Because most philosophies that frown on reproduction don't survive.

Friday, November 16, 2012

Exploiting a Tragedy

Hard cases may make bad law, but they make great headlines. Thus, certain sectors of the news and opinion world are abuzz with a tragedy that occurred in Ireland:
Two investigations are under way into the death of a woman who was 17 weeks pregnant, at University Hospital Galway last month.

Savita Halappanavar (31), a dentist, presented with back pain at the hospital on October 21st, was found to be miscarrying, and died of septicaemia a week later.
Speaking from Belgaum in the Karnataka region of southwest India, Mr Halappanavar said an internal examination was performed when she first presented.

“The doctor told us the cervix was fully dilated, amniotic fluid was leaking and unfortunately the baby wouldn’t survive.” The doctor, he says, said it should be over in a few hours. There followed three days, he says, of the foetal heartbeat being checked several times a day.

“Savita was really in agony. She was very upset, but she accepted she was losing the baby. When the consultant came on the ward rounds on Monday morning Savita asked if they could not save the baby could they induce to end the pregnancy. The consultant said, ‘As long as there is a foetal heartbeat we can’t do anything’.

“Again on Tuesday morning, the ward rounds and the same discussion. The consultant said it was the law, that this is a Catholic country. Savita [a Hindu] said: ‘I am neither Irish nor Catholic’ but they said there was nothing they could do.

“That evening she developed shakes and shivering and she was vomiting. She went to use the toilet and she collapsed. There were big alarms and a doctor took bloods and started her on antibiotics.
She spent a further 2½ days “in agony” until the foetal heartbeat stopped.

The dead foetus was removed and Savita was taken to the high dependency unit and then the intensive care unit, where she died of septicaemia on the 28th.
Ireland is one of the few developed nations which bans abortion, and those who oppose its anti-abortion laws have taken up this case as a rallying cry, despite the fact that it appears that Irish law would not in fact have prohibited treatment of Ms. Halappanavar even if the treatment would have resulted in speeding the (probably inevitable in this case) death of her child:
The question that needs to be asked is: was Ms Halappanavar treated in line with existing obstetrical practice in Ireland? In this kind of situation the baby can be induced early (though is very unlikely to survive). The decision to induce labour early would be fully in compliance with the law and the current guidelines set out for doctors by the Irish Medical Council

Those guidelines allow interventions to treat women where necessary, even if that treatment indirectly results in the death to the baby. If they aren't being followed, laws about abortion won't change that.

The issue then becomes about medical protocols being followed in hospitals and not about the absence of legal abortion in Ireland.

Professor John Bonnar, then chairman of the Institute of Obstetricians and Gynaecologists, spoke about the matter to the All Party Oireachtas Committee's Fifth Report on Abortion, saying: "In current obstetrical practice, rare complications can arise where therapeutic intervention is required at a stage in pregnancy when there will be little or no prospect for the survival of the baby, due to extreme immaturity.

"In these exceptional situations failure to intervene may result in the death of both the mother and baby. We consider that there is a fundamental difference between abortion carried out with the intention of taking the life of the baby, for example for social reasons, and the unavoidable death of the baby resulting from essential treatment to protect the life of the mother."

With this medical practice Ireland, thankfully, has one of the lowest death rates of mothers in pregnancy anywhere in the world.
In this regard, Irish law and medical practice are in line with a Catholic understanding of the principle of double effect, which is to say: Not only did Irish law not mandate that the hospital decline to treat Ms. Halappanavar, but Catholic teaching does not either.  And, indeed, Ireland is right to be proud of its record of caring for the health of both mothers and children. The percentage of women who die of pregnancy related complications in Ireland (6 out of every 100,000 pregnancies) is half that of the pro-choice UK and less than a third of that of the United States. Most Catholic and pro-life writers that I am aware of have been quick to point out that this tragic case is not an example of the Irish law working as it was intended, but rather the reverse. The exception is a hysterically self indulgent rant written by Sam Rocha at the Patheos Catholic Portal. Having prefaced his piece with the warning that he intends to vent, Rocha writes:
These idiots — who denied Savita Halappanavar an early induction that would have saved her life — deserve court and confession, prison and penance.

These idiots also happen to be my religious kin. They used the word ‘Catholic’ and their Irish national identity carries a long, storied relationship to my Church. In this case I might as well be an Irishman. We cannot throw out the uncomfortable and inconvenient; we must face it and speak to it directly. When your brother or sister commits a heinous crime, you cannot disown them. You are responsible. There is nothing easy or tidy about it.

Guilty by association. That’s me. Guilty. It is not fair and it doesn’t follow rationally, but it does resonate because it should. I am my brother’s keeper. I will not try and be calm about this. I’m certainly not a fucking journalist. I write this as a Catholic, a furious, outraged Catholic. Nothing more and nothing less.
So, headline story is angry, in good old chest thumping style. He self-consciously drops a swear word to let us know he's really serious, and he loudly demands that people go to jail. I'm not normally one to run down my fellow countrymen, but I have to say: Is there anything more typically American than the conviction that whenever something bad happens it must because some wicked person needs to go to jail for a long time? No wonder we have a ridiculously overloaded prison system. Demanding the imprisonment of others becomes a form of moral preening for us.

