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Irish bishops: doctors must try to save mother even if child may die as a result

By on Thursday, 22 November 2012

Tributes to Savita Halappanavar in Dublin (Photo: PA)

Tributes to Savita Halappanavar in Dublin (Photo: PA)

Ireland’s Catholic bishops have said pregnant women must receive all treatment to save their lives, even if it results in the unintended death of an unborn child.

The bishops were responding to an outpouring of public anger over the death of a pregnant woman following a miscarriage in an Irish hospital.

In their statement they expressed anguish and shock at the deaths of Savita Halappanavar, 31, and her unborn child. Mrs Halappanavar died after hospital medical staff determined they could not end the child’s life because they could detect a foetal heart beat, even as the woman’s husband, Praveen, urged them to save his wife’s life.

Mrs Halappanaver’s death at University Hospital Galway has prompted thousands of people to take to the streets calling for the country’s constitutional ban on abortion to be overturned.

In its statement, the Standing Committee of the Irish Catholic Bishops’ Conference described the case as “a devastating personal tragedy” for the Halappanavar family and acknowledged that the circumstances of her death had “stunned our country”.

The bishops sought to clarify Church teaching on the need for medical intervention to save the life of a mother. The bishops said they believed Ireland’s medical guidelines contained adequate ethical provisions to allow medical staff to intervene as long as necessary steps had been taken to save both mother and unborn child.

The bishops insisted that the Catholic Church has never taught that the life of a child in the womb should be preferred to that of a mother.

“Whereas abortion is the direct and intentional destruction of an unborn baby and is gravely immoral in all circumstances, this is different from medical treatments which do not directly and intentionally seek to end the life of the unborn baby,” the bishops said in their statement.

The bishops also said that Ireland was a safe place for expectant mothers.

Pointing to international health care data, the bishops said: “Ireland, without abortion, remains one of the safest countries in the world in which to be pregnant and to give birth. This is a position that should continue to be cherished and strengthened in the interests of mothers and unborn children in Ireland.”

The maternal mortality rate in Ireland stands at 4.1 per 100,000 births and is among the lowest in Europe.

Archbishop Diarmuid Martin of Dublin had earlier told the American Catholic News Service that he believed doctors, nurses and midwives “set out always to save lives”.

“The fact that our maternal mortality is so low is a sign that there is something that is working well in the system,” he said.

Meanwhile, pro-life campaigners have expressed concern at the appointment of Sabaratnam Arulkumaran, head of obstetrics and gynecology at St George’s, University of London, as chairman of a Health Service Executive inquiry into Mrs Halappanavar’s death. They cited a 2009 statement in which he argued that abortion should be a legal right for women.

Contributing to this story was Michael Kelly in Dublin.

  • paulpriest

    Sorry Sarah but could you please tell us what they actually said?
    [p.s. Do YOU know what the Catholic teaching is?]

  • la catholic state

    I think the Bishops need to be careful.  They came out and stated Church teaching that the lives of both child and mother were of equal value.  With this statement they are contradicting that and putting the life of the mother above the child.   In my opinion….they should state that doctors should try to save all lives….or if that’s not possible then they should strive to save one life without the direct killing of the other… that the mother or child.

    Instead of pandering to the pro-abortion lobby…..they must stand their ground.  Secularists will never be appeased…..and its time Catholics realised this and stood firm.

  • counterpunch

    This is a serious matter and there are too many hacks, bloggers, chancers, twitterati, voices etc willing to write and say whatever. We need clarity, a clear presentation of Catholic teaching relating to this case. The vast majoirty of pro-life and Catholic comment on the death of Savita and her child has been a shambles – no understanding of Catholic teaching i.e. early induction of non-viable children, what and how double effect does and does not apply. Might I suggest reading the statements from the Society for the Protection of Unborn Children?

  • mark startin

    The statement is at:

    Crucially I am uncertain that it means what Sarah has said it means.  If it does mean what she says then the Irish Bishops have mad Catholic Morals subordinate to Irish medical Ethics.

