Sir, – Eamonn McCann asks about the absence of any reference to so-called "fatal foetal abnormality/anomaly" in the HSE's consultation paper, Bereavement Care Standards Following Pregnancy Loss and Perinatal Death ("Are there signs of a 'pro-life' group influence in HSE document?", Opinion & Analysis, July 23rd).
He takes issue with the term used by the HSE – “life-limiting conditions”.
The term preferred by Eamon McCann is greatly criticised in the medical literature. In 2012, the British Journal of Obstetrics and Gynaecology reported a review of the international medical literature. The review showed no agreed definition of a lethal or fatal foetal abnormality and no agreed list of conditions that might fit such a description. In fact, survival in all of the conditions usually described as "fatal" has been reported. To give just one example, studies have reported 75 per cent live births of babies diagnosed prenatally with anencephaly.
The language of “fatality” is laden with value judgment. It implies a conclusion about which there can be no certainty when a prognosis is required. Experts caring for children with these conditions prefer the term “life-limiting”. – Yours, etc,
CAROLINE SIMONS,
Dublin 4.