What is it that makes Rocha so angry? Why does he consider that Catholics as a group are guilty by association in Ms. Halappanavar's death? Rocha admits that Catholic teaching and Irish law both agree that the way Ms. Halappanavar was wrong.
First, the physicians in question did not deny Savita an abortion. They effectively aborted her, the mother. In doing so, they violated the statutes of the Irish Medical Council and, therefore, the law. They were not following the law of the land and deserve to be tried in court (for at least involuntary manslaughter) and quarantined from the Irish medical community.
Catholic teaching and doctrine on this point derives from the principle of Double-Effect. It is well-established and very old doctrine, grounded in philosophy more than theology. It can be found in Augustine and Aquinas, and more. It can be rationally understood and practiced. These medical professionals failed to understand or practice it. Their failure, their total ignorance on what the Church actually teaches, puts them in grave offense against the Church. They need to confess and begin penance — hopefully while doing time in prison.
So if the medical staff who acted wrongly here acted contrary to Catholic teaching, why is the Church the target of Rocha's self accusing outrage?
Even though the Church teaches otherwise, the fact that these people were so poorly catechized is an evangelical, mystogogical failure that all the faithful must embrace and share. We should not reject the fact that this spectacular failure to understand the holistic reality of pregnancy is a particularly Catholic mistake.
So the Church teaches otherwise, and Irish law directs otherwise, but because the medical staff cited "this is a Catholic country" as their reason for not acting in this case, it's the Church's fault. To Rocha's mind, it is the Church's fault because the Church should have done a better job of teaching these people to understand Catholic morality. Admittedly, we don't actually know if the hospital staff in question were actually Catholic in name or practice, they may have just been engaged in the sort of passive aggressive rule enforcement for rule enforcement's sake which is occasionally found in large organizations in which people come to care more about covering their perceived liability under "the rules" than about actually achieving their mission. However, the Church's failure to teach successfully is not Rocha's final target here. That target turns out to be political.
LIFE IS NOT AN ISSUE. It is not a political trophy to be used to get votes or preserve things you like or get rid of things you don’t like. The simplistic binaries that pit women against their children and infants against their mothers has gone on long enough. ENOUGH!
I am sick over the fact that I suspect that one reason these perfect idiots thought they were following Church and State mandates had something to do with this: life has been violently re-cast and perverted into a talking point, a sanctimonious — and expensive — lobby effort that is rooted in oversimplification and vulgar imbalance. Even those on right side of the matter are on the wrong side.
My silence on the beautiful question of life has been because I don’t find an easy entry into the matter. There is no room to talk about this in a way that respects the reality in question. So I’ve mostly held my tongue.

Today my silence reveals a slothful and selfish cowardice. This is not the time for silence. I fled the conversation because of election politics and the bitter, infantile rivalries within the American Catholic Church. I said to myself “I am a man. I should let the women and the infants speak for themselves.” Excuses. “Through my fault, through my fault, through my most grievous fault.”

The empty-headed, calloused opportunists — despite their truest and very best intentions — have had their say. We know what the pro-choicers and the pro-lifers think. They have NOTHING new to say or add and haven’t for years. What we don’t know, and surely do not begin to understand, is the event itself. Life. The bare reality.

Savita was not aborted through malice. She was aborted because of ignorance and silence. For this reason, her death is worst than malicious. It could have been prevented by the very national and ecclesial traditions it misinterpreted. What a failure.
So there we have it. Irish doctors refused to give Ms. Halappanavar the medical help she so desperately needed because American Catholics don't discuss the pro-life/pro-choice political divide in a way that Sam Rocha happens to like. Once again, I feel like I'm talking for "the other side" here, but: Can we get any more Ameri-centric than this? Why should we imagine that the problem here is American discourse on "social issues" is the cause of what happened in Ireland? Does Rocha know where the major Irish political parties stand on abortion and how the issue is discussed in Ireland? I'll be the first to admit: I don't. But then, I didn't decide to go write a rant on the topic.

Does our political discourse in the US on this issue tend to get divisive and bitter very quickly? Of course. Political faction tends quickly to lead to simplification, dehumanization of the opposition and anger. This happens all the more so on abortion because the issue is so personal and the stakes perceived by both sides are so high. While I support the pro-life movement, I don't for a moment imagine it doesn't fall prey to these problems. In order for truth to be conveyed, these problems need to be fought aggressively. However, what Rocha does in this piece is not engaging in constructive criticism of how the pro-life movement behaves. Rather, he takes a horrible event, the unnecessary death of a young mother, and yanks it out of context in order to serve as an opportunity for moral preening.

Savita Halappanavar did not die because Rocha failed to sufficiently speak out against American political discourse that he finds distasteful. She died because the hospital staff she encountered failed to act as Irish law, Catholic morality, normal medical practice and basic human decency would demand. The hijacking of her death to make political or rhetorical points, however angrily self-righteous, is wrong.