  • mark startin

    I agree with what you say; that there is confusion about what the Church’s teaching actually means and about the application of the Principle of Double Effect.
    It does seem immoral, in circumstances similar to the case under discussion, to say that the only right course is to leave mother and baby both to die.

  • paulpriest

    Well? This is what they say…

    ” Where a seriously ill pregnant woman needs medical treatment which may
    put the life of her baby at risk, such treatments are ethically
    permissible provided every effort has been made to save the life of both
    the mother and her baby.”

    But what does this mean?
    Technically anything one wants it to mean…

    Now John Smeaton is correct in that:

    a] the termination of pregnancy before viability (which would certainly have killed the child) would have been directly intended, and would not have been (as double-effect requires) an indirect and unintended effectb] the sole immediate effect of the inducing would have been the termination of pregnancy before viability, thus killing the child

    & citing the USCCB  “Ethical and Religious Directives for Catholic Health Care Services”

    “45. Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable foetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion…”
    “49. For a proportionate reason, laboor may be induced after the foetus is viable.”

    But what does viable mean?
    ..and what is a proportionate risk? is it mandatorily >50% ? or is any risk worth taking if the alternative is death for both mother and baby and there have been other rare cases of survival?

    Now one of the major problems with determing foetal viability survival rates is
    due to downright duplicity by the pro-abortion lobby [and MPs]  of goalpost shifting by misuse and abuse of the terminology so although life may begin at conception

    Gestation: Point beginning from last period [i.e. foetal age plus 2 weeks]
    Pregnancy: Point beginning from 1st missed period [i.e. foetal age minus 2 weeks]

    So a woman who is 17wks pregnant has a 19wk old foetus of 21wks gestation.
    Confusing isn’t it!?

    What makes it even more difficult is that the three terms are misused and misattributed – especially in the media – and even recklessly on allegedly informed medical advice websites.

    but as of 2005 – the UN figures based on major simultaneous four-year studies:

    14% +/- 3% for a 20wk foetus
    27.5% +/- 7.5% for a 21wk old foetus , rising to 50, 70, & 90 every subsequent week
    [note that '20 wks pregnant' is where a foetus has a 50% chance of viability]

    Survival rates for 19 wks are extremely difficult to determine but it is estimated at anything between 3 and 9 per cent [difficulties arise due to ideological/political refusal of institutions to recognise such viability together with formal policies of refusing to medically intervene to save the lives of babies born at such an early stage]

    Normatively no child under 19wks has survived for more than a few hours [remember 19wks is '17 wks pregnant' - there are only 3 recorded cases of 18wks +5/6days].

    The Holy Office directed in 1902
    “with respect to time…no accleration of the birth is licit, unless
    it be performed at the time and according to the methods by which in the
    ordinary course of events the life of the mother and that of the foetus
    are considered.”

    That gives us a cut-off ‘normative point’ of 24 wks gestation – 22 wks since conception – 20wks pregnant. Where the survival rate for the foetus is >50%

    …where – as in the ordinary course of events – before that point there would be more chance of foetal death than survival – it would be gravely sinful to induce a pregnancy before this limit for any reason other than one both critical and grave.

    The critical grave reason is not merely maternal death [as both Sarah's interpretive reporting & the Irish bishops in their 'equal value' fallacy have enthymemically implied]

    …but both definite maternal [irrespective of procedure] and definite foetal death without the attempted delivery.

    In other words the Church directs:
    Inducing a birth before 22weeks after conception [i.e. 20 weeks pregnant] may only be performed in an attempt to save the life of a foetus – not when solely the mother’s life is at risk.

    A mother cannot directly or indirectly kill her child to save her own life.
    Before 22wks a mother must not induce pregnancy. The Church commands that nobody has the right to kill an innocent to save their own life. Contrary to what the Catholic Times’s Mgr Loftus said – a foetus cannot be deemed  an unjust aggressor and negative double-effect moral dilemma criteria do not apply – it would not be killing in self-defence.

