As Andrea Prudente’s case against the state proceeds, a mixed outcome seems to be a real possibility. Not outright victory for either side but a legal victory for the state and a moral one for the pro-choice lobby which denies the legitimacy of the anti-abortion law.
The moral victory is more important. The argument over abortion law is ultimately political. It is won or lost over who commands the high ground. The protection of the unborn child’s right to life currently commands the moral support of the majority. If the Prudente case ends up weakening that support, a change in law is only a matter of time.
Prudente came to Malta from the US in the summer to celebrate her 16-week pregnancy. In Malta, trouble arose; medical checks at Mater Dei Hospital showed she had lost her amniotic fluid. She was kept under constant observation and her life was never in danger.
Nonetheless, Prudente and her partner, Jay Weeldreyer, claim she was treated with no concern for her fundamental rights. Prudente is suing the state, not the hospital, because she says that it’s the law that forced the hospital to act the way it did.
The reported testimony, so far, suggests a more complicated picture. Maybe it was not the law but the medical protocols. Perhaps it wasn’t even the protocols but a failure to follow them.
Prudente has chosen not to testify in her case. She has been certified as suffering from severe post-traumatic stress disorder, testimony in itself.
However, Prudente gave the BBC an interview last summer. She described her experience as “terrifying”. She says a midwife told her that doctors would intervene to save her life when she was “on the brink of death” (in those very words). All this, while she was told that her baby had no chance of survival.
No one should have to undergo such an experience. The question is whether it’s what any woman would go through, given the law, or whether it happened because of the circumstances.
What Prudente says contrasts with what doctors say is the policy. John Mamo, president of the College of Obstetricians and Gynaecologists, told the BBC that doctors intervene as soon as there’s the slightest risk. There are some five such cases a year and there’s no question of waiting for imminent risk, let alone the brink of death. As for the chances of survival, studies vary; Mamo cited studies giving 10 to 40 per cent.
What Prudente heard, in her acute stress, isn’t necessarily what she was told. But Weeldreyer’s court testimony helps us understand why she heard what she did.
At a private hospital, before going to Mater Dei, they were told the baby had no chance of survival and she needed to go to Mater Dei immediately as she was in danger. US doctors, whom the couple got in touch with, also gave zero chances.
At Mater Dei, Weeldreyer says they were given no straight answers. The danger of infection was highlighted, presumably to underline why Prudente should not leave hospital.
Against this background, we can understand why Weeldreyer can credibly describe the entire experience as torture and how it sent Prudente into panic for her life.
We can also square this version with the doctors’. The danger to her life was underlined to get her to go, and stay, in a hospital; but, as long as she was under medical supervision, there was no actual danger.
Perhaps, there’s a midwife loose who needs to be taught what the English term ‘brink of death’ means- Ranier Fsadni
As for the stated chances of survival, there was no consensus because studies vary and which numbers you discount depends, in part, on what kind of liability you want to avoid.
A private hospital wants to make sure that if the baby is lost, the reason is pinned on the mother’s condition, not on its standard of care. A public hospital is obliged by law to make sure that it does all it can if there’s any chance of survival (and those chances are rarely zero).
What we’re left with are busy medics answering anguished questions with curt answers, perhaps overlooking that appropriate medical care includes giving extra attention to a woman whose mental state is challenged by the circumstances. (And, perhaps, there’s a midwife loose who needs to be taught what the English term ‘brink of death’ means.)
We can agree that no woman should have to go through this, let alone risk severe post-traumatic stress disorder, but still find it difficult to see court-grade proof that the determining cause was the law.
That’s why the legal case might end up being won by the state.
But the process that leads to winning the legal battle may well end up destroying the moral authority of the anti-abortion law. The law’s legitimacy is based on care for the dignity of all people and that means a wager that protecting the life of the unborn does not come at the expense of the dignity of women.
Here’s how the court case might undermine the credibility of that principle. First, the legal system itself is adversarial. It obliges the state to treat Prudente as someone whose testimony needs to be undermined.
Next, there is the particular legal strategy that’s being followed. The lawyer for the state pressed Weeldreyer on when Prudente’s “spotting” began. As it happens, this was before the trip and the answer may be of relevance for the purposes of legal fault.
But, from the perspective of respecting dignity, it is bitchy. Most of us end up in hospital because of our poor lifestyle choices; that doesn’t mean we don’t deserve to have our fundamental rights respected.
The moment that the defence of the anti-abortion law depends on an inquisition that seeks to blame a woman for the loss of her child is also the moment when the anti-abortion law will seem more about repression and less about care.
Then, the court might find for the state but the proceedings will, for many people, also confirm the picture of a legalistic, bureaucratic healthcare more concerned with form than with care and dignity.