Termination in Cases of Foetal Abnormality: One Day More (Resumed)

I welcome our witness back to the committee.

I thank Ms McDermott very much for coming here today. I know how hard it is for her to tell her own story. I completely understand that it is only now - after 2002 - she is able to come here to do so. I am sure that at times it is very difficult. How is John now? I believe that no one has asked this of Ms McDermott today. In the last session Ms McDermott gave us the poem from the sixth class about John, but I am assuming he is with us still.

Ms Liz McDermott

He has moved on and he is 14 years old now.

He is 14. Is Ms McDermott caring for him at home?

Ms Liz McDermott

Yes. In fact I left him on his own doing his homework when I came in here.

I just thought it might be important that we acknowledge that John exists.

Ms Liz McDermott

I thank the Deputy. He does.

I would also like to point to the issues that Ms McDermott dealt with at the time of his birth and some of the lessons that can be learned from that. There are aspects that have been brought up at the Oireachtas Joint Committee on Health in respect of the national maternity strategy and the ten-year Sláintecare report about the provision of maternity services in Ireland. The witness may not be aware that new HSE national standards for bereavement care to ensure clinical counselling services are being rolled out to support all women, even in the cases of a miscarriage, an intended termination of a pregnancy or a late-term miscarriage. This is in the pipeline and there is recognition, on behalf of the Minister for Health, that this is an area we have not looked at before. I just wanted the witness to know this as a positive out of all this.

Ms Liz McDermott

I am glad to hear that.

I also take on board some of Ms McDermott's points about anomaly scanning and getting that letter to book. I remember getting my own letter for the anomaly scan and genuinely not really knowing what that meant. When I had a not-great experience at that scan, I learned very quickly what it meant. My experience is at odds with Ms McDermott's experience. When I had a diagnosis for my first child of complex physical birth defects - not of a fatal foetal abnormality - which was my second pregnancy, no one pressurised me into anything. Like Ms McDermott telling her story, I distinctly remember such details of that day; I remember what I was wearing, I remember what the doctor was wearing, I remember the weather, I remember the heat, I remember the face of builder I met when I was going out.

Ms Liz McDermott

It is because it is such a significant day.

Yes. It was a significant day and I will never forget it. I remember asking the consultant a very straight and direct question. I am prone to asking direct questions.

When I asked if this was grounds for a termination - I had not discussed this with my husband who was sitting beside me - she said "No" but when I asked if I could have an amniocentesis so I might know what I was dealing with her answer was that that was no problem. My experience was completely different. At no point of my journey did anyone suggest to me that I would be better off starting again and so on. That never was the case. I did not have a fatal foetal diagnosis, rather I had a complex physical defect, possibly combined with genetic defects, that would have lead to a fatal foetal diagnosis. I am not trying to diminish Ms McDermott's situation. My situation turned out to be very positive in that my child had no genetic defect and is now alive and seven years old. Throughout that process, I was assisted by doctors in one of our leading maternity hospitals in keeping my son alive in the best in utero conditions possible. For example, I ensured I had the best possible healthy lifestyle and that I took adequate rest because as we all know the longer the child remains in utero the better the outcome.

Ms McDermott mentioned Dr. Oslizlok, the paediatric heart surgeon in Our Lady's Children's Hospital. In my experience as a pharmacist - as my pharmacy is open late and located near a maternity hospital I tend to have more experience in this area than other pharmacies - the diagnosis of cardiac conditions pre-natal are used to the benefit of the survival of the child. I am not a cardiologist. In the case of a diagnosis at 22 weeks of a chamber not forming correctly that information is used by cardiologists to monitor the pregnancy, by scanning every couple of weeks, to see if the situation improves. Often such problems rectify themselves. Also, it is possible to treat in utero. It is often argued that scanning and diagnosis leads to children with abnormalities being discarded. I would argue that scanning and diagnosis helps children survive because it allows all involved, including parents, to know what they are dealing with.

Ms McDermott mentioned to Deputy Chambers that they are 25 people in her group. Is that correct?

Ms Liz McDermott

Yes.

Ms McDermott also said that she has no evidence that anybody has referred these people for counselling. To my mind, that is in breach of the law of this land. If there is repeated pressure being put on people, I have a problem with that. We heard at length from psychiatrists of how women can be vulnerable owing to hormonal changes that occur in pregnancy. What Ms McDermott stated is to my mind to take advantage of people. Perhaps when she next meets the group she would suggest to them that they retrospectively complain. As a Member of Dáil Éireann I am uncomfortable that people in vulnerable situations are being directed in a particular way by our hospitals.

Deputy O'Connell has been speaking now for almost six minutes and she has not yet put a question to the witness.

I believe in choice. I understand where Ms McDermott is coming from in that she made her choice and continued with her pregnancy and now has her son, John, who brings her great joy. I continued on my journey. Does Ms McDermott believe we should be compassionate to the people who might not be in as fortunate a situation as she and I were? Where a woman of 52 years of age finds herself pregnant with her fifth child and her husband has a problem with alcohol and her youngest child is in university, the situation is completely different. Would Ms McDermott agree that there is a spectrum of situations such that what might suit her or me would not suit everybody?

