The pro-choice lobby’s exploitation of the Savita tragedy could backfire badly

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The old saying “hard cases make bad law” should be heeded as much by progressive campaigners as by fusty lawmakers. Because it is equally true that tragic cases make bad reforms. The pro-choice activists currently holding up photos of Savita Halappanavar, while calling on the Irish authorities to legislate for some forms of abortion in order to “protect women’s lives”, could unwittingly help to give rise to an Irish abortion law that negates women’s autonomy rather than accentuating it.

It is not surprising that people are angry about what happened to Halappanavar, a dentist from India who had settled in Galway. It is a genuinely shocking case. Halappanavar died from septicaemia and E Coli in a Galway hospital, following a three-day-long, excruciatingly painful miscarriage. It is reported that she asked doctors to terminate her pregnancy, but they refused on the basis that the fetus still had a heartbeat. In Ireland, following the 1992 Supreme Court ruling in the case of X, it is legal to carry out an abortion if there is a real and substantial risk to the life of the mother – but this was not done for Halappanavar.

The protests in response to Halappanavar’s death, which have taken place in Dublin, Cork, Galway and outside the Irish Embassy in London last night, are understandable. People are angry and they want answers. Indian people are angry, too, with one newspaper headline there unapologetically declaring: “Ireland Murders Pregnant Indian Dentist.”

But what is worrying is the way many of these protesters are extrapolating from the Halappanavar case to depict all women in Ireland as permanently at risk, as vulnerable creatures who could at any moment “die at the hands of misogynists”, as one commentator puts it, through being forced to continue with their pregnancies. Not only is this an inaccurate portrayal of the abortion situation in Ireland – it also adds up to a demand that Irish women should be granted abortion rights on the basis that they are vulnerable to harm, rather than on the basis that they ought to have moral autonomy over their lives, including, crucially, over their reproductive lives.

Pro-choice activists have self-consciously turned Halappanavar into a symbolic victim – of Ireland’s backwardness on abortion, of the Catholic Church, of misogyny. Like all symbolic victims, she is referred to simply by her first name, Savita, and her smiling face adorns the placards held up by concerned pro-choice activists on protests-cum-vigils. She has been turned into a symbol of downtrodden Irish womanhood, with activists telling us that this could be “your sister, your mother, your daughter, your aunt, your friends, your colleagues”. “These are the lives at stake”, we are told. “We are all Savita Halappanavar.”

Yet this pretty opportunistic playing of the victim card does not accord with reality. The fact is that it is mercifully rare for a woman in Ireland to die as a result of being denied an abortion. Indeed, it is the uniqueness of Halappanavar’s case that makes it so standout shocking. For the most part, women in Ireland who want an abortion travel to England to get one (around 4,000 do this every year) and then return home to continue with their lives. This is a huge inconvenience, and it is an outrage that Irish women are still denied abortion services in their own country; but it is simply not the case that Irish women are dying “at the hands of misogynists”.

The post-Halappanavar playing of the victim card doesn’t only misrepresent Ireland as a Third World country or as a woman-hating theocracy – it also fundamentally transforms the idea and meaning of abortion rights. In elevating the patheticness of your average Irish woman, who is apparently one unwanted pregnancy away from dying a gruesome death like Halappanavar’s, pro-choice activists depict abortion as something women need to alleviate their vulnerabilities rather than something which will allow them to further realise their autonomy. That is, abortion comes to be treated purely as an emergency public health measure, one that can “save women’s lives”, rather than as a libertarian concern.

More and more pro-choice activists now depict women who seek abortions as vulnerable, even as the hapless victims of circumstance who need the state to protect and care for them. Commentators refer to abortion-seekers as “vulnerable women”, who sometimes come from “the needy poor”, and who have found themselves in “the worst circumstances”. There are “the neediest women in our society”, apparently. Some pro-choice groups even suggest that there should not be a loud or rowdy public debate about abortion, because, in the words of Marie Stopes International, “the last thing vulnerable women need is a culture war over abortion”. In short, so vulnerable are the women who seek abortions that even treating abortion as a political issue – which is fundamentally what it is, pertaining, as it does, to women’s equality and liberty – is a potentially harmful thing.

