Medical care during pregnancy

Sir, – Many generations of medical doctors have attempted to follow the basic principles as outlined in the Hippocratic Oath. In 1948 the Declaration of Geneva, which was adopted by the general assembly of the World Medical Association, was intended as a revision of the Hippocratic oath to a formulation of that oath’s moral truths that could be comprehended and acknowledged in the modern world, especially following the atrocities of the second World War.

The Declaration of Geneva has since been modified several times to keep up with modern views. Two of the 11 pledges made in the present version state “the health of my patient will be my first consideration”, and “I will not permit considerations of age, disease or disability, creed or religion, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient”.

For more than 30 years I was a consultant general surgeon to one of Dublin’s maternity hospitals, working with six different masters and their colleagues. Most of our joint patients were pregnant. Many were in the first half of their pregnancy. There were many difficult decisions to be made, in women with bowel obstructions, tumours, ruptured spleens, malignant tumours, appendicitis and so forth. Often two lives had to be considered. Decisions were made at consultant level.

However, if the obstetrician said that the foetus or baby was dead, or judged for some reason to be incapable of surviving, then our decision-making became a lot easier. Then our sole consideration was the well-being of only one patient, the mother, and she would get what was judged to be the best and most expeditious treatment for her condition.

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I sincerely hope that all our politicians, as well as all our doctors, are familiar with the Declaration of Geneva. When legislators meddle in things that they don’t understand, sometimes all hell can be let loose. They need to be well advised. – Yours, etc,

BILL BEESLEY,

Sandycove Avenue East,

Sandycove,

Co Dublin.