Ms Liz McDermott

There is a spectrum of situations. We cannot legislate for all situations. In legislating for abortion we are making a statement about life, namely, that life is contingent upon what particular people can deal with. That is a very dangerous line to cross. I have repeatedly made the point that women need support so that they do not feel that abortion is the only thing they can do to get themselves out of this reality. We cannot, unfortunately, make women unpregnant but we can put in place measures that will support and help them. I acknowledge that for a woman who is advanced in years, has put having children behind her and has moved on with her life, the road ahead in terms of pregnancy is not an easy one but it is not impossible either. That has been my experience and I want to share that with everybody. We also have to be mindful-----

I understand. Does Ms McDermott believe there is any ground for abortion in this country? A "Yes" or "No" answer will suffice.

Ms Liz McDermott

No, I do not consider abortion solves-----

The witness has been asked to a give a "Yes" or "No" response.

Ms Liz McDermott

I do not see children as a problem or a thing that needs to be managed or dealt with in that type of life-ending way. There are always more compassionate responses. I take the Deputy's point about needing to be compassionate to women. I am not seeking to target women. It is for society to put in place the supports which take women out of that choice situation. Sometimes, it is not that they do not have a choice. Deputy O'Connell and I were fortunate. We had opportunities that others do not have. We need to rectify that.

Does Ms McDermott believe the enactment of the Protection of Life During Pregnancy Act 2013 was a good idea given she does not agree with abortion, ever?

Ms Liz McDermott

No, I do not think it was a good idea.

The Deputy's time has expired.

I would like to comment on a couple of points made. I am definitely not over Senator Mullen timewise.

People take a long time to get over me, generally.

Reference was made earlier to nervous system development. It is stated in a medical research paper that I read - this information was also provided to the committee by experts in this area - that there is no nervous system development until 24 weeks and, arguably, 30 weeks. I just wanted to clarify that point.

Thank you, Deputy O'Connell. The next speaker is Deputy Naughton.

My question follows on from previous questions. I thank the witness for being here. She has spoken very articulately and it is important that the committee hears her viewpoint.

Ms McDermott made the point that women need support. We are all agreed that we need to do more in this country to improve our pathways to care for women when dealing with a crisis pregnancy, be it fatal foetal abnormalities and so on. In this regard, we need to ensure that they have proper supports, including counselling. Am I correct that in the case of a woman who obtains a diagnosis of fatal foetal abnormality, who receives all the counselling that is appropriate and required in that regard, and having discussed the matter with her partner, opts to not continue the pregnancy, bearing in mind that she planned the pregnancy and wants the baby, Ms McDermott does not believe that she should have that choice?

Ms Liz McDermott

I do not know that that has ever been the case. I do not know that that level of support is given and so it is impossible to judge-----

I am being hypothetical. In that scenario, would Ms McDermott-----

Ms Liz McDermott

I am not going to get into that hypothetical situation. To reiterate a point I made earlier, there are two lives involved. As a country we have to balance, acknowledge and uphold rights and declare what those rights are. The eighth amendment refers to the equal right to life of mother and child.

As for us having that view and acting upon it, I appreciate that many countries do not do that. They have a different perspective on it and make the rights of the child contingent on a range of other circumstances and people's say-so. If we support women and say their babies are important to us as a country and not just to them but that we are in this as a collective - there is a tendency to individualise and thereby isolate people, put them into little cells where one person says one thing and I say something else - how do we legislate or adjudicate the rights and wrongs in that? This is a collective and the common good must always be legislated for. When women are in extremely challenging circumstances, as happens, the supports need to be there. It is how one views abortion as a solution. Is it a solution? It is not really a solution for a baby. I come back to the point of the trauma of it being carried out, particularly if it is a late-term abortion, in the sense that women want these babies. We want our babies, think our babies are healthy and perfect and then find out they are not. They are very sick, will not survive or will be very disabled. We must form a new relationship with that baby. We cannot just say "well, this is a wanted child" because what is that child now? Our understanding of what that child is has changed because we now know that child is different from the one we had in our minds.

This is where counselling may come in.

Ms Liz McDermott

Yes. Counselling can really bring someone to a point of saying this is the reality of who their child is. My child and the children of lots of other people with disabled children have revealed to them aspects of their personality and contributed to their lives in a way we cannot foresee.

I agree with that but my question relates to the case where a woman felt she had gone through everything, discussed it, received all the counselling and supports that were there for her and felt that at the end of the day, she could not continue in the case of a fatal foetal abnormality. Ms McDermott has expressed her point. I do not want to delay it. I think I have got the answer.

Ms Liz McDermott

That mother has to give birth in some shape or form. Is she giving birth to a baby in the natural course of its life or do we intervene and bring that baby's life to an end and then deliver a dead baby?