Calah said...

I dunno, I didn't really see it as moral preening. I actually really liked Sam's post. I guess my question is, is he really exploiting her death? I think the pro-abortion crowd who says, "look, this is why abortion should be legal" when in fact abortion has NO bearing whatsoever on this case definitely are exploiting her death. But I read Sam as feeling convicted by it, using it as a teachable moment for himself more than anyone else. Isn't that what we do as bloggers, chronicle our thoughts and reactions to things that happen? And although I agree (and didn't see it until you pointed it out) that it's kind of America-centric, I think the idea is rather that too many people are silent in the face of the abortion debate, and more voices could have contributed to save her, and that Sam is using himself as an example. Maybe I'm reading it wrong.

Darwin said...

I took it as moral preening because under the apparent self accusation, his argument is basically: "This woman died because pro-lifers are too politicized and talk in ways that I don't like. I should have called them out and attacked them for opposing abortion in ways that I don't like."

In other words, his claim is that if everyone who opposed abortion did so in the more enlightened and less politicized way that he does, then this wouldn't have happened. I find that both hard to credit and also a rather distasteful way of capitalizing on a personal tragedy to attack those one doesn't like.

Baron Korf said...

Bravo. Spot on analysis of everything that annoyed me about that post.

Anonymous said...

She died of a highly Ab resistant E. coli infection and blood poisoning. So we have to ask:

1). Where and when did she acquire the infection?
2). Why was she in the hospital fully dilated and leaking amniotic fluid on Sunday, but not given antibiotics till Tuesday?
3) it sounds like they performed a D&C after her baby died in utero. Why, when that would spread a localized infection systemically?

We know so little of what was wro g, that we can't make an effective judgment of what went wrong. Although, my understanding of this E. coli strain says that her chances once she acquired the infection were not good.

samrocha said...

I don't usually get paid the compliment of a line-by-line refutation, so thanks Darwin. I've aways liked you, as you know. If I was being exploitive, you're surely paying me the ultimate compliment by keeping the flame going.

The real question is simple and it comes down to authenticity. Fair enough. Here's my story:

When I typed it out yesterday, on the first draft, it just fell out of me. It was a rant, so I warned people about it afterwards, mostly to keep my mom away --- she hates it when I swear.

But you're right: the title and the wind-up and the delivery all project what I think about this, as you noted. So did I exploit this? In one sense I did. But that sense would not be the original PURPOSE of the post. It is just the scent that now seems to overtake the rather over the top prose and style. So it's complicated.

Here's what I can promise was entirely authentic: I felt like shit when I read this story --- the day before I wrote about --- and even worse when a day passed and I tried to forget about it. What was I so afraid of? Why was this off limits? Why (and you can read an earlier post where I mentioned this) was I so silent about abortion? Am I some passive kin to Catholics for Choice? These are real. 100% You have my word. I even warned the other Patheos people to leave me alone for a while on it, because I was upset.

Now, please don't forget that I am also NOT making the other argument being made by the abortion activists. I am denying that form explicit exploitation, but doing so without having to deny my own role in the matter, as a part of the body of Christ.

FInally: I've never been accused of being too American. So thanks for that. It helps me have a sense of humor that, on grand display yesterday, I surely need more of.

Peace and good,


BettyDuffy said...

You guys both make sense to me. I wish I could have a drink on it.

Darwin said...


Agreed. In all the fuss, it's rather hard to understand what the actual medical situation was. Indeed, few seem to care much at this point.

Sam Rocha,

Thanks for your irenic response.

I don't question that your reaction as written is authentic. However, I think our authentic reactions are often not good ones. In this case, while I can certainly see how one might get emotionally from "I often don't like the way that fellow Catholics and pro-lifers express themselves" to "that mode of expression is responsible for Savita Halappanavar's death", I think that it's a wrong jump, and one which ends up exploiting a human tragedy in order to give extra force to one's own rhetorical or philosophical preferences.

Charming Disarray said...

It never ceases to amaze me that Catholic men get so bent out of shape over abortion, but pay zero attention to domestic or emotional abuse, even when it's going on right under their noses or when somebody actually tells them about it.

There's a lot of self-satisfied blaming of the "other" in the pro-life movement. I guess it's something that men in particular can feel safe getting outraged over because there isn't actually anything they can DO about it. If some number of teenage girls in another state or wherever, without names or faces, rush out and get abortions, no one could reasonably expect them to do something about it, but if the man in the pew next to them is emotionally abusing his wife and kids, or perhaps physically, it's better not to think about it because that would require stepping in, and that would be difficult and embarrassing.

I'd like to see an angry rant from a Catholic male blogger one of these days, instead of endless ranting about abortion and gay rights, but I'm not holding my breath.

Charming Disarray said...

That was...angry rant about domestic violence.

And yes, it may not be going on your church in particular, although it might be, but neither is abortion.

Joseph said...

You can make a plausible case this was due to pro-choice rhetoric. One of their talking points (up to the past election) was that pro-lifers are hypocrites because they make exceptions before birth but not after birth. Some pro-lifers may have taken that seriously.