Dr. Meabh Ní Bhuinneáin:

Yes. In my experience, outside a tertiary institution, the commonest reason in our current practice for invoking the protection of life in pregnancy is with ruptured membranes before viability. That is where the waters have gone around the baby and the mother is at risk of the subsequent impact of infection. That process of information, education and communication with the woman starts from the time we are giving the diagnosis. It is a process over time. It is not a single act. While the witnesses have advised that there may be uncertainty, the timeline to advancing to more serious signs of infection, what we call sepsis, and then to times where the mortality rate significantly goes up, what we call septic shock, are very variable among women. We are always conscious of that because, as I mentioned, we are measured in retrospect if there is an adverse outcome, but we do not have that ability to see ahead at the time. Communication, information and consent are changing and evolving over time. The paternalistic approach to consent in Irish medicine across many domains is evolving over time as medical ethics develop over time.