Again, I thank Ms McDermott for coming in today. We were complaining earlier about people not coming in. That is their right but Ms McDermott has certainly brought the other side to the committee today and I am delighted to learn things about Hugh's House and A Perfect Gift. I was not aware of those organisations and supports. Some people say it is cruel to ask a woman to go through with a pregnancy if she really believes she cannot face it. Is that ever true in Ms McDermott's opinion? Does she think that is cruel?

Ms Liz McDermott

I think it is cruel to put pressure in any shape or form from whatever direction on a woman to abandon her baby. Babies are there and we are carriers of them. It is in our nature as women and we need to come back to that. I felt, as perhaps did others, that when your baby looks different to everybody else's baby or has lots of things wrong with him or her, you feel a bit judged and that you are somehow the parents of a child who is not ideal. That in itself puts pressure on parents. As for women who are on their own or who are older, I have heard older mothers say they felt like they were the grandmother in the antenatal class. There are all sorts of subtle pressures that women must endure during pregnancy. I do not like to talk about it in terms of it being cruel to force, and I do not even like the word "force", women to continue a pregnancy. When you are pregnant, you are pregnant and there is a baby there. As for the idea of forcing that to continue to its natural process, it is not a forcing question. It is about supporting the woman who has found out something new or has particular challenges to deal with. It is not about forcing or locking them up and telling them "you are not allowed to leave this room". It is about being compassionate and humane to both parties - both patients - and encouraging the woman to bond and believe in herself. Sometimes women say that they just need someone to tell them they can do this. Lots of people have abortions because nobody really said they would be there for them if they had the child. Lots of people told them that if they had the abortion, they would be there for them but they did not say that if they had the child, they would be there for them so there is a big burden on women to opt for abortion that is just subliminally in the air we breathe because it is a case of "well, why wouldn't you?". I am trying to change that perspective, attitude and approach to pregnancy and unborn babies. I do not think it is cruel. I do not see it in that paradigm but I think we need to support women.

I did not use the word "force". I said "ask". Perhaps Ms McDermott can speak a bit about the harm that occurs when we continue to describe very sick unborn babies as having fatal foetal or life-limiting conditions or conditions incompatible with life. She knows that after a group travelled to Geneva and lobbied, and I introduced a Private Members' Bill, the HSE changed the language it used around this area. I was surprised that Ms Justice Laffoy allowed the use of the term at the Citizens' Assembly despite the HSE having issued guidelines. Could Ms McDermott elaborate on that?

Ms Liz McDermott

The language around children who have something wrong with them - language such as fatal foetal abnormality - cannot but dehumanise the baby and is disrespectful. It is also disrespectful to the parents of that baby because he or she is their baby. When I read about the 50 years during which the Abortion Act has been in place in the UK, I discovered that somebody wrote that the kind of language used in the House of Lords debates involved described disabled people as mongols, spastics and monstrous. Terms like "fatal foetal abnormality", anomaly or "incompatible with life" seem to be a slightly more subtle way of describing those children. As it is the 21st century version of that dehumanising language, that should not be allowed in any case. We have to call things by what they are and according to their nature. Terms like "baby with a lot of health problems", "baby who is not going to live for very long" or "poor survival" constitute the proper language that respects the mother of that child who is hearing it because it is hurtful. She is already stressed enough dealing with her pregnancy and its challenges. She does not need other people to hear her baby being described in a belittling and dehumanising way.

Would Ms McDermott agree with a previous-----

It is a point of clarification if that is okay, because the time is up.

No, it is another question. We were told by an expert here some weeks ago that she felt the eighth amendment was damaging the mental health of every person in this State - man, woman and child. How is Ms McDermott's son doing now? Is he in secondary school? Ms McDermott might be allowed to read a poem if that is possible. I would like to hear it - later or any at stage.

Ms Liz McDermott

What was the Deputy's first point?

An expert stated here that the eighth amendment was damaging the mental health of every person in this State - man, woman and child.

Ms Liz McDermott

Obviously, I do not agree with that statement and I do not see how one could medically verify it other than by interviewing every person in the State. We hear the other side - that people are alive because of the eighth amendment - so our mental health is not that bad.

I asked about the little boy, who must be a big boy now.

Ms Liz McDermott

Yes, he is 14 now and in second year in school. He is very bright and popular and has a very full life. He is probably the most outgoing of all of my children. He faces his challenges. It is hard for me to talk about him because he is my son, but the poem his teacher gave me when he finished primary school taught me what other people, and not just me, get from him. He would probably cringe now if he knew I was reading this poem out. It will not win any prizes but it says a lot. The teacher writes:

John McDermott, what a guy,

Never afraid, not all that shy,

He inspires all around him from day to day,

Blue Steel surrounds him, come what may.

Modesty and brilliance wears well on his shoulders,

His friends will testify that he's strong as a boulder,

He is friends to all, both young and old,

Never a bad word to say, no matter how bold.

His work speaks for itself from year to year,

No challenge too big, the solution always clear,

His wit and humour delight his peers

Always there for his friends over the years.

John was born to discover and create

To feel inspired, never to imitate.

