Written Answers. - Women's Health Issues.
Jan O'Sullivan
Question:
65
Ms O'Sullivan
asked the
Minister for Health and Children
the reasons the Women's Health Council was not consulted prior to the publication of the Twenty Fifth Amendment of the Constitution (Protection of Human Life in Pregnancy) Bill, 2001 regarding the council's statutory role to advise him on all aspects of women's health; his views on the concerns expressed by the Women's Health Council in its public statement of 1 February 2002; and if he will make a statement on the matter.
[5761/02]
Eamon Gilmore
Question:
104
Mr. Gilmore
asked the
Minister for Health and Children
his views on the concerns expressed by the National Women's Council in its public statement regarding the implications for women's health of the Twenty Fifth Amendment of the Constitution (Protection of Human Life in Pregnancy) Bill, 2001; and if he will make a statement on the matter.
[5763/02]
I propose to take Questions Nos. 65 and 104 together.
The proposals to be put to the people in the forthcoming referendum represent the culmination of a detailed process of consideration and consultation over a four year period. In the first instance the Government decided in 1997 that a Green Paper on Abortion would be prepared. This document was published in September 1999 and was welcomed by many interests as a clear and balanced document, setting out as it did the history of the issues and the different arguments advanced, and discussing the principal constitutional and legislative options.
The Government referred the Green Paper to the All-Party Oireachtas Committee on the Constitution, chaired by Deputy Brian Lenihan. The all-party committee embarked on a detailed process of consultation, first seeking submissions on the options discussed in the Green Paper. The committee then held hearings at which the issues were explored in detail with many of those who had made submissions, including representatives of the medical profession and of the churches attending. The Women's Health Council made a submission to the all-party committee and representatives also participated in the hearings subsequently held by the Committee. The committee's detailed report was published in November 2000 and was then examined by the Cabinet com mittee established by the Government to consider the issues.
It was the task of Government to consider and decide on the appropriate response to the detailed process of consultation and discussion which had preceded the publication of the all-party committee's report. To have engaged in a further round of consultation would not have elucidated matters any further. There was a period of more than two months between the publication of the referendum proposals and the completion of the legislation's passage through the Oireachtas. It would have been open to the council to convey its views on the matter to me during that period but it did not do so.
The council raised a number of specific issues in its recent public statement. It suggested that the proposed legislation on the protection of human life in pregnancy is inconsistent with the WHO definition of health. The WHO definition concerned is couched in non-legal terminology. The proposed legislation deals with the criminal law and as such must be precise as to the meaning of the terms used and their effect.
The Government has carefully considered the question of whether it is appropriate or feasible to permit legal abortion in the State where there is a threat of suicide. Having considered the evidence available in this regard, and also the testimony and conclusions in the report of the All-Party Committee on the Constitution, the Government is of the view that these do not support the maintenance of suicide risk as a ground for abortion in Ireland and would not justify the enactment of a legal basis for abortion to avoid such a risk.
The all-party committee heard a considerable amount of evidence about this issue, and the Government has carefully weighed up the arguments made. Testimony heard by the committee indicates that the appropriate response to a pregnant woman considered to be at risk of committing suicide should be to help and support her and to treat her underlying mental condition – not to offer her an abortion. The committee also heard expert evidence that there is no test or fail-safe way of saying that a person will or will not commit suicide, and that where suicide occurs it is due to the interaction of multiple factors, rather than just one. The Government has concluded, having considered all of the evidence on this complex matter, that providing an abortion cannot be considered the appropriate response where a pregnant woman threatens suicide.
The council also raised the question of legalising abortion in cases of rape, incest or where the foetus is non-viable. The question of the appropriate response where pregnancy follows a sexual assault is one which was also discussed at considerable length by the all-party committee. The Government acknowledges that this is a particularly sensitive and difficult issue and it has reflected carefully on the arguments. Having carefully considered the issues, the Government is of the view that it would not be appropriate to provide for legalised abortion where a woman has been the victim of sexual assault.
The Government also recognises the very sensitive and difficult nature of a pregnancy involving a serious foetal abnormality. The All-Party Committee on the Constitution heard testimony from a number of experts, including the masters of the maternity hospitals, in this regard. The issue was also discussed in the Green Paper on Abortion. It is clear that there would be great difficulty in deciding where the line should be drawn if such a regime were proposed. It is not possible neatly to define conditions incompatible with life and there is a wide spectrum of congenital malformations which cause greatly differing degrees of incapacitation or disability.
Depending on the condition and the circumstances of a particular case, the period of survival after birth can vary from nil to some hours, several days, weeks or even months. The Government has decided that it would not be feasible to provide in law for a regime where abortion would be permitted in cases of severe foetal abnormality, and to confine such an arrangement only to cases where the child would not survive after birth.
In relation to the morning-after pill, the legal advice which the Government has received is that its proposals, if passed, will resolve doubts which may exist in relation to the legality of such emergency contraception measures. The envisaged legislation deals with the offence of abortion within this jurisdiction and does not seek to curtail women's rights to avail of services that are legally available in other countries. Section 4(2) of the proposed legislation states that the Act will not operate to restrict any person from travelling to another state on the grounds that his or her intended conduct there would, if it occurred in the State, constitute an offence under section 2 of the Act. This will remove any doubt which may have existed about the right to travel for an abortion, even though it would be illegal to have such an abortion in Ireland. The Government's proposals do not prohibit a health board assisting a young woman in their care from having an abortion, should a rare case such as the C case arise in the future.
The Act's provisions in relation to approved places are to ensure that women who, during pregnancy, are suffering from a life-threatening medical condition, can receive the most appropriate care, and in the most appropriate facilities.
The expert medical advice received in the course of preparing this legislation is to the effect that procedures of the type envisaged are not carried out at very short notice. The type of medical condition, such as cancer of the womb, pre-eclampsia or Eisenmenger's syndrome, would have been diagnosed and monitored and managed for a period, before the stage was reached where the question of having to intervene so as to save the woman's life arose.
Therefore, there would be time for the woman to be treated in the most appropriate facilities, where the highest level of medical care, expertise and other supports are available. The Government considers that it would be undesirable to increase the scope for a medical practitioner to intervene in a place where perhaps the necessary supports and other expert advice would not be available.
Normal medical practice where certain conditions, such as haemorrhaging, arise during pregnancy, will not be affected by the Act. In such a situation a doctor would act to stabilise the woman's condition, rather than to end the pregnancy and the legal advice to the Government is that the Act will not affect the provision of such medical care.
The Government does not accept the suggestion that, in enabling the people to have the final say on the proposed legislation, and on any subsequent amendment of it, this could have negative health consequences for some women.