This patronising view of women who seek abortions is being intensified on the back of the Halappanavar case. Activists are being encouraged to write to Irish politicians to call on them to “legislate to protect women’s lives”.

Not only is this depiction of abortion inaccurate (a great number of the British and Irish women who have abortions are not vulnerable at all, but rather are mothers or students or career women who know full well what they want to do with their lives); more depressingly, it exploits Victorian-sounding horrors stories about destitute women suffering terrible hardships as a way of putting moral pressure on the authorities to force through some kind of abortion law. That is, it implicitly downplays women’s capacity to exercise moral autonomy by depicting them as constantly “at risk”, as vulnerable beings who need to be rescued by the state rather than as individuals who should be liberated from the state’s criminalisation of abortion.

The end result in Ireland could be the introduction of narrow and specific legislation in relation to the X case, which will officially, rather than just unofficially, grant women the right to abortion if their life is in real or substantial danger. That will be useful for the mercifully tiny numbers of women who, like Savita Halappanavar, find themselves in such a dire situation. But it won’t be of much use for the vast majority of Irish women, who need the complete decriminalisation of abortion in order that they might more fully determine their destinies free from the diktats of the state and assorted modern moralists.

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  • Henry94

    You are not wrong Brendan but people in Ireland tend to be against abortion in the abstract but in favour of it in particular circumstances.

    If we were to wait for the right abortion law we would make no progress and after a 20 year wait for legislation on the X case I’d say the chances of a principled right to choose are slim and of course would require a referendum which would probably be defeated.

  • Ní Dhuibhir

    Obviously we people of the female persuasion need safe, legal, free-at-the-point-of-use abortion available to all of us, whether we are ‘career women’ (ick!), homeless youngsters, or the married, respectable, not particularly ‘vulnerable’ woman Savita was *before her pregnancy went horribly wrong and was allowed to kill her*. The line isn’t that hard for us to cross.

    It’s a mistake to think women remarking that Savita’s case makes them personally afraid of their government are being disingenuous, or over-stating the case. It is frightening. It’s OK to say that.

  • FuturePhysicist

    I believe the poster is simply attacking the use of moral irredentism by some.

  • Ní Dhuibhir

    Do you?!

  • FuturePhysicist

    He’s differentiating between medical necessity and libertarian action rather than suggesting that all libertarian action needs to be seen as medically necessary. I would say that’s honest, perhaps stating the obvious but honest.

  • http://nalil.blogspot.com Nevin

    “women in Ireland who want an abortion travel to England to get one (around 4,000 do this every year)”

    The figures for 2011 for Ireland and for Northern Ireland were 4149 and 1007 respectively, according to the UK Dept of Health abortion statistics for England and Wales [pdf file];

    Women resident outside England and Wales

    2.26 In 2011, there were 6,151 abortions to women resident outside England and Wales, compared with 6,535 in 2010. Principally, these non-residents were from Northern Ireland (16%) and the Irish Republic (67%). The number of abortions to non-residents has fallen each year since 2001, when the figure was 9,910. The 2011 total is the lowest in any year since 1969

  • Ní Dhuibhir

    Sorry, my tone wasn’t clear. I know what the post says. I read it.

  • GavBelfast

    I was listening to a radio debate about the subject earlier, and the only real conclusion I drew from it was that many so-called “pro-life” people are only actually selectively pro-life.

    Some of them are really anti-abortionist purists and come across as rather heartless zealots.

    That said, we do not know if the Republic’s laws (and attitudes) contributed to the poor woman’s death, so the outcome of a proper enquiry is awaited with much interest.

  • http://nalil.blogspot.com Nevin

    “Like all symbolic victims, she is referred to simply by her first name, Savita”

    Is this true? It seems rather silly to me. I prefer to use first names; it just seems friendlier, more human. The use of surnames exclusively has echoes of exchanges between schoolmaster and pupil and a mismatch of power relationships. In the case of Savita, her first name is so much easier to spell. The term ‘symbolic victim’ IMO is also over-emotive.

  • Alias

    “But it won’t be of much use for the vast majority of Irish women, who need the complete decriminalisation of abortion in order that they might more fully determine their destinies free from the diktats of the state and assorted modern moralists.”

    Which is, somewhat ironically, a moral position on the issue. What do you think “a woman’s right to choose” is if not a moral argument?