So please John, allow us to thank your eight years,

It goes without saying your leaving St. Mary's brings us all to tears.

Blue Steel is something from a cartoon, I think. I do not know about the members of the committee but I have never had a poem written for me. That is what John meant to this school and to other people.

On a point of clarification: I think Blue Steel is the intellectual property of Mr. Zoolander. The teacher obviously did not know enough-----

I thank Senator Mullen for that very important clarification. I call on Senator Ned O'Sullivan.

I welcome Ms McDermott. I am very thankful that she came before us and she has certainly given us much to think about. I hope that her presence here and the reception that she has received from all of the committee members will encourage other witnesses who have declined our invitation to perhaps reconsider and come before us so that we get the broadest possible range of views presented to us. I am very glad to hear that John is doing so well. Ms McDermott's story has been both eye-opening and somewhat horrendous to me with regard to the degree of both direct and indirect pressure brought to bear upon her to terminate the pregnancy. The same would seem to apply to the other families' stories she also circulated here today. I am somewhat surprised that the One More Day group does not primarily focus on addressing this particular issue because, as previous speakers here have said, it would seem that some of the medical professionals in question were actually in breach of the law. One More Day has the knowledge and wherewithal to pursue this matter and bring it to the public. It is a sensitive matter for the mothers involved but I believe that such a move would do the State a great service. I would in no way, shape or form condone any attempt to coerce a woman into having an abortion; in fact I would condemn it outright. The only parallel I can think of in our society are the cases where women who wish to terminate in this country, in the case of fatal foetal abnormality for example, are forced to go full term. I wonder if Ms McDermott might consider that there is quite a strong connection between the pressure that she was put under and the pressure that a great many of women in this country have been put under down through the years and right up to the present.

Moving on to more general matters, I am not sure where Ms McDermott made the leap to reach her conclusion on the eighth amendment. I am at something of a disadvantage here because she did not include much detail on this leap in the document that was circulated to us. I tried to see the Blacks of the transcript during the interval but I just did not have time to do so. I thought that I had perhaps missed a page, which in turn meant that I was not able to really concentrate.

Ms McDermott's main message to us today concerns the eighth amendment. I can very clearly understand that she made a very strong choice. I am sure that it was a difficult choice but from what she has said, there was no hesitation there and I do not that think that the word "abortion" featured in her lexicon at all. She had a choice; she made her choice; it was the right thing for her to do and I support her 100% in that choice. Does she not think, however, that the same compassion should be shown to women who might make a different choice in equally difficult situations?

Is it fair of me to ask if the circumstances of John's birth informed Ms McDermott's views on abortion in general or did she have strong convictions about this beforehand? Has she always been pro-life by conviction or did this result from the unfortunate circumstances of John's birth? Has she been lobbying for the pro-life movement for the entire interim period? A previous speaker asked where One More Day stood on the Protection of Life During Pregnancy Act 2013. I am not sure whether the group adopted a position on that Act and campaigned on it. I am just trying to see where that particular leap came from so perhaps Ms McDermott might address this.

Ms Liz McDermott

I will respond to the question on my pro-life convictions, or otherwise. Like most people, I never thought about abortion very much because I did not need to think about it. I did not like the idea of it but I was certainly not in any way actively involved in pro-life politics or campaigning. When I had John and was confronted by abortion as a real option, I realised that I felt very strongly that babies are not choices for anybody else to make. Babies are separate human beings to whom we owe duties and responsibilities. We have, not rights over them, but rather duties towards them. At the time I reacted instinctively as a mother to want to protect my baby, who seemed more vulnerable than other children and perhaps more in need of mothering. That is why I was upset when he was unexpectedly taken away from me after birth. No care plan had been put in place for me that was sensitive to my needs and my desire to bond with my child. I would say then that my conviction that abortion is neither a solution nor a good path to follow stems from my experience of having gone through that journey.

The Senator asked if compassion should be shown to women who make another choice. I do not see babies as choices for us to make once they exist and once they are living and growing inside us. The choice over whether they are there or not and whether they live or not is not for us to make. We have to fall back on the question of what are human rights and who is entitled to them. We did not know much about life in the womb back when abortion was legalised in the United Kingdom, our nearest neighbours. We know much more now about the action and development in the womb in the very early stages, right down to the first 24 hours after conception. Science is catching up with the pro-life conviction when it now says that the human life starts at the beginning and is on a continuum. Does it have the right to life or does it not? I do not see that it is up to us to legislate for and qualify that. I do not have the authority to do this and nor does anybody else. We have human rights because we are human. That is it and that, as far as I am concerned, is the qualifier.

I do not like the fact that women feel they have to make that choice. I would love to see a more compassionate system in place that says to them, "We value you and your baby too much. We love you too much to do that and we love your baby too much to do that, and we want to support you."

Does Ms McDermott not see the corollary between someone trying to force her to do something that was totally against her wishes in relation to John and the person who has no choice at present in this country about taking another decision?

