Can I get my donated blood back?
14 Dec 2007 | Filed Under: Crankypants + Ireland + Politics
You know the country’s healthcare system is really fucked when we’re witholding treatment from people desperate for it while foisting it on people who don’t want it.
Currently at the High Court is a woman who refused a life-saving blood transfusion in a Dublin maternity hospital, despite hemmoraging 80% of her blood after giving birth. She’s brought suit against the hospital that got a court order to force her to have the transfusion against her wishes. And I hope she wins.
The hospital contends Ms K’s constitutional rights to freedom of conscience and the free practice of religion did not allow her to decline appropriate medical treatment.
The hospital can contend whatever they like, but the hospital is wrong. I mean really: allow her to decline treatment? We need a hospital’s permission to say “don’t do that to me” now? Because I’m pretty confident that person best placed to decide what constitutes “appropriate medical treatment” for me is me.
After reading all the huffing and puffing in the comments over at Twenty Major, I can’t help but think that people really have the wrong end of various sticks on this issue. The issue is not:
- That she originally lied and gave her religion as Catholic;
- That she is in fact a Jehovah’s Witness;
- That she made her choice knowing she would likely die;
- That she is from the Congo, that she is here illegally, or that she is seeking asylum.
The issue is really simple: she’s an adult, capable of making her own decisions about her medical care. She made one, emphatically, and the medical professionals around her overrode her. They violated her wishes, and her bodily integrity, and performed a medical procedure without her consent.
(It’s also really complicated: this case smacks of issues of a patriarchal medical establishment, the particular dis-empowerment of women giving birth in hospitals, the rise of the Nanny State, religious intolerance, racism, and institutional misogyny. But none of those issues are being addressed in this court case - or anywhere else I can find, for that matter.)
What’s interesting to me is that nobody accused the women victimised at Lourdes Hospital of being out of order when they sought financial compensation for unlawful hysterectomies. The issue here is largely similar - a procedure they did not want, performed without their consent.
I’m not a legal professional, but it seems to me the transfusions in this case were equally unlawful. It’s simply irrelevant who she is, where she’s from or even why she refused them.
Everyone currently sounding off about how she’s an ungrateful asylum seeker bilking the government for money and should be deported so this case quietly goes away ought to be hoping that she wins. Because even if she is deported, the rest of us still have to live here after she’s gone - and the laws that failed to protect her are the same laws that are supposed to protect the rest of us.
AvoidingLife says:
Sabrina I couldn’t agree more! I had my second child here in Ireland and the amount of times I had to tell doctors to F off for offering me pain meds and unnecessary procedures to get her out faster was astounding. In the end I was able to get an understanding midwife to guard the door and help me have her naturally and drug free, but the fact that these predominantly male doctors kept trying to get me to do things that would ultimately make their lives easier was appalling! As you said the duality of the system is amazing. Here I want treatment and can’t get it and when I didn’t want or need it, they were forcing it on me, and ultimately my baby as well. *SIGH* Thanks for your continued support!
Friday, 14 December, 2007, 6:49 amnouns says:
Very well put Sabrina. It’s a shame that the race / nationality / asylum seeker issue provokes such a predictable kneejerk reaction in people that it masks what should be discussed - everything you have in the paragraph in brackets.
I wouldn’t even credit most of what’s over in Twenty’s comments with ‘huffing and puffing’ …
Friday, 14 December, 2007, 8:25 amTwenty Major says:
I suspect that it’s the fact that she’s not a very believable person is what’s causing the ‘huff and puff’ (and I hope that everyone would treat some of the more over the line comments with the contempt they deserve).
Personally, I agree with you that if an adult refuses treatment then any hospital should respect that. If she was in a car crash, for example, then I’d have no problem with letting her die. She’s stupid, but that’s her choice.
However, if a person refuses treatment and it’s going to leave a newborn child without a mother then there are more important considerations than somebody’s belief system.
Friday, 14 December, 2007, 10:37 amLouis Cipher says:
One point about AvoidingLife’s comment, which I don’t fully understand. Surely if you wanted your child to be born “naturally” you shouldn’t have gone to a hosipital, you should have opted for a home birth really. No one is going to tell you what to do in your own home. Once you step in to a hospital you’re playing by a completely different set of rules and are essentailly getting so-called experts involved in the delivery process.
Friday, 14 December, 2007, 11:07 amsabrina says:
Twenty, I’d *like* to think it’s the fact she’s not a truthful person that’s causing the huffing and puffing, but really I think it’s because she’s here from Somewhere Very Else and is ZOMG Using *Our* Tax Euros that is putting people’s panties in a wad. It’s the same BS we hear all the time about how Those People are milking the system for every entitlement and ripping off the taxpayers and not paying in a penny and clogging up the health service and bunging up the social housing queue and should all just go home.
Yawn.
I’m also not behind the “won’t someone think of the children?” argument. Women need to have autonomy over their bodies, regardless of their status as child-bearers. I’m terribly sorry that utterly sucks for the infant involved, but I’m really not willing to buy into a two-tiered system of rights where we can allow you to make your own medical decisions unless you happen, by the biological accident of your gender, to be someone’s mother.