    After 22wks discernment grounded upon an informed conscience comes into play  – The Church will not command anyone to virtuously sacrifice or risk their life for the sake of giving more chance for their child’s survival. The Church only commands someone to not do that which is wrong: It does not command anyone to do that which is good. Therefore to induce after 22wks is permissible.

    [n.b. somewhat perturbed/disconcerted by spuc's Anthony McCarthy's letter to the Herald in regard to ectopic pregnancy and hysterectomies for cancer - these are NOT VALIDLY justified without the absolutely mandatory conditional that the foetus was doomed to die irrespective of the treatment - the double effect does not come into play without that absolutely imperative criterion - the cited reason of 'solely acting upon the mother's body and indirectly killing the foetus' is both misleading and fallacious and not the moral grounds for justifying the action through the double-effect - the grounds for the act are the saving of the mother's life when the foetus will definitely die anyway]

  • paulpriest

    Agreed – but as I say below I am deeply concerned at spuc’s comments regarding the double-effect in other situations. There are distinct hints of Grisez/McCormick & Curran in the exposition and [inadvertent?] misrepresentation of the double-effect – and it isn’t Catholic teaching without the conditional that it is not merely indirect killing but the critical reluctant indirect hastening of a death of someone doomed to die in order to directly save a life.

    There are already too many Catholic commentators and bloggers claiming that a mother has a right to indirectly kill their child once their own life is at risk irrespective of the future life of the child [echoes of the above plus McBrien and any Tablet 'moralist' you care to mention] – and it was sorely remiss of Anthony McCarthy to not mention the crucal imperative criterion that the child cannot be saved.

  • mark startin

    The quotation that you give is:
    ” Where a seriously ill pregnant woman needs medical treatment which may
    put the life of her baby at risk, such treatments are ethically permissible provided every effort has been made to save the life of both the mother and her baby.”

    This surely bears, and supports most directly, the interpretation that once a medical team determine that they can take no further action that would help save the life of the baby, then they can concentrate solely on saving the life of the mother by whatever medical route.  This is why I said that the Bishops have subordinated Catholic teaching to medical ethics.

  • paulpriest

     I know…but there’s that pertinacious equivocation at the end – the cop out that “provided every effort has been made to save the life of both the mother and her baby.” – which is utterly antinomial to the context of the entire statement – like saying all square circles must be deemed square unless they are circular.

    Yes it’s technically a deplorable example of ideoporn – where it pretends to be saying one thing  [and has that opt-out clause which claims to be appealing to Catholic morality to cover their backs] but it is actually directly contravening Catholic moral teaching and signing a baby’s death warrant once it compromises a mother’s health…but sic transit gloria mundi and all that – what more can one expect from the Irish hierarchy given the self-interested havoc they’ve wrought for generations?

    It’s depresssing..but I’ve given up expecting more from them…

  • Parasum

    “In my opinion….they should state that doctors should try to save all
    lives….or if that’s not possible then they should strive to save one
    life without the intentional killing of the other… that the mother
    or child.”

    ## That would be much better.  They are clearly preferring one life to the other, which makes a nonsense of “stat[ing] Church teaching that the lives of both child and mother were of equal value” – if indeed they are held to be of equal value by Church teaching. At present they seem to be privileging a possible life over a real one. Which also seems crazy.

    ““The fact that our maternal mortality is so low is a sign that there is something that is working well in the system,” he said.”

    ## A fat lot of comfort that will be to those who have been bereaved – especially those who are not even Catholic. The Church’s bishops seems incapable of seeing other people except as members of anonymous collectivities. It is better for the individual – indeed, many individuals – to suffer or die, rather that the nation or the Church or the collectivity should perish. That is exactly how Caiaphas reasoned:

  • Parasum

    The solution seems to be to let the mother die, along with the non-viable baby, so that both die. Howe is that better than having one die, and only one ? How is letting both die even remotely moral ? That is not considered – which means that the current teaching  is wholly inadequate to deal with cases that do in fact arise, such as this. Something said in 1902 had to deal only with much more primitive conditions – it is woefully inadequate to deal with those of 110 years later, when medicine has changed out of all recognition & problems are now commonplace that were not then. If the CC’s Magisterium is stuck in the past, and refuses to deal with the present, it disqualifies itself from a hearing by anyone who is not equally willing to live in the past.