Ms Liz McDermott

My experience was not that I was being forced to have an abortion. There was a kind of a lack of care, a lack of concern, a lack of provision for me which is all I was asking for. I did not need to be supported. I had already made that decision. My husband probably had not at that stage but I took the lead on it, I suppose.

There is not really a corollary. When one is talking about choosing to honour the life of a child and choosing to take it away, I do not see that one can put those two on the weighing scales and say that the two are really the same argument in reverse because I cannot bring myself to look at any child, any baby, as anything other than human potential and a member of our society who needs to be protected. That is where I stand with it.

I thank Ms McDermott. I have to move on to Deputy Rabbitte.

I thank Ms McDermott for her presentation earlier on. I am one for direct questions as well. Ms McDermott stated earlier on that she believed the child has equal rights to those of the mother. Is that correct?

Ms Liz McDermott

That is what the eighth amendment states. I would agree with that, yes.

Where the life of the mother is at risk, what does she believe along those lines?

Ms Liz McDermott

Risk is a wide-----

She could lose her life.

Ms Liz McDermott

With life at risk, if there is an emergency, there is cancer or there is something like that, of course, treatment must be provided to a mother so that she-----

Is there a choice to be made between-----

Ms Liz McDermott

It is not a choice. No, there is not a choice in that case because the treatment that the mother needs may or may not bring about ending the life of the baby. If she needs it, if there is some sort of rupture or a placenta praevia, or something like that of a dramatic nature, there has never been any question. It is not considered as abortion. It is life-saving treatment that a woman needs in that moment and there is no problem with that. I do not consider that as abortion.

All right. No, no, I just needed-----

Ms Liz McDermott

On risk, one can be asked to define risk. When it comes to mental health, it is too vague a thing. Professor Veronica O'Keane said it is very difficult for us to diagnose or assess or quantify the risk. What is the risk? How do we deal in percentages? I had the one-in-a-million child and then I went on to have a child who got leukaemia at the age of two and almost died. Percentages, risks and statistics are kind of meaningless and that is why I think-----

To me, they are not, to be honest with Ms McDermott. When I talk about risk to the mother, I think about the mother whose life is at risk and who could have three other children at home. That is the life of the mother. That is why I sit on this committee. I have sat here for the past number of weeks to welcome the people here to inform me. This is the one part I battle with. I battle with the life of the mother whose life is at risk because there are other children or family dependent on her. That is my biggest battle in trying to figure out where this whole debate will go. Is Ms McDermott saying to me she agrees then that the life of the mother supersedes where the life of the mother is at risk?

Ms Liz McDermott

If it is directly at risk, if she is likely to die unless she receives medical intervention-----

Intervention, yes.

Ms Liz McDermott

-----it is a medical assessment. I am not in that position so I cannot say. My problem is that once one starts legislating for particular categories of risk and assessment, one just gets into very grey areas. In the grey areas, one can reach a situation which we have in the UK where the legislation still calls for there to be a substantial risk to the life or health of the mother but that is not what happens in practice because nobody can really quantify that. If a woman comes in and says, "my health is at risk", "my life is at risk", or "my mental health is at risk", no doctor will say, "well, I am not sure that it is."

No doctor will say that it is at present because, under the legislation, we have his or her hands tied. Legally, they are tied because there is a 14 year sentence for them to make a decision.

Ms Liz McDermott

I cannot comment. I do not know that many obstetricians have been prosecuted for the judgments that they make, and quite rightly so. It is a serious issue. Everybody and the legal system would be sensitive to the circumstances, but it is still important to have. If there is a flagrant breach of the legal requirements and medical best practice, I suppose the legislation is there for that kind of extreme situation that might kick in. To answer the Deputy's point, I am not a doctor and I do not have a problem with doctors making the call when they have to take action.

Ms Liz McDermott

I do not think that has ever been a problem.

I will ask another question, if Ms McDermott does not mind. When Ms McDermott gave birth to her beautiful son, John, did she give birth in Northern Ireland or southern Ireland?

Ms Liz McDermott

Southern Ireland.

That is okay. I thank Ms McDermott.

I would echo everyone else's comments in relation to how Ms McDermott was treated. It is appalling that anyone would be treated in such a manner.

I also am one for direct questions. If it comes across as confrontational, it is not intended to be. I will say that upfront.

I question some of what Ms McDermott has put on the record of the committee here today. First, on Ms McDermott's comments in relation to Down's syndrome, Ms McDermott stated that 90% of such pregnancies in the UK are terminated. She went on to state that in Denmark the corresponding figure is 100%. Ms McDermott also went on to say that some such abortions happen during birth itself. I was just wondering if Ms McDermott has any evidence of that and, if she has, what evidence she is relying on in terms of the figure of 100% of pregnancies of children who are diagnosed with Down's syndrome being terminated.

Ms Liz McDermott

In Denmark, it is stated government policy to eradicate Down's syndrome by 2030.

Ms McDermott said that 100% of children who were diagnosed with Down's syndrome are terminated in Denmark. I am just wondering what medical evidence she has. Where is the research that Ms McDermott came up with in that regard?