And not to put too fine a point on it, but I very much doubt many people would be making the “won’t someone think of the children?” argument if it were that child’s father in the hospital bed. Capiche?
Friday, 14 December, 2007, 11:09 amLouis Cipher says:
From what I’ve read on this story so far, didn’t the woman say that being childless at her time of life was considered an “Abomination” back in her own country? And that she came to Ireland to have her child safely (after losing several through miscarraige)? Surely then if she decided to end her own life by refusing the treatment she was given, which is entirely her own choice I must admit, she would have left the child motherless in a foreign country. Now before you shoot me down saying that the father of the child was here (even though she initially said he wasn’t), and the child would have been placed in his care. Its still a pretty selfish decison to make on her part considering the reason she put forward for choosing the Irish health system in the first place. From where I’m standing the entire debacle is built on one lie after another and smacks of hypocrisy on her part.
Friday, 14 December, 2007, 11:20 amsabrina says:
Loius, I think the point is rather that women should be able to make the choice to give birth where they feel most comfortable without having to fear that they are signing up for unnecessary interventions.
Home birth is a fabulous option (and actually statistically safer than a hospital birth) but is *not* available to all women. It depends where you live, if the health service can allot you a midwife, and to an extent on how well you can advocate for your right to home midwifery. (See here if you’re interested.)
It also depends if you’re “eligible” for a home birth - which again, depends on if its a singleton or a twin pregnancy, if the baby is vertex or breech or some other sub-optimal position, if you have risk factors like gestational diabetes, and how far you are, physically, from a maternity ward in case of an emergency transfer. Long distances (and Ireland is still quite rural) will disqualify you.
There are any number of factors that can rule a woman out of a home birth. An excellent middle ground would be midwife run birthing centres attached to maternity hospitals, but as far as I know, this is not an option anywhere in the Republic.
Friday, 14 December, 2007, 11:24 amsabrina says:
Legally, it shouldn’t matter how selfish the decision is. It is her decision to make. Morally is another issue, but in her particular case she felt she was making the right moral decision, one firmly aligned with her religious beliefs.
Would I opt to die and leave an infant motherless? No. Do I want that to be my decision to make, regardless? Yes.
Friday, 14 December, 2007, 11:29 amLouis Cipher says:
I understand what you are saying about home births, (all excellent points) but in your reply you said women should be able to give birth
“without having to fear that they are signing up for unnecessary interventions”
Surely, doctors and midwifes would have a better idea of the medical risks involved during delivery than most women just in off the street and they would not view any of the procedures or drugs administered during a hospital delivery as being unnessary? This is not a slight toward woman, more of a comment on the health system set-up.
Also, the comment made earlier on about male doctors being in a rush to get deliveries completed as quickly as possible was a stark generalization. My own daughter was delivered by an all female team including the consultant who was called in at the last minute when things nearly went horribly wrong. Neither I nor my partner questioned anything they did during the delivery as , outside of a basic working knowledge of the human body - male and female models, neither one of us had the experience nor the nerve to question what being done to save our daughters life.
Friday, 14 December, 2007, 11:38 amLouis Cipher says:
What about the medical staffs beliefs? Their overriding guideline when it comes to treatment any person (male, female, black, white, rich poor) is “Do No Harm!”
How is it possible to reach agreement between the morality of a doctor or nurses job and the religious beliefs of an individual who feels that her beliefs supercede all others, in cluding those of her unborn child? The short answer is, it is not possible so the case should be judged on its own merits.
Leaving religion aside (which personally I don’t view as a problem) it comes down to a decision made by a group of professionals who took an oath to do everything in their power to save someones life regardless of their protestations. Also, if memory serves, the hospital in question went to the high court to get an injunction to stop this woman refusing a transfusion. This of course adds another dimesnion to the saga, that of the law of the land!
Friday, 14 December, 2007, 11:55 amTwenty Major says:
And not to put too fine a point on it, but I very much doubt many people would be making the “won’t someone think of the children?” argument if it were that child’s father in the hospital bed. Capiche?
Would that not be due to the fact that most people accept that a maternal influence is better for a small child rather than any kind of implied sexism?
I don’t think the hospital thought ‘This is just a woman. We’ll give her a transplant’. I suspect it’s very difficult for doctors and nurses to stand by and watch somebody die when they know they can make them better.
Friday, 14 December, 2007, 11:55 amSabrina says:
Louis, if this is a topic that really interests you, you could do some Google research on “maternal birth trauma” and “cascade of intervention” for a start.
I’m not questioning what happened during your daughter’s birth, but a lot of “emergency” cesareans, for example, are avoidable. Cesarean sections increased by 72% in a 10 year period in Ireland where the neo-natal mortality rate remained steady.
There is not some mysterious uterine defect suddenly affecting 72% of birthing women in Ireland. There is, however, a dramatic rush towards intervention at routine births in a hospital setting. So sadly, no, I do not trust that Doctor Knows Best in this country, not by a longshot.