    Can we drop the hack propaganda that anti-abortionists are moralists but pro-abortionists are not?

  • Alias

    Also, “complete decriminalisation of abortion” requires ” the diktats of the state” since it is the State that will be legislating for it.

  • david thistle

    Shocking case, and an easy target for those who wish to portray Ireland as backward and run by priests.
    I thought Ireland had moved forward; it seems not.
    Rome Rule indeed.

  • Old Mortality

    ‘In Ireland, following the 1992 Supreme Court ruling in the case of X, it is legal to carry out an abortion if there is a real and substantial risk to the life of the mother – but this was not done for Halappanavar.’
    In that case the blame falls entirely on the shoulders of the doctors involved. Were they fearful of the consequences if they terminated or were they possibly imposing their personal views on the matter?

  • Alias

    “Were they fearful of the consequences if they terminated or were they possibly imposing their personal views on the matter?”

    There isn’t any evidence that an incorrect decision was made. The prognosis for septicemia isn’t good, especially combined with other infections, so it’s just a wide assumption at this point that the failure to allow the patient to self-diagnose her treatment is what killed her.

  • Alias

    *self-diagnose and specify her treatment

  • TwilightoftheProds

    “self-diagnose and specify her treatment”-

    I’d place at least as much faith in the self diagnosis of a patient in agony as medical treatment informed by a religious doctrine confecting the wishes of a supernatural entity.

    Patient’s extended agony vs medical treatment informed by the expectations of a ‘catholic country’.

    Not satisfactory in 2012.

  • Alias

    The decision about whether or not a substantial risk to the life of the mother exists is not made by a doctor while referring to the bible. He will make that determination from his medical training and, if necessary, in consultation with his colleagues.

    If he forms the opinion that a termination of the life of the child is necessary to save the life of the mother then he his bound by medical ethics to act accordingly. It’s in the medical code of conduct – and it also makes it explicit that termination is legal in that circumstance.

    Therefore, contrary to expedient invention, there were no constraints at all on the doctor, medical, legal, or – laughably – religious.

    We have this nonsense now invented that the patient is best placed to self-diagnose and prescribe treatment but only, apparently, when she wants an abortion. We don’t hear similar nonsense spouted for ‘the patient’s right to decide’ when it comes to the removal or a kidney or a liver, which the doctor must duly preform without objection.

    There is also this nonsense spouted that abortions must be performed not for the purpose for which the law allows (a real and substantial risk to the life of the mother) but simply because it is claimed – without a shred of supporting evidence – that abortion must be carried out to alleviate the temporary discomfort of the mother.

    The abortion would most probably have killed her anyway given that her system was gravely weakened by her severe infections (septicaemia and e-coli are a deadly combination) with no reason to suppose that the abortion would have eased her pain from her septicaemia and e-coli.

  • http://gravatar.com/joeharron Mister_Joe

    Alias,

    Would it not be better to await the outcome of the investigation rather than lay people making their own prognosis without having examined the patient?

  • Alias

    Exactly, Joe, which is why you should follow your own advice in regard to your previous comments, e.g. “Does that mean that you think it’s ok to let a pregnant mother die in agony even though the foetus is already doomed, just because the potential child still has a heartbeat?”

    As I already pointed out above:

    “There is also this nonsense spouted that abortions must be performed not for the purpose for which the law allows (a real and substantial risk to the life of the mother) but simply because it is claimed – without a shred of supporting evidence – that abortion must be carried out to alleviate the temporary discomfort of the mother.

    The abortion would most probably have killed her anyway given that her system was gravely weakened by her severe infections (septicaemia and e-coli are a deadly combination) with no reason to suppose that the abortion would have eased her pain from her septicaemia and e-coli.”

    I wasn’t aiming that comment at your interjection even if your knee-jerk suggests to me that you assumed otherwise.

    However, the statistics for septicaemia are well known (except to you) and I wasn’t making a prognosis for the deceased since she is, unfortunately, deceased and therefore such prognosis would be unfairly favoured by hindsight.

    Incidentally, current medical guidance from the Guide to Professional Conduct and Ethics for Registered Medical Practitioners (2009) is as follows:

    21.1 Abortion is illegal in Ireland except where there is a real and substantial risk to the life (as distinct from the health) of the mother. Under current legal precedent, this exception includes where there is a clear and substantial risk to the life of the mother arising from a threat of suicide. You should undertake a full assessment of any such risk in light of the clinical research on this issue.