Ms Liz McDermott

In the statistics that come out, I think it is 100%. In Iceland, there has not been a baby with Down's syndrome born in five years.

Ms Liz McDermott

Apologies, I meant to say Iceland. In Denmark, their government strategy is to eradicate Down's syndrome by abortion by 2030. If that does not put pressure on women who have a Down's syndrome baby to abort-----

Okay. Ms McDermott is willing to correct the record that it is not 100% in Denmark?

Ms Liz McDermott

I will correct the record, yes.

Could Ms McDermott give me the-----

Ms Liz McDermott

I would like it read into the record that in Denmark there is a government policy to eradicate Down's syndrome by 2030.

Could Ms McDermott give me the evidence where some abortions happened during birth itself?

Ms Liz McDermott

I have read that. I have come across that.

Where has Ms McDermott read it?

Ms Liz McDermott

I have read it in various literature.

Can Ms McDermott name one of those pieces of literature?

Ms Liz McDermott

I was just reading about David Alton talking about it. In the UK, he is a pro-life government Minister. I have not got medical evidence. I can get that for Deputy O'Brien, if he really wants me to.

Would Ms McDermott be willing to pass it on to the committee?

Ms Liz McDermott

I would be perfectly willing to, yes.

I want to get through as many questions as possible. Ms McDermott also stated that the abortion rates in countries where the setting has been liberal are much higher than those countries where it is restrictive. All of the evidence that we have heard before this committee, including evidence from the Guttmacher Institute, states that abortions rates, whether in a restrictive setting or a liberal setting, are comparable. I am just wondering where Ms McDermott got that research from.

Ms Liz McDermott

I was comparing this country, which has a rate of one in 20, with countries where abortion is lawful or where there is a liberal abortion regime, where the rate is one in five. That includes the UK, America, Canada and various countries like that.

We had a session at which we discussed abortion rates worldwide. The highest abortion rate, according to our evidence, occurs in Sweden, where it is 18 in every 1,000. The lowest is in Switzerland, where the rate is five in every 1,000. I do not know how that tallies with the 20% figure, or one in every five.

Ms Liz McDermott

These statistics are provided by governments. It is not from surveys or a slanted view. I do not have the data here.

Will Ms McDermott pass on the data?

Ms Liz McDermott

Sure.

I can offer clarification at the end of the meeting. Those figures do not necessarily contradict themselves as like is not being compared with like.

That is fair enough. Ms McDermott said she has experience of working with other groups, saying that some of the women she worked with in partnership with other groups had stated they did not want to do it but they felt they had no option but to obtain an abortion. What other groups has Ms McDermott worked with?

Ms Liz McDermott

I have worked with a counselling charity called Gianna Care. We tried to reach out to girls who think they want to have abortions and try to offer them supports.

What about the Every Life Counts group? Has Ms McDermott worked with it?

Ms Liz McDermott

No.

Okay. Does she know anybody who has done any work with it?

Ms Liz McDermott

No.

Ms Liz McDermott

I am not involved with every pro-life organisation out there.

I was just wondering.

Ms Liz McDermott

I do what I can. I am primarily a mother raising my family.

I understand that.

Ms Liz McDermott

I try to do what I can to support things in which I believe. I am here to share my story but I prefer to be on the ground, trying to give people constructive and practical help.

I appreciate that. Ms McDermott stated that she is opposed to the Protection of Life During Pregnancy Act.

Ms Liz McDermott

Yes.

The Act allows terminations where there is substantial risk to the life of the mother. Is Ms McDermott opposed to terminations in those circumstances?

Ms Liz McDermott

The Deputy asks about where there is substantial risk to the life of the mother but in the mental health arena, this can be vague and nondescript. I do not want the Deputy to trap me into saying something. That is the way I am feeling, to be honest. I feel I am being entrapped into making a statement. I do not agree, in the mental health arena, that abortion is helpful to women in general.

What about where there is a risk to the life of the mother?

Ms Liz McDermott

If there is a risk to the physical health and it is presented by a serious complication within pregnancy, an abortion, a termination or a treatment must be given that targets it. That is instead of deliberately targeting the life of the child.

What about the risk to the life of a mother through suicide?

Ms Liz McDermott

I would have to say there is evidence that suicidal ideation is not solved by providing abortion and there are other ways to support women.

My final questions relate to the right to travel, which is the 13th amendment to the Constitution, and the right to information, which is the 14th amendment. Does Ms McDermott agree with them?

Ms Liz McDermott

People have the right to travel to do anything. I am not in favour of curtailing the borders and preventing people from travelling. We are talking about what we have in place with our laws in Ireland. We cannot control what other people do and we cannot prevent people travelling to do whatever they want abroad.

Are we not preventing people from doing what they want by forcing them to get on a boat and go abroad to get a termination?

Ms Liz McDermott

Nobody is forcing anybody to get on a boat or a plane to have an abortion. That is a choice made by women.

It is a choice they do not have here.

Ms Liz McDermott

That is because we do not believe it is a good choice for anybody to make because it interferes with the life of the unborn, which is protected by our eighth amendment. I think it is a good thing.

