Guidelines sought over pregnant women declared brain-dead

The South Eastern Health Board is to seek Medical Council guidance over procedure in cases where pregnant women have been declared…

The South Eastern Health Board is to seek Medical Council guidance over procedure in cases where pregnant women have been declared brain-dead.

The SEHB's chief executive officer, Mr John Cooney, told The Irish Times that the board was still considering the implications of a case at Waterford Regional Hospital last May when a pregnant woman was put on life support after suffering a brain haemorrhage. She had been pronounced brain-dead.

Following legal advice, the woman was kept on life support in an attempt to keep her organs functioning long enough to deliver her baby by Caesarean section. She was 14 weeks pregnant, and would have had to be maintained on life support for three to four months. The foetus died after 21/2 weeks, and the machine was switched off.

"We are still debating among ourselves as to what lessons are to be learned from this," Mr Cooney told The Irish Times yesterday. "We're in a better position now to sift through the stuff. There are no clear-cut clinical guidelines. We're trying to develop them.

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"We will be consulting the Medical Council and seeking guidance. This is still evolving and we will pass it on to our colleagues.

"We had access to the Attorney General. We're still trying to distil all this into policy," he said.

One of the issues was the obligations of health boards under the Child Care Act. "Things have got very complicated since the Act came into being. We have an obligation to protect the child. The Act did not spell out if that included a child that was as yet unborn. We're still not certain what the essence of it all was," he said. Doctors were anxious to do everything possible to save the baby.

Asked to comment on the medical opinion which said this was a futile exercise, Mr Cooney said: "You'd need to be Solomon to figure it out."

Following an approach from solicitors for the health board, the Attorney General, Mr Michael McDowell, said that in his opinion the life-support machine could be switched off without recourse to a court decision.

Asked why the hospital did not act on this advice, Mr Cooney said: "There were still uncertainties in the minds of the clinical staff. I do not think anybody else could have done anything else.

"There were legal factors and medical-ethical issues. We were concerned about the possibility of saving the baby, and how far we could go to achieve that. It broadened out into broader legal issues. If you're in the middle of a clinical crisis, you don't immediately look at the legal situation."