A Brief Note on the Death of Savita Halappanavar

A short while ago I wrote a guest post of the BSA Med Soc Cost of Living blog on Why a pro-life Northern Ireland depends on a pro-choice UK. They invited me to update the post following the tragic death of Savita Halappanavar. Here is what I had to say: 

The tragic case of Savita Halappanavar does not precisely reflect the concerns expressed above.  But it does illustrate something about the consequences of reducing debates about abortion to simplistic moral arguments that stifle legitimate debate. It seems evident that even in a country with restrictive abortion legislation that women whose pregnancy places their life at severe risk should receive lifesaving treatment. In this respect the tragic events in Galway make it difficult to come to any other conclusion than that Savita Halappanavar’s care was, at best, mismanaged. Two investigations have now been launched to find out where things went wrong. 

However that this tragic event occurred is not simply a matter of legislative or professional incompetence but a broader political failure of those in positions of power – whether they are legislators, professionals or clergy. Only last year, a group of Irish medical professionals declared that ‘abortion was not medically necessary to save the life of a pregnant mother.’ In the light of this comment on the clinical parameters of Savita Halappanavar’s case this is a  bizarre statement from trained medical professionals. It is evident that both North and South of the border clinicians need further guidance. The intransigence of the powerful belies the increasingly organized grassroots pressure on the Irish and Northern Irish governments to tackle the issue of abortion legislation. Their continued failure to do so maintains the status quo where women travel to other countries to get the services they need whilst moralist rhetoric monopolises public, political and professional discourse.

The power of these moralists extends, it seems, all the way to the clinic where it needlessly cost Savita Halappanavar’s her life. This state of affairs cannot continue. Both political and professional actors need to accept their responsibility to create proper legislation and clinical guidelines for abortion before any more women die needlessly. 

A Word Cloud of My Entire Zotero Library

My favourite reference manager is the marvellous Zotero and I recently discovered the Paper Machines add on. This extension analyses and adds to the data in your library and allows you to make new connections and see interesting links. Ot it might once I get to grips with it! At the moment I can produce a 'wordle' like visualisation, like this: 

This is based on the ridiculous number of citations I have in my entire library (just north of 10,000) including all the .pdfs I have attached. I don't think there is any surprises here, except it is a bit odd that the word 'education' appears to be missing. Still, here is another, based on the same data.

Quality, Quality of Care, and Ethics: Some Notes.

‘Quality’ is a curiously amorphous word that has, nevertheless, become a major policy driver, particularly in regards healthcare where we find a ubiquitous concern for the ‘quality of care.’ Akin to ‘choice,’ quality is held to be a self-evident good yet, at the same time, as there is little that is not in fact ‘a quality’ and the word offers very little specification. In fact its significance lies not in naming any particular quality or qualities of (health)care but in suggesting first, that there are some aspects, properties or qualities of healthcare that are good (whilst others are not so good or downright bad) and second, that those qualities that are good can be improved. This being the case then the idea of the quality of care must be unpacked and its specific meanings explored. Obviously ‘quality of care’ might mean different things in different contexts and to different people – particularly to professionals and patients. Obviously the care required and, therefore, the qualities that constitute such care differs in A&E, primary care, care of the elderly in a hospital setting compared to a community setting may well be differ in specific instances of care. The specifics of ‘care’ and the particular qualities on which its overall quality are to be judged can be variable. Given a particular case a clinical team might foreground particular aspects, the management some other (measurable) aspects, the patient some other aspects, and the patients family still others.