Ms McDermott says "we do not believe". I am sure that is the case for her but every expert medical opinion that has been presented before the committee would disagree with that analysis.

Ms Liz McDermott

Perhaps the committee just needs to hear from other medical people. If the committee has heard one side of the story, it needs to hear the other. That should happen.

I am sure Ms McDermott has no regrets about the decision she made and had support from her partner or husband and family at the time. Will she try to put herself in the position of a very vulnerable young woman who may have had the same or similar diagnosis? Could Ms McDermott understand if that woman made a different decision and accessed a termination? One of the questions that has been asked of Ms McDermott by several members but which she has not yet answered relates to compassion. Does Ms McDermott have any compassion for a woman who decides she just cannot go through with a pregnancy?

Ms Liz McDermott

Of course I have compassion for people like that. That is why organisations offer post-abortion counselling to people who struggle with their feelings.

Those would be abortions they are not allowed to have in this State.

Ms Liz McDermott

If women have abortions, it does not matter where they have them-----

Ms Liz McDermott

-----if they suffer afterwards.

It does if a woman does not have the money and has to go to a moneylender or get into the height of debt. There may be shame and stigma and family members may not know. It makes a difference to those women.

Ms Liz McDermott

It does. I regret that this is the way it is and women feel such shame and stigma in Ireland. They also see a lack of support and poverty, and they may have to resort to moneylenders to do anything. It is incumbent on the State to avoid that.

I put it to Ms McDermott that the shame and stigma arises because of how the State treats women through its health care.

Ms Liz McDermott

I disagree with that.

Ms McDermott referenced Gianna Care. Is that the same group that operates from No. 46 Dorset Street? Those groups were highlighted in an article in The Times and Ms McDermott might use the word counselling for what they provided. I do not think I would.

It was directive counselling.

Yes. They advised women there was a link between abortion and breast cancer. Is that the same group?

To clarify, that is an organisation called Ask Majella.

I am addressing-----

That is an attempt to trap-----

It is not. It is an attempt to clarify a matter.

It was in No. 46 Dorset Street. I am asking if it is the same organisation.

Ms Liz McDermott

That is its office.

That is grand. It is all I need to know. I thank Ms McDermott

Ms Liz McDermott

I take issue with the Deputy's attempt to cast a slur-----

I am not trying to cast a slur on anybody. I was seeking clarification that it was the same outfit highlighted in the newspaper.

The Deputy got that.

It is an organisation.

Apparently it is.

I thank Ms McDermott for coming today. We have all been very impressed by her story and it is great to hear John is doing so well. In particular, there are some very important messages for the committee to take on board with regard to the level of care and support that should be there for women who choose to continue with their pregnancy in challenging circumstances. Like my colleague, Deputy O'Brien, I am conscious of the time so I will offer a couple of direct questions to Ms McDermott. She should know it is not about in any way being confrontational. I was struck by a comment made by Ms McDermott just a moment ago. She said nobody is forcing anybody on a boat or a plane. As we speak, we know that at least 12 women are travelling to Britain for abortions. Why does Ms McDermott think they are travelling?

Ms Liz McDermott

They are doing so for myriad reasons, I suppose. Many of them would not be able to see a way of having their child.

There could be a whole host of reasons why they would travel. I suppose for them to feel forced to travel means they feel forced to have an abortion. I think it is just getting into the whole issue of pressure and how we view people in difficult pregnancy situations.

Surely, the reason they are on that boat or plane is that the State is saying it will not facilitate terminations.

Ms Liz McDermott

We are saying that we do not consider that terminations are appropriate medical care or health care for women and babies.

So if they want a termination, is it not true to say they have no choice but to travel?

Ms Liz McDermott

If they want a termination, they are free to travel.

That is one way of putting it but my point, coming back to Ms McDermott's original line that no-one is forced, is that she has conceded herself that they have no choice but to travel if their mind is set on a termination. That is true, is it not?

Ms Liz McDermott

Yes but we are talking about our legal system and we are talking about mothers and babies.

It is more than that.

Ms Liz McDermott

If the Senator is ideologically disposed to saying abortion is a good thing, then let us just open it up and have open season and just strip unborn children of their rights altogether. Women have abortions for all kinds of reasons and a lot of those women and girls who travel do not have supports. That is why they travel. It would not be any different if they were having the abortion here. They would still be in that predicament. Whether she travels down the road or across the sea, it is the act itself, what is being done. Focusing on the geography of where that happens is missing the point.

To take up the point that Senator O'Sullivan and indeed Deputy O'Brien made, Ms McDermott rightly spoke about compassion. She should have been shown an awful lot more compassion and support in her situation. However, there are women who desperately need compassion here at home, who passionately feel that they have to have a termination. We have had medical evidence, not from cheerleaders for the pro-choice side but from the Master of Holles Street and the Master of the Rotunda. These are people who look after our mothers and babies and feel just as passionately as Ms McDermott does and more so. The evidence they have given us is that they honestly believe from their experience that we need to allow for terminations in Ireland.