    21.4 In current obstetrical practice, rare complications can arise where therapeutic intervention (including termination of a pregnancy) is required at a stage when, due to extreme immaturity of the baby, there may be little or no hope of the baby surviving. In these exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the life of the mother, while making every effort to preserve the life of the baby.

  • BluesJazz

    If the patient is in distress and wishes to survive, can an air ambulance /RAF (helicopter?) not be made available to send her to a 1st world country (the UK mainland) where she could access proper medical care, without voodoo / Catholic superstition interceding?

  • BluesJazz

    Any word from the Northern Ireland parties on this abomination?

  • TwilightoftheProds

    Alias, come on.

    In 2010 the European Court of Human Rights ruled against Ireland in that the X case judgement was not supplying proper information, structure and guidelines over the use of abortion in potentially life threatening circumstances. Thus we have the tragic spectacle of medical staff resorting to a ‘this is a catholic country’ fallback in explaining their decision to a despeartely ill woman….

    we can’t know if the abortion would have saved her life yet. But the cervix was dilated and leaking amniotic fluid- it seems reasonable to consider that this could have affected the course of the infection…I wouldn’t play it down.

    …leaving aside the physical effect, a seriously ill woman was told that the unviable foetus inside her had to remain there until its heart beat to its very last. I’d say that added to her distress and anxiety, when she was in a very physically fragile state.

    ‘to alleviate her temporary discomfort’ as you say? Lets call it what it was….her final agony and distress.

  • http://gravatar.com/joeharron Mister_Joe

    I guess I was extremely foolish to believe the reported diagnosis of the first doctor that the woman was having a miscarriage and it would be all over in a few hours. I had no idea that a superior diagnostician would come along and say that the woman wasn’t having a miscarriage, she had blood poisoning and was doomed no matter what.

  • fordprefect

    As I said in another thread regarding this, Savita should have been saved, even if it meant carrying out an abortion. I also said, as I’m sure Mr. Joe would have seen (that I agree with him), and Gav Belfast said, these so-called Pro-Lifers are very selective. Especially in the US (as usual) these Pro-Lifers are the same people that believe in the Death Penalty and have have killed doctors, nurses and innocent bystanders (including a cop) in their “war” against abortion clinics! Yeah, really Pro-Life!

  • Alias

    Joe, that is a revised version of what you said.

    Your actual claim is that the woman died in agony because of the miscarriage and more precisely, because of the doctor’s failure to break the law and medical guidelines by performing an abortion for the purpose for which you believe the abortion was required, i.e. to alleviate the mother’s discomfort.

    It might be that the pain and the incomplete abortion were related or it might not but either way it is not legal to perform an abortion for the purpose of alleviating temporary pain. I refer you to the text quoted above.

    She died four days after the abortion (or, rather, after the removal of the foetus) from septicaemia and an E.coli infection. That’s what killed her according to the pathologist.

    As septicaemia has high mortality rate, it’s then a case of finding out if any delay contributed to her death or if she would have died from septicaemia anyway. That is a question of medical practice, of whether the existing guidelines and best practice were followed, having zero to do with law of other factors.

    Twilight, nothing in Catholic theology forbids the doctor from complying with current guidelines. In fact, if the doctor was – as it is claimed – a devout Catholic who put Catholic theology before medical guidelines then he would have performed the abortion, not refused to perform it.

  • Alias

    Incidentally, the Catholic Church’s position on the issue differs from accepted practice (that the life of the mother takes precedence over the life of the child) in that it grants parity of esteem to both mother and child but where the life of the child or the mother cannot be saved then the moral obligation on the doctor is to save the life of whichever of the two can still be saved.

  • abucs

    So if you are right Alias, and an abortion wouldn’t have saved this poor woman’s life, then all this ridiculous Catholic bashing is because a woman was in pain for three days while doctors deliberated on whether they could save a child’s life?

  • http://www.e-consultation.org/ davenewman

    The reason people only use Savita Halappanavar’s first name is because so few Irish people are used to pronouncing names that are not Irish or English. It is part of the ingrained racism that led to the doctors treating her worse than they would a Irish woman.