Ironically, considering the issue of the original post here, if women were better educated about childbirth and therefore empowered to actually decline things like monitoring, the cascade could be avoided for a lot of these women.
On the other hand, if we had a medical culture of respect for the autonomy of the patient, instead of a cookie cutter baby birthing conveyor belt, that would help, too. Simply asking “Would you like to be monitored?” instead of saying “Stay still so we can hook you up to the monitor” would be a good start.
Of course, as you point out, most women don’t seem to know they can decline the monitor. The fact that people *make other people* with less research than they put into buying a new car I do find somewhat amazing. Nobody turns up at a car dealership saying “well, I won’t bother with that issue of Which?, I’m sure they know what they’re doing.”
Friday, 14 December, 2007, 11:59 amSabrina says:
20, living in a free society is better for the grown child, so it’s even odds on that one IMHO.
I have worked in an A&E. It is very difficult to watch people die, especially if someone can intervene to save a life. I am not unsympathetic to the difficulty the woman’s healthcare practitioners were put in. But (and yes I realise this is ironic) they have a duty of care to the patient to not force them to undergo treatments they do not want. Prioritising their own needs, or their own morals, over those of a patient within her legal rights is an abuse of power.
Friday, 14 December, 2007, 12:04 pmTwenty Major says:
Prioritising their own needs, or their own morals, over those of a patient within her legal rights is an abuse of power.
Can’t argue with that at all, the law is the law and all that. Morally I think she’s absolutely bankrupt though.
Don’t understand the first part of your comment though.
Friday, 14 December, 2007, 12:08 pmnouns says:
I’m with Sabrina on this one. It’s not an issue of the nature of the decision (and I fully agree Louis, to leave a child motherless anywhere is a very selfish decision), it’s about her having the choice. This is obviously ignoring a lot of other potentially influencing factors, but the post is about the medical professionals involved not permitting her the choice.
Friday, 14 December, 2007, 12:15 pmSabrina says:
Oh, sorry, you said a maternal influence is better for a small child and I was short handedly saying that while that may be true, living in a free society - ie one where adults have autonomy over their own person - is arguably more important to that child in the long run.
It’s a debating point with no definitive answer, though, hence my saying it’s even odds.
Friday, 14 December, 2007, 12:18 pmLouis Cipher says:
I’m going to have to pull you up there, during the nine months of my partners pregnancy, I attended all of the relevant classes, all of the required scans, read all of the literature on pregnancy etc.
Yet when the day arrived and things started to go wrong this knowledge counted for absolutely nothing. In the heat of the moment decisions had to be made which would affect the outcome of the delivery and off all the people in the room both myself and my partner were the least qualified to make those decison, despite the research we had done. Pressing all the keys on a piano once does not make you a pianist just as “reading” about birth trauma etc does not gurantee that you will be in a position to make the “right” decsion at the time.
I’m not overly confident in the medical system in this country but last year over 8000 babies were delivered in the Coombe so the system must be working to some degree. Could it be better? Of course. Do doctors make mistakes? yes they do! Should they be held accountable? Absolutely. But IMHO, ultimately it is doctors and nurses who have both the academic and practical knowledge which gives them the edge over lay folk during any medical procedure.
Friday, 14 December, 2007, 12:22 pmSabrina says:
Louis I’m sure everyone made all the right decisions and nothing you could have done would have changed the circumstances of your daughter’s birth. At the end you got a healthy baby and (I presume) a healthy mother and that’s fabulous.
But your individual case study aside, the broader fact remains: 72% increase in c-sections in 10 years. That points to something being very off in maternity wards, is what I’m saying. If we’re talking of “do no harm” as you mentioned earlier, I’d just point out that c-sections have a complications rate four times higher than vaginal births. If a significant percentage of the cesareans taking place in Ireland are indeed medically unnecessary, that is putting women at serious risk.
Friday, 14 December, 2007, 12:39 pmTwenty Major says:
It’s a debating point with no definitive answer, though, hence my saying it’s even odds.
I’ll give to you 2-1 on that being true.
Friday, 14 December, 2007, 12:46 pmLouis Cipher says:
Of the 72% increase in C-sections, how many of these were requested by the mothers? I accept that the figure is very high and may point to something untoward taking place but I also feel that this is a legitimate question as it ties in with the general theme of this thread. Some woman prefer c-section deliveries over vaginal deliveries for various reasons. T
Friday, 14 December, 2007, 2:13 pmSabrina says:
That question is difficult to answer because of the definition of “elective cesarean” which is what you’re asking about. The term covers any woman who has a cesarean without going into labour, for any reason - from high maternal blood pressure (where a cesarean may be medically indicated) to simple maternal preference (where there is no medical indication).
However, in the US, which has similar rates of c-section which are similarly rising, about 28% of cesarean sections were elective in 2005, and 72% were emergency cesareans. So some percentage of your 28% will be maternal request, yes.
Friday, 14 December, 2007, 5:40 pm