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Head of Savita review says greater clarity on terminations urgently needed

The professor says the Government needs to look at changing the law to minimise the risk of such a case happening again.

Professor Sabaratnam Arulkumaran of the University of London, who headed up the HSE review of the death of Savita Halappanavar.
Professor Sabaratnam Arulkumaran of the University of London, who headed up the HSE review of the death of Savita Halappanavar.
Image: Sam Boal/Photocall Ireland

POLITICIANS NEED TO consider changes to the law to clarify when doctors can carry out a termination in cases where the health of the patient is rapidly deteriorating, according to the professor who headed up the HSE review of the Savita Halappanavar case.

Professor Sabaratnam Arulkumaran said there was an immediate and urgent requirement for greater clarity, so that doctors could carry out the procedure without worrying about later legal repercussions.

The review into the handing of the 31-year-old’s case found that “inadequate assessment and monitoring” were contributory factors in her death from septic shock following an E.coli infection at Galway University Hospital on 28 October last.

The report also found an “apparent over-emphasis on the need not to intervene until the foetal heart stopped together with an under-emphasis on the need to focus appropriate attention on monitoring for and managing the risk of infection and sepsis in the mother”. It added:

The interpretation of the law related to lawful termination in Ireland, and particularly the lack of clear clinical guidelines and training is considered to have been a material contributory factor in this regard.

It said that “similar incidents with a similar clinical context could happen again” unless there was “greater clarity as to the application of the law”.

Speaking following the publication of the review, Professor Arulkumaran said the case had been complicated “by the difficult association with the application of the law in Ireland relating to the termination of a pregnancy.”

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The professor – who is also president of the International Federation of Obstetrics and Gynaecology – said that doctors, the legal community and politicians needed to consider changes to the law and new guidelines on the management of cases where a miscarriage was inevitable:

There should be some clarity. Some hospitals or some consultants might have made a termination earlier on, where as others would wait according to the law as they interpreted it.

He said he had read the Government’s planned legislation on abortion, and recommended that changes similar to those outlined in the Bill could be brought in to cover cases like Savita’s:

I got the the latest legislation, which I read this morning. That specifically addresses the issue of suicide, and how to intervene in cases of suicide and saving the mother.

A similar change in the law, but for situations where conditions can rapidly escalate, needs to be considered.

He said Irish doctors needed such a measure in place so they couldn’t be accused of breaking the law if they terminated a pregnancy in cases where it was clear that would be the correct course of action.

Inadequate care and monitoring were factors in Savita’s death – HSE report>

In full: The HSE report into the death of Savita Halappanavar>

Savita report ‘hard-hitting, straight and doesn’t pull any punches’>

Timeline: A death that shocked a family, a hospital and a country>

Savita inquest: The coroner’s nine recommendations endorsed by the jury>

About the author:

Daragh Brophy

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