Investigations begin into death of woman who was refused an abortion

BMJ 2012; 345 doi: (Published 16 November 2012) Cite this as: BMJ 2012;345:e7824

Re: Investigations begin into death of woman who was refused an abortion

The story of Savita Halappanavar is that of the young pregnant woman who died following rapid worsening of septicaemia, in spite of an attempted surgical treatment at the Galway University Hospital, consisting of a uterine evacuation at the 17th week of pregnancy.

From what we learn in this week’s BMJ (1), the case arrived in the headlines because in the preceding days the patient, experiencing severe pain, had appeared before the doctors at the same hospital and requested the pregnancy termination, with the response then being a firm denial, on the reasoning that a foetal heartbeat was still perceptible and that “Ireland is a Catholic country”.

This account of the facts paints a very theocratic image of what is in fact a democratic nation, while also risking an inaccurate interpretation of the Catholic religious orientation in situations resembling the one described.

In fact, the Roman Catholic doctrine does not propose a scale of values where the life of the foetus is of greater importance than that of the pregnant woman. These are two distinct lives, with the same value, and the sacrifice of both in the name of the presumed supremacy of one over the other – as unfortunately took place – is certainly not requested from the Catholic doctrine.

For believers there is a moral basis for the choice of difficult treatment solutions under extreme circumstances, particularly when there could be two goods of equal value.

We mention in passing the doctrine of the state of necessity, which in cases of real and imminent danger for a person’s life, would alone permit the individual to make choices in exclusive consideration of their will to survive.

However, Catholic doctrine has also long postulated the ethical principle known as “double effect” (2). This principle could clearly have been proposed in the solution of the case of the young woman in Ireland, given that the most-often-cited example of application is precisely to the situation of those who could be unintended abortion, due to the surgical or pharmacological treatment of a life-threatening maternal disease.

The applicability of this principle is yet more apparent in conditions where the foetus is alive but is still in state of symbiosis, without sufficient maturity to aspire to a separate, “autonomous” life from that of the mother.

Thus to portray Catholicism as the root cause of the exceptionally sad ending of Savita’s story could serve to flatter the feelings of the community of convinced reformist readers, or of those who are openly non-religious, but it cannot contribute to an understanding of how the facts evolved.

Such understanding might instead be gained from the inquest begun after Savita’s death, and judging from the sequence of events reported by the woman’s husband, the investigation could very well lead to a conclusion of clinical malpractice, rather than providing any example of Catholic malpractice.


1. Houston M. Investigation begin into death of woman who was refused an abortion. BMJ 2012; 345: e7824.

2. St. Thomas, 2-2, q.64, a.7.

Competing interests: The authors work in a Roman Catholic institution

29 November 2012
Giuseppe Vetrugno
Medical Directorate
Antonio G Spagnolo, and Fabio De Giorgio
Policlinico Universitario "A. Gemelli"
L.go "A. Gemelli", 8 00168 ROMA