  • Dr. Jon Brownridge

    The principle of two-fold effect propounded by the bishops in this classic doctor-mother-baby (DMB) case is nothing new. It was certainly a central principle in my Moral Theology studies years ago. There is a lot of confusion expressed in some of these comments here. The crucial point is that where the two-fold effect comes into consideration we are talking about a single action that has two simultaneous effects.

    It is sometimes explained like this:  Suppose you are a medical professional in a war zone. You come across two seriously injured soldiers, A and B, and both need your immediate attention in order to save their lives. By treating A you are neglecting B. You can foresee that if you give your attention to A then B will die and your act of treating A will ensure it. Obviously, you are not morally culpable for B’s death. You regret it and would have saved him if you could. It’s better to save one than to allow both to die.

    In the DMB case, the act of saving the mother is the very act that results in the baby’s death. The baby is not viable and cannot be saved. The mother can be saved and the surgeon must do what he must to save her life. If he does nothing, both lives are lost. This was apparently the case in Ireland. The surgeons clearly did not understand either Irish law or Catholic moral theology.

  • mark startin

     This is a point that goes to the heart of the moral dilemma that we face.  In 1902 the detection of a faint foetal heartbeat would have been rather hit and miss, and a doctor could have ‘not heard’ the heartbeat.

    With the sophisticated monitoring and recording that takes place there is now no doubt, even very faint heartbeats are heard and recorded, thus prolonging the mother’s agony as she waits for her baby to die.  There is also the fact that no-one knows how long this could potentially take; any research would be unethical.

  • mark startin

    The DMB scenario that may be represented here is not like the soldier A / soldier B case.  The choice is more than in order to save A, who can be saved, you have to deliberately bring about the death of B, who will die regardless of what you do.  Thus in the case of a miscarriage the pregnant woman is suffering, and open to infection, but the non-viable foetus still lives.  Catholic moral theology would not allow the doctor to administer Oxytocin, or perform a D&C, as these directly bring about the death of the baby.

  • Lewispbuckingham

    It is really good that some medical practitioners are discussing this on this site.
    Talking to one practitioner he was quick to point out, in another context, that medical success is now based upon the client’s expectations, and that the outcome, from the client’s perspective, is all that is important.
     However practitioners live in the real world of autoimmune and induced immune mediated disease,aggressive viruses, super bugs, supreme neglect from addictive behaviour,as well as people, including babies,carrying lethal genes.
     It is surprising that the family is dictating the terms of the enquiry, without allowing those practitioners most affected a direct say in the enquiry, but presumably they are the accused guilty ones who did not sort out all the problems and give the expected and desired outcome as they were obliged to do.
     As such they will be at the mercy of a process that may destroy their careers and will speed up the exodus of competent doctors and surgeons from labor wards.
     Recently in Australia there has been a case involving a surgeon whose patients did not all survive.Despite the fact that his skills were as good as you get the relatives mounted numerous attacks on his competence, particularly in the media. The prosecution made the mistake of changing the attack half way through the case when the surgeon’s competence was established and the prosecution ‘s case collapsed.There is an appeal.
     Every society needs competent medical practitioners.The last thing they need is to be placed on the front line of a concocted ‘secular’ vs Catholic war.

  • TreenonPoet


    If the CC’s Magisterium is stuck in the past, and refuses to deal with the present, it disqualifies itself from a hearing by anyone who is not equally willing to live in the past.


    For the Church to admit this would be self-destructive. For the Church not to admit this would be a continuation of its deceit and the consequent evil.

  • Parasum

    “claiming that a mother has a right to indirectly kill their child once their own life is at risk irrespective of the future life of the child”

    ## But if it’s going to die anyway, how does that justify letting the mother die as well ? That makes the Church’s teaching mean – even if it is not intended to mean - that two deaths are better than one.

