ITALY – Seven doctors on trial for manslaughter in the death in Sicily of Valentina Milluzzo in 2016

SevenItalian doctors are on trial for manslaughter, accused of failing to carry outa life-saving abortion as emergency obstetric care in 2016 for ValentinaMilluzzo, who beganmiscarrying when she was 19 weeks pregnant with twins. She died ofsepsis, which with prompt and appropriate care, including emergency evacuationof the uterus, can be prevented/treated before it becomes fatal. This cause ofdeath happened to Savita Halapannavar in Ireland four years earlier.

Thecourt has sat twice so far, on 17 and 29 October 2019. The Financial Timesreported on 29 October 2019 that the doctors said they could not do an abortionbecause there was still a fetal heartbeat. If this is true, then they werefollowing Catholic health policy. The Financial Times report says the hospitaland staff deny any wrongdoing.

TheFinancial Times focuses most of its report on the extent of conscientiousobjection in Italy, which is widespread. However, waiting for the fetal heartbeatto stop is a different excuse for inaction from refusing to do an abortion on thegrounds of conscientious objection, even though both may be the case. In anemergency situation, conscientious objection is illegal in Italy, according toseveral Italian abortion rights advocates who have commented on the case. Will thetrial answer the question of whether the refusal to do an abortion on thegrounds of a fetal heartbeat, even though the fetus is not viable, is alsoillegal, at least in an emergency? Or what else is going on?

Members of Valentina’s family gave evidence on 29 October2019. Her parents reportedly said they had been told the pregnancy was notviable, but the doctors refused to terminate it. A more detailed report of thetrial in La Sicilia on 4 November 2019 states that her parents knew at the timethat she had septicaemia, which had killed one of the two foetuses before sheherself died. They also said all the doctors claimed conscientious objection toabortion. La Sicilia even argues that the fact of the conscientious objectionis not disputed.

What is disputed is whether the doctors knew she hadsepticaemia and whether they were able to treat it in time. A swab test wasreportedly done two days before Valentina died, which showed infection.However, the evidence from the swab disappeared from the hospital. Valentina’sfather reported that the evidence from the missing swab was sent anonymously toValentina’s parents’ lawyer. In the meantime, a new examination was apparently done,according to one report, at 14.00 on October 15, the day before she died. The resultsindicated there was no sepsis.Her father called this a lie.

Hermother told the court: “I remember the words of the doctor on duty: “Until I [donot] hear the little hearts beat I cannot intervene because I am anobjector” ….”

Thehead of the ob/gyn department and president of the Italian Society of Gynecologyand Obstetrics, PaoloScollo, whowas absent when Valentina died, denied that the doctors in the delivery room refused toterminate the pregnancy. He was reported to say: “The fact that we areobjectors means nothing; the department has an external colleague whom we callfor pregnancy terminations. And there is no waiting list, zero days. All documented.Unfortunately Valentina died of sepsis that consumed her in 12 hours and wewere unable to prevent her death.”

LaSicilia reports, on the other hand, that the prosecutor has argued that there was”professional negligence” on the part of the doctors, including“imprudence, negligence and inexperience” and in particular, “thefailure to implement adequate antibiotic therapy” both on 14 and 15October, the “failed recognition of sepsis in progress”, the”failure to collect samples for microbiological tests”, the”failure to promptly remove the source of infection: the fetuses andplacenta” and “lack of administration of red blood cells during surgery”.

After Valentina’s death, inspectorswere sent by the Ministry of Health to the Cannizzaro Hospital in Catania. Theyreportedly concluded that the sepsis “started spontaneously” and was”unstoppable, treated in an emergency regime” and “is in no waycorrelated to conscientious objection”.They said:

“ProfessorFrancesco Enrichens, who signed the conclusions, also reconstructed thesequence of events that preceded Valentina’s death: “The relatives werekept constantly informed by the entire team of obstetricians and anaesthesiologists.At11.30 pm (on January 15th,ed) there was thespontaneous expulsion of the first dead fetus … at 24 the infusion ofoxytocin began in coherence with the clinical necessity to induce the expulsionof the second fetus occurred at 1.40 “.This last step is crucialbecause it would seem to deny a “wait-and-see” attitude of theobjector doctor, as he had been accused by the victim’s family. The calvary ofthe parturient, on which a feverish state had already been found, however, doesnot end on the morning of January 15th: as a result of the infection, on whosecauses the inspectors did not pronounce, the woman died at 1.45 pm on 16January.”

Thefinal report of the inspectors will be filed in a month.

Yet everyone, both media and advocates, keeps returning toconscientious objection. La Sicilia reports that in Sicily, conscientious objectors are 87.6%,according to data provided by the Ministry of Health, updated last April.

Thetrial and the verdict will set a precedent with a great many repercussions, notonly for Italy but for other countries as well, regarding professional competencein the face of a rare obstetric event, where health professionals followCatholic health policy on abortion, and where both these issues andconscientious objection are still killing pregnant women.

SOURCES: Corrieredella Sera, 27 October 2019 (in italiano) ; FinancialTimes, by Hannah Roberts, Marianna Giusti, 29 October 2019 ; Corrieredella Sera, by Felice Cavallaro, 3 November 2019 (in italiano) ; LaSicilia, 4 November 2019 (in italiano) ; PHOTO: Valentina’s father,speaking on TGCOM24(see La Sicilia article)