That does not square with Ms McDermott's point of view, and I get that. However, this committee has to make its judgments based on evidence. The evidence has been consistent. When we hear somebody like Professor Anthony McCarthy from the National Maternity Hospital describe a woman literally beating herself, beating her womb because she is so desperate to have a termination, I cannot understand the lack of compassion in that circumstance. To me, in that circumstance, I can fully understand why Professor McCarthy is so frustrated at having to say she has to go elsewhere, to England, and that he cannot even direct her to a hospital.

Ms Liz McDermott

I am not a medical practitioner, obviously, and I do not claim to talk for the medical profession and the situations they encounter. Do we legislate for terminations for babies just based on a woman saying "I do not want this baby"? That is a cultural shift in this country that I think is massive and we have to acknowledge that. I do not see it as compassionate treatment for the baby or for the woman, either. I see it as a violent act that harms a baby and harms the mother. She cannot know when she is pregnant. Sometimes - I do not want to diminish - I am not saying that women are not capable of making a proper decision - but our hormones are all over the place. We are extremely vulnerable to all kinds of things and our feelings can fluctuate from high to low to being all over the shop throughout pregnancy. I come back to women saying "I had the abortion and I came home and felt awful. I felt stripped of my child. I woke up and they were not there". It is only at that point sometimes that they feel the loss and they regret what they have done. What does the Senator recommend I do or any of us does to that woman? Do we say "well, actually, tough, you made your choice"?

I am glad Ms McDermott raised that because I think it is the fundamental point. I do not think I am in a position to say to any woman what decision she should make in respect of her body and her health.

Ms Liz McDermott

It is not her body. It is not just her body.

Can I please finish? By all means, Ms McDermott can then answer. This comes to the crux of it. Does Ms McDermott not believe that we should trust women on this issue?

Ms Liz McDermott

Trusting women to do something bad to their babies-----

So you do not think we should trust women.

Ms Liz McDermott

If abortion was not harmful to women there would be no such thing as abortion regret. There would be no such thing as women turning to drink. Even in the case of well-known people, somebody like Stevie Nicks has said she had an abortion because the father did not care whether she kept the baby. Women are very vulnerable.

I am a big fan of Fleetwood Mac but we are dealing with evidence here and the evidence we have seen tells us that, actually, most women are fine after an abortion. I understand that is not Ms McDermott's perspective. My last question has, in fairness, been answered. Ms McDermott does not believe we should trust women on this issue, does she?

Ms Liz McDermott

It is not a question of trusting women or not trusting women.

I think it is.

Ms Liz McDermott

I think that is skewing the thing. Women are being----- we take in messages from the environment around us that say "you are not going to be able to mind this child or cope with this". It is a kind of undermining of women and women feel very ill-equipped. All they can see as a solution to the predicament is abortion. They think, "at least it is done, it is over, there is a certain outcome to that, I will be relieved of all responsibility".

With respect, that is the witness's own personal perspective and we get that.

Ms Liz McDermott

It is a factual thing.

I do not think she could then extend it to say that is every woman's perspective. It clearly is not.

Ms Liz McDermott

Obviously people have different opinions.

We are getting into the realm of speculation here. In fairness to the witness, she is not a medical practitioner. We are very grateful to her for attending here today. I really feel that she has done a service to the point of view she represents by turning up. I thank her for her presentation and for attentively answering all of the questions that have been put to her by the members. We really appreciate her attendance.

Ms Liz McDermott

I have tried. Could I just make a point of clarification?

Ms Liz McDermott

Deputy Bríd Smith was asking about the charitable status of One Day More. There is a new process. We are practically at the point of getting the charitable status applied but it is just a process that is ongoing. It has been applied for and is in the system.

Five years after it was set up?

Ms Liz McDermott

Yes. We have only applied for charitable status because it has become-----

I am just wondering if the process takes five years. That is all.

Ms Liz McDermott

No, we did not apply-----

The Deputy should bring in the Charities Regulator. She is badgering the witness.

I asked the question about it earlier on and the witness has made a point of clarification.

Ms Liz McDermott

We were not seeking charitable status initially. We were just there as a sort of an outreach, doing this. Then it became more firmed up and we got involved with other things, and sought charitable status.

I thank the witness.

Thank you for that clarification. Is there any other business?

I have a question. It has nothing to do with today's proceedings. I want to draw the attention of the committee to one issue that has been coming up, the question of directive counselling. I did not get satisfactory answers last week from the crisis pregnancy programme about where it is defined. Could we get our legal advisers to give us some help on this? What is the law in this country around directive counselling and where is it defined? Is it a crime? For example if, as Ms McDermott described, somebody is suggesting that a woman could go to England, is that illegal?

I think that is a good idea, Senator.

I would really welcome some clarification on those issues.

Perhaps we could seek written evidence on that and then address it with the committee's legal adviser when we meet her closer to the decision-making process. It is a good suggestion.

The joint committee adjourned at 7.40 p.m. until 2 p.m. on Thursday, 23 November 2017.