This Bill provides for constitutional and legislative reform in relation to the protection of human life in pregnancy. This proposal, which represents the first legislative response to the legal issues which remain unresolved since the X case in 1992, represents a fair, reasonable and compassionate approach.
Abortion is a sensitive issue for society and it is heartening that, in general, the response to these proposals to date has been of a measured, mature and thoughtful nature without, thankfully, the rancour that characterised the debates in 1983 and 1992. It is very important to acknowledge that laws alone cannot deal adequately with the often tragic realities of crisis pregnancy in modern society. On more than 6,500 occasions in the past year alone, women giving an Irish address have had abortions in Britain and, of course, many Irish women have made this journey in previous years also. The difficult situations faced by these women and the often lonely decisions they have made demand a sensitive, understanding and compassionate response from us all.
We must also, by every reasonable means at our disposal, strive to reduce the incidence of crisis pregnancy. Law is