Tuesday, October 12, 2004

Flashback: Ottawa Abortion Kills Teen

Ottawa Citizen Thursday, April 17, 1986
Jury urges changes in abortion review procedures
by Robert Sibley

The Civic Hospital will study its abortion review procedures after a coroner’s jury Wednesday criticized the hospital for not effectively reviewing a teenagers abortion request before the operation that resulted in her death.
The hospital’s abortion committee needs more expertise to judge abortion applications and should do a better job of decision-making, the four-member jury said at the conclusion of a three-day inquest into the death of 18-year-old Erin Shannon.
Peter Carruthers, executive director of the Civic Hospital, promised to consider the recommendations over the next few weeks.
“We will take a very positive view of the recommendations and we will respond to the best of our ability.”
He said the inquest results may have wide implications for abortion committees in hospitals across Canada.
Erin died Jan. 23 as a result of a rare complication that caused her heart to fail during a therapeutic abortion.
With the cause of death not in doubt, the hearings focused on the abortion committee’s role in approving the abortion.
The committee was criticized for ignoring the intent of Canada’s abortion laws in not doing a proper review of Erin’s abortion application.
“Perhaps the letter of the law is being followed (by the committee), but certainly not the spirit of the law,” Crown Attorney Andrejs Berzins said Wednesday.
Ontario’s chief coroner, Dr. Ross Bennett, said the committee treated Erin’s abortion request as a “rubber stamping procedure.”
The jurors recognized those concerns in their recommendations.
They said there’s a need to ensure abortion committees are effective and efficient, and approvals only granted after “careful deliberation of all relevant information.”
The Criminal Code isn’t specific about the duties of abortion committees, saying their purpose is for “considering and determining questions relating” to abortions in hospitals.
The jurors urged changes to the Criminal Code so abortion committees could be reorganized to include qualified gynecologist, obstetricians or internists as members.
The committee, they said, should also get reports from the family doctor, the gynecologist and have an ultra-sound report.
The Civic’s committee is currently made up of two general practitioners and three radiologists.
The law only requires an abortion committee to have at least three members who are qualified medical practitioners. They need little information beyond a doctor’s abortion request and what may be a one-sentence letter saying why the abortion is needed.
The jury also recommended the minutes of abortion committee meetings be fully recorded.
Throughout the inquest there was conflicting evidence about how the Erin Shannon abortion was approved. No one could say exactly when the approval was given.
There was even some questions whether the abortion went ahead without the legally-required approval of the committee.
“I’m not satisfied this was a legal abortion,” Gary Chayko, the Shannon family’s lawyer, told the jury. At best, he said, the abortion was “questionably legal.”
Bennett wouldn’t go that far, but said the way the committee operated is “bound to lead to abuses.”
He later said he was confident the jury’s recommendations would be implemented and the confusion about the role of abortion committees resolved in many hospitals across the country, given attention on the Shannon case.
The Shannon case was the first fatal abortion in Canada since 1979.
Erin’s abortion was one of 2,000 done each year at the Civic Hospital. Last year, the committee approved every abortion request.
During the inquest questions were raised about whether the committee approved Erin’s abortion on the day before the operation, Wednesday, Jan. 22, or only minutes before she went into the operating room on Thursday, Jan. 23.
Abortion committee chairman Dr. Jane Chambers testified Monday the abortion was probably approved at the committee’s regular meeting on Thursday, Jan. 23, sometime around 10 a.m.
But nurse Donna McMurtry said later Erin’s abortion was on a list of “approved” operations for that day as of 8 a.m.
Chambers returned to give more testimony on Wednesday. She recalled there was a special meeting on Jan. 22 at which Erin’s abortion was probably approved. She couldn’t give a precise time for the meeting, nor say where it was took place, despite claiming an “excellent memory.”
“I assume it (the meeting) was prior to Thursday,” she said, insisting the abortion wouldn’t have been done without the committee’s approval.
Berzins criticized hospital staff for “less than complete candor” in their testimony and for having selective memories about circumstances leading up to Erin’s abortion.
The lingering doubts about the abortion committee’s actions in the Shannon case have left open the possibility of a lawsuit against Civic Hospital and the doctors involved.
Ron Peterson, a lawyer for the Shannon family, said the possibility of a lawsuit will be considered over the next few days following a review of the inquest evidence.
He said the family hopes the jury’s recommendations are carried out, particularly one calling for more research into the medical complication that caused their daughter’s death.
Erin died of what is known as a amniotic fluid embolism, an extremely rare complication in which fluid in the uterus enters the blood stream, creating an embolism that causes the lungs to stop pumping oxygen to the heart. The result is massive and sudden heart failure.
Erin was about 18 weeks pregnant. She didn’t know she was pregnancy until Jan 13, or nearly 17 weeks into the pregnancy.
The jurors recommended that women seeking abortions be given more information about the operation and its potential risks. They urges existing social service agencies to emphasize the importance of recognizing pregnancy early.
Reaction to the recommendations varied.
Blowden Piercy, of the Ottawa branch of the Canadian Abortion Rights Action League, said she was concerned the recommendations mean more red tape and delays for those seeking abortions.
Hospitals and abortion committees are already overburdened and it would be unfortunate if the recommendations slowed things further, she said.
Lettie Morse, co-ordinator of Ottawa’s REAL Women (Realistic, Equal, Active for Life), praised the recommendations, particularly those to increase information and counselling.
More information, she said, could help dissuade women from abortion once they know the risks involved.