Over the past fortnight, the inquest into the death of Savita Halappanavar has been one of the biggest stories in Ireland. Listening to the evidence unfold was both gripping and, far too often, deeply troubling.

Back in the 1980s, Charlie Haughey coined a phrase to describe the moment when it emerged that the murderer Malcolm McArthur had been hiding out in the apartment of the then Attorney General, Patrick Connelly: grotesque, unbelievable, bizarre and unprecedented. The former Labour Minister, Sunday Independent columnist Conor Cruise O’Brien, turned it into an acronym that came to characterise the entire Haughey era: GUBU.
The four words which underpin GUBU are frighteningly apt to what happened in Galway University Hospital from the time that Savita Halappanavar arrived there, 17 weeks pregnant and suffering from severe back pain. In so many small ways, the medical team under consultant obstetrician Dr. Kathleen Astbury completely failed Savita and her husband Praveen. Sloppiness, incompetence and human error riddled the treatment that was given to the vibrant young Indian woman, who entrusted her life to the hospital and its medical staff.
And yet, bad and all as they look – and bad and all as they undoubtedly were – mistakes of the kind that were made in the general treatment of Savita Halappanavar probably happen all of the time in hospitals, here and elsewhere, without disastrous consequences.
Charts go missing. No one follows up on a blood test. A nurse fails to report a change in a patient’s condition to a doctor. Someone prescribes the wrong drug. As long as the patient pulls through, no one need be any the wiser. But this case was, and is, different. Because underlying the mistreatment of Savita is a major issue about freedom of choice and the extent to which one religious perspective has been allowed to dominate medical practice in Ireland, to the enduring, ongoing detriment of those who view the world differently.
This is why a dispassionate analysis of what happened in Galway University Hospital is so critically important. Listening to the evidence, you could sense the medical profession closing ranks. Dr. Peter Boylan gave testimony which more or less exonerated Dr. Astbury, and which shifted the locus of responsibility for what happened onto politicians, for failing to legislate as to when an abortion becomes permissible in Ireland.
Peter Boylan is right, of course, that doctors have been forced to operate in a grey area, as a result of a disgraceful and cowardly abnegation of responsibility by politicians here over the past 20 years. But Boylan’s evidence also seemed to be curiously beside the point.
If simple common sense had prevailed, the termination that was requested by Savita and Praveen Halappanavar would have been carried out, once it was clear that the foetus was unviable. What was not established at the inquest is precisely why Dr. Kathleen Astbury did not take that common sense approach.
After the inquest, Savita’s husband, Praveen Halappanavar, concluded that Dr. Astbury was hiding behind the law. He seemed to be suggesting that, rather than delaying an abortion because of her interpretation of the restrictions of Irish law, Dr. Astbury was operating out of some kind of personal – possibly religious – conviction, that as long as the foetal heartbeat was present, then even the minutest suggestion that the baby might be born and miraculously survive had to be given equal weight to the threat to the life of the mother.
Dr. Astbury’s evidence seemed to confirm that view of why she failed to act. She referred to the notion that there was a possibility – however slim – of the foetus surviving. She also seemed quite happy to justify her prevarication on the basis of assumptions about the ‘balance of probability’ – as if it was widely understood and agreed that the risk to a pregnant woman’s life had to be 51% or more before an abortion became a potential option.
To the ordinary person, not operating from any religious view about the sanctity of an embryo, this is a shocking thought: that a doctor might only do the thing which a patient’s health requires if the risk to her life shoots seriously into the red zone. Why would a gynaecologist wait until a woman’s life is seriously in danger before acting in her best interests, when the imminent threat of death might have been avoided by a more immediate decision to terminate?
Lat issue, I said that Savita Halappanavar was a victim of the 8th Amendment to the constitution of Ireland. And it is true. Whatever other medical misadventures may have happened, the doctor, to whose ultimate care Savita had been entrusted, spent her time watching the ethical clock as it was set in Ireland in 1983, rather than acting decisively to protect the patient – and Savita died as a result.
This is a country in which the alarm bells have been set in the wrong place, for all the wrong reasons, and by the wrong people.
What’s even more disturbing is that we are about to be lumped with more of the same, with the provision being tabled by the Minister for Health James Reilly that a panel of doctors will have to agree before a decision can be taken to carry out an abortion on the basis of the threat to the life of a mother as a result of suicidal feelings.
This is an impractical, morally reprehensible and (once again) cowardly example of our legislators bowing ignominiously to Rome – and ignoring the fact that before abortion was introduced in England, an astonishing 10% of women who committed suicide in Ireland were pregnant. The figure has subsequentlydropped, confirming that suicidal women are accessing abortion in Britain.
In the region of 6,000 Irish women travel abroad for terminations every year. Over the past 30 years, close to 200,000 women have chosen that option because they believed that it was the right thing for them to do. A tiny percentage aside, they are as comfortable now as they ever were that they did the right thing. And yet, we are so determined to bury our heads in the sand that we want to continue to ship these women abroad, forever and ever amen.
I believe in the innate goodness of the majority of people. I believe also that, to the greatest extent possible, we must free those people to shape their own lives and their own destinies. And that means allowing them the freedom to do that by their own lights, in the country where they live, and pay their taxes and to which they contribute in countless ways as citizens.
And, finally, I believe that it is imperative that no one moral view should be allowed to dominate the way in which that freedom is constrained, but rather that genuine freedom of choice should be extended to people of all faiths and none, to do what they believe to be right for them in relation to their own fertility, in their own good conscience.
There is a lot that is right with Ireland, and a lot of which I am proud. But in our treatment of women, we continue to demonstrate the very worst of the hypocrisy, moralistic bullying and general vindictiveness which have characterised the attitudes of officialdom here in so many ways since the foundation of the Free State.
It is long past time for this bullying of women to end.