    STM the teaching is not only a sentence of death to any woman whose pregnancy becomes complicated, but that it is also inhumane & deeply defective because no attempt is made to adjust it so that it is able to taken into account what can and does happen when complications occur. A doctrine that is too undeveloped to meet the contingencies it is supposed to be adequate to meet is not only backward but dangerous.

    And as for claiming anything, ISTM that the CC is claiming the right to kill women. Only in certain circumstances, perhaps; but murder is still murder.

  • paulpriest

     Parasum I’m sorry but you seem to be misreading what I’m saying – these are conditionals for when the child will not necessarily die – and neither may the mother – they may simply be at greater risk….and the point is that risks must be endured if the alternative is deliberate killing.

  • mark startin

    Surely the real ethical dilemma is not what if both may die, but what if both will die unless we act?  The Church teaches that we may not do anything to terminate the pregnancy; although the Bishops’ statement appears to wish to avoid this fact.

  • paulpriest

     This is further compunded with the fact that even when read in the most moral perspective it’s the most obscure interpretation of it. It’s a struggle finding the morality via double-negatives and enthymemes – and it requires a lot of obliging good will….
    Badly-motivated badly-written bad morality…

  • tommir

    I think this video answers some of the questions

  • tommir

    Check out this video that has more details

  • Arden Forester

    “The bishops insisted that the Catholic Church has never taught that the
    life of a child in the womb should be preferred to that of a mother”. The trouble is fact and fiction is obscured in the secular world. And it’s not helped by some Christians getting the wrong end of the stick and repeating inaccuracies to others.

  • Plightholder RN from USA

    I thought this lady died from infection which is treatable whether she was pregnant or not. It seems to me that the question should not be why her pregnancy wasn’t terminated earlier, that would happen eventually all by itself, but why she wasn’t monitored for infection and treated for that promptly. Wasn’t it infection that killed her rather than the pregnancy? They should have been looking for infection.  

  • Aerdirnaithon

     This isn’t pandering. This is the Catholic stance. Unfortunately, many people do not realize that Catholic moral theology is incredibly complex and has ways of handling these kinds of situations.

  • doctors in manchester

    A controversial but very interesting read! Thanks!

  • la catholic state

    The Catholic stance is that the mother and child are of equal value….and one must not by default be put above the other.

  • David

    “Whereas abortion is the direct and intentional destruction of an unborn baby and is gravely immoral in all circumstances”

    So they are supporting the doctors in not killing the foetus whilst a heart beat was present.
    Verbiage galore does not change the meaning of the above quote.

  • IsaacM50

    like torturing and murdering non-believers…or anyone who doesn’t agree with their ‘moral’ values….

  • Probaby

    Everybody knows that babies are superior to women. Anyone who disagrees is obviously pro-abortion.

  • la catholic state

    Um….actually…..all people are equal in the eyes of God.

  • Jackreylan

    China has just started using biologically cloned humanoid drones in its factories and military to counter population aging from one child policy. This biocloning was started by Tong Dizhou in the early 1990s to produce star athletes but was later taken up by the PLA military. The clones are grown in the wombs of slave women from allied African dictators. and have been known to appear on American soil as illegal workers. Food and Drug Administration investigators say the Chinese spiked pet food with melamine so that they would appear in tests to have more value as protein products. They sell drywall which emit suflide fumes! Given their blatant disregard for American safey in products they sell, because they don’t care if we stay alive after we enrich them, it is worrisome that these clones have not been adequately tested for potential disease transmission. Why aren’t anti-American professors who were hawking phoney Japanese “quality” complaining about their fellow reds in China?

  • Pastizzi56

    I tink the Irish Bishops are referring to the principle of double effect. According to catholic moral teaching doctors cannot kill directly the unborn child to save the mother’s life. But doctors can and should apply treatment that directly heps to save the mother’s life even if indirectly it puts the baby’s life in jeopardy.

  • Evesons

    Well – given your stance perhaps the advice to Catholic women should be, “Don’t get married and don’t get pregnant or you may end up sacrificing your life because of it.”