Written Answers. - Women's Health Issues.
Jan O'Sullivan
Question:
70
Ms O'Sullivan
asked the
Minister for Health and Children
his views on the concerns expressed by the Adelaide Hospital Society 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.
[5762/02]
On 15 February I wrote to the Adelaide Hospital Society in response to its letter 1 February. I indicated that the Government shares the society's concern about the significant number of Irish women who have abortions abroad each year. It acknowledges that a comprehensive range of compassionate, supportive and non-judgmental services is vital to provide women with the supports they need to deal with a crisis pregnancy.
It is for these reasons that, having considered the recommendations of the All-Party Committee on the Constitution, I have established the Crisis Pregnancy Agency, which will have the task, in consultation with Government and other statutory and non-statutory agencies, of drawing up a national strategy to address crisis pregnancy and overseeing its implementation. Funding of €6.5 million, £5.19 million has been allocated to the agency in 2002.
The prevention of crisis pregnancy in the first instance will be a primary task of the agency. Preventative issues concerning education of young people and adults as well as services appropriate to their needs and lifestyles will be addressed. The agency will work to develop strategies to make women more aware of their options, should they have a crisis pregnancy, and to improve the supports and assistance available to women in this situation so that they will feel that they have genuine alternatives to abortion.
Women who have had an abortion, either recently or some time ago, have particular needs also and this is another area the agency is being asked to address so that women are treated with compassion and understanding and that their emotional and physical health needs are attended to.
The establishment of the Crisis Pregnancy Agency is intended to play a major role in the development of co-ordinated, responsive and appropriate services. The Government hopes that, over time, it will be possible to reduce the incidence of unwanted pregnancies among Irish women and ensure that women who find them selves in this situation will have available to them the widest possible range of assistance to help them to deal with their situation.
Abortion is already a crime under the Offences Against the Person Act, 1861, with a penalty up to life imprisonment for a breach of the Act. The maximum penalty under the Act envisaged in the referendum proposals therefore represents a reduction on that currently in force. 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 which 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 it care from having an abortion, should a rare case such as the C case arise in the future.
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, it 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 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 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 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 handicap.
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.
The Act lays down conditions to be met so 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 envisaged Protection of Human Life in Pregnancy Act will be capable of amendment in the same way as any other piece of legislation. However because of the provisions of the proposed Article 40.3.5 of the Constitution, any amendment would have to be approved by the people in a referendum before it could be prom ulgated as a law. The Government is of the view that on such an important issue as the protection of unborn human life the people have the right to be consulted on any change in the law which may be proposed in the future.
The legal advice which the Government has received is that its proposals, if passed, will resolve any doubts which may exist in relation to the legality of emergency contraception such as the morning after pill.
The Government's proposals are not intended to address issues in the area of assisted human reproduction. In February 2000, I established a commission on assisted human reproduction with the following terms of reference, "to prepare a report on the possible approaches to the regulation of all aspects of assisted human reproduction and the social, ethical and legal factors to be taken into account in determining public policy in this area."
