannaver’s solicitor, has spoken to RTE news, stating that he is ‘surprised & disapointed’ at the leaking of the report to the Media.
      He has stated that even he, has not yet seen the report.
      The Irish Patients Association, have also expressed their concerns, about the leaking of the incomplete draft of the report.

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    • Zedabelzer,

      The procedure we are referring to is not controversial or a ‘grey area’. It happens all the time in Irish hospitals. I urge you to look at the guidelines for yourself. I have many times and they are crystal clear. The point of matter is that even if they had induced when she requested she may have still died as it may have spread too far at that stage. Only if the blood test results weren’t ignored when she was admitted would she have had the best chances of survival.

      The problem I have with legislation is that it puts the onus on the patient but it should be with the doctor as it is now.

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  • Actually the report shows the opposite of Rabitte’s spin. It shows that this women was mistreated by Irish doctors, e.g. her infection was not identified and this led to her death. Spare us the spin Rabitte

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    • It actually does support that legislation is required, read again: “there are no clear guidelines here and that doctors felt that their hands were tied”

      Which is what caused this tragedy

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    • Niall,
      That is Rabitte’s interpretation, not the report’s text. A lot of people have called for better guidelines instead of legislation. There is a mighty strong case for guidelines. The report actually describes a litany of medical failures which a failure to induce labour could be part of.

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    • Pretty much every poll taken shows people want legislation over guidelines, not to mention our referendums on the matter which have to be put into law if we are to maintain that we are a democracy.

      The only people proposing guidelines are the likes of Iona, YD and the Catholic Church, who have been discredited so many times it isn’t even worth repeating.

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    • Oh I’m not absolving the hospital of blame either. They should be investigated for malpractice and also to see if the ‘This is a Catholic country’ comment is true. Any medical practitioner who would dare say that to anyone as a reason for not giving treatment needs to be struck off immediately.

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    • Niall, Actually your forgetting to mention that there are senior party members in all parties who oppose legislation, including Labour. A fact that terrified Enda into disallowing a free Dail vote.

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    • Fergal, the high risk of intrauterine infection should be always taken into account in such cases. She should have been offered termination. She wasn’t. She asked for termination, and the request was denied. It is a medical negligence, but the reason was, most probably, political.

      (Seriously, If I still remember this after dozen or more years since my studies – and I’m not even working in any medical profession – I can’t imagine that a professional with a gynaecological/maternity background could be so clueless as to not realise what the medical indications are. Ms. Halappanavar, as a medically trained person, certainly did and she clearly requested termination.)

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    • Miroslaw,

      In principal I agree with you as there is no legal implement to this. That is exactly why it sounded like malpractice from the start. Inducing labour like this is not unusual or controversial. Its the norm. In fact the family shouldn’t have to ask.

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    • Fergal, any TD who opposes legislation is opposing democracy, as they want us to ignore the results of referendums on the matter and they wish to cast aside the will of the people, and should be removed from parliament. Personal opinions do not come into this, the people of Ireland voted on the matter and it is their duty to legislate for this immediately.

      That it has taken 20 years for this to happen shows the cowardly nature of previous governments. I do not agree with Enda Kenny on many things, but he is to be commended for pushing through legislation in his time in government. On this matter, he has not failed in his duty as Taoiseach, unlike Ahern, Cowen, Bruton and Reynolds.

      This isn’t a matter of pro-life vs pro-choice, it is a matter of democracy. It is a shame that it took the tragic death of Savita to push it to the forefront of the public’s minds once again, but legislation does not rest on the findings of this inquiry.

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    • Well said Niall. I couldn’t agree more.

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    • Why is there a problem with making the treatment of savita illegal. Guidelines are all well and good but makes nobody responsible. We have animal rights legislation so why is there a reluctance to endorse women’s rights .

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  • Wow what a shock! We are being railroaded in to legalising abortion.

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  • Patients in severe pain say things like “just let me die” Medical rightfully ignore such.

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