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A clinically dead but pregnant woman is being kept on life support because lawyers believed the Irish Constitution demanded it, Ireland’s High Court was told Tuesday.
The court heard that the young mother of two and her partner had discussed and chosen male and female names for her unborn child; they had been looking forward to the birth, and planned to get a house together.
In late November, however, the woman experienced headaches and vomiting. She fell in a bathroom of the local hospital on November 29, a week after her admission, and after returning to bed became unresponsive. She was sent for a CAT scan which revealed that she was suffering from a brain edema — an accumulation of fluids in the brain — and was transferred to Dublin Beaumont hospital, the national neurological center. A cerebral angiogram established that there was no blood flow through her brain, and on December 3 she was declared dead.
Neurosurgeons treating the woman recommended that life support be switched off, but one member of the team reportedly expressed concerns about legal issues, given the woman’s pregnancy and the fact that Article 40.3.3 of the Irish Constitution imposes on the State the qualified duty to “defend and vindicate” the right to life of unborn children, ”as far as practicable.”
Lawyers for Ireland’s Health Service Executive (HSE) became involved, and although the woman’s family and partner agreed that life support should be turned off, the HSE kept vital functions operational with a view to saving the unborn child, which is currently at 18 weeks gestation.
Today, however, HSE lawyers told the court the HSE believes life support should be discontinued. Senior Counsel Gerry Durcan said the medical evidence indicates that there is no reasonable prospect of the child being born alive, even if the mother’s vital functions are maintained, and that as such it is not practicable to vindicate the child’s right to life.
Dr. Brian Marsh, a consultant in intensive care at Dublin’s Mater Hospital, explained to the court that the woman’s body was afflicted with a chest infection, a urinary tract infection, and two infections in the head, and required ventilator, hormonal, and nutritional support. Conditions were unlikely to remain stable, he said, and he doubted that things could be sustained for a further 14 weeks, to a point where delivering the child would be appropriate. Dr. Frances Colreavy, one of Marsh’s colleagues, said that in her clinical opinion it was neither possible nor advisable to continue supporting vital functions.
“The unborn baby also has a right to life under the Constitution,” according to David Quinn of Dublin’s Iona Institute, adding that, “but that right to life does not mean that a baby must be kept alive by any means, no matter how disproportionate. So what the court has to decide is whether or not the means of keeping the baby alive in this case is disproportionate or not.”
Situations like this, while not common, are far from unique. Only last Thursday, December 18, a baby boy was delivered at 32 weeks in Milan, despite the child’s mother having suffered a brain hemorrhage and died in October during her 23rd week of pregnancy, and this February in Canada another baby boy, Iver Benson, was delivered at 28 weeks, six weeks after his mother, Robyn, had been declared dead following a massive brain hemorrhage.
Father Vincent Twomey, professor emeritus of moral theology at Maynooth and a former doctoral student of Pope Benedict XVI, said a case such as the Benson one involved a “prudential decision.” Explaining that Church teaching does not demand that extraordinary means be employed to keep a person alive, he told Catholic Ireland that “the difficulty is that normally this is applied to the patient, but here the means are meant to keep the woman alive so that the child can develop naturally.”
While the general principle, he said, is that “if you can promote life, keep a life, you should do all you can to do so,” he said other factors needed to be considered, not least the burden treatment would impose on the hospital and the family of the bereaved, as well as whether the hospital’s resources might be better used to save another life.
Lorcan Price, a lawyer and member of Ireland’s Catholic Comment media group, cited a 2010 University of Heidelberg study in telling Aleteia that, “In these extraordinarily rare cases which have arisen in jurisdictions other than Ireland, each case is treated on an individual basis.”
The study, entitled, “One life ends, another begins: Management of a brain-dead pregnant mother — A systematic review” stated that when dealing with brain death in a pregnant woman, “physicians must primarily focus on saving the life of the fetus, and therefore the treatment protocol should give special recommendations on how to support the mother in a way that she can deliver a viable and healthy child.”
As such it was “most regrettable,” Price said, that Ireland’s pro-abortion lobby was willing to “make cynical use of the plight of this woman and her family to try to build a case against Article 40.3.3, even though the same issues arise in jurisdictions with no constitutional protection for the unborn.”
Highlighting the tragic cases of Savita Hallapanavar and “Miss Y” as instances that had been similarly exploited, he noted that the Heidelberg study listed cases in which the gestational age at the time of the mother’s brain death “was 15, 16 and 17 weeks, with the mother being kept on life support and live babies delivered at 32, 31 and 25 weeks respectively."
In the first two cases, he said, the babies’ outcome was fine, but the third died from a complication of prematurity and infection. The review’s ultimate conclusion, he said, was that the question of maintaining vital support was one which must be addressed “on an individual basis."
In the context of the Irish case, he said it made legal sense for the hospital to have maintained vital support until “the position of the unborn child has been fully considered.”
“In the event of a fatal injury to a pregnant woman, having made all necessary efforts to save the woman, the treating medics must consider steps to saving the life of the unborn child,” he said. “If the child has reached a point of ‘viability’ outside the womb a doctor may consider terminating the pregnancy by way of a Caesarean section. In this case the issue to be considered is whether prolonging the mother’s life artificially may on balance have a positive outcome for the unborn child.”
Ireland differs from other countries, Price said, in that doctors have a legal duty to take the life of the unborn child into account, but as the Heidelberg study says, it is in any case normal medical practice to attempt to save the unborn child if doing so is practicable.
Cora Sherlock, deputy chairwoman of Ireland’s Pro Life Campaign, expressed sympathy for the young woman’s family and described what has happened as “one of these most difficult of situations brought about by modern medicine.” Explaining that while it was appropriate, especially in a mature society, that “the life of the baby should be considered,” she nonetheless said that this was not the only factor to be considered.
“Modern medicine puts at the disposal of doctors a huge range of extraordinary interventions,” she said, “But there is never an obligation to employ extraordinary means.”
Like Price, she cautioned against lobby groups seeking to exploit the situation by pushing for constitutional change, pointing out that “cases like this have arisen elsewhere so it is simplistic when people seek to blame the Eighth Amendment to the Constitution for what is happening.”
The three-judge panel said it would hear lawyers’ closing arguments on Christmas Eve and give its judgment Friday, an unprecedented measure on what is a national holiday in Ireland, St. Stephen’s Day.
Greg Daly covers the U.K. and Ireland for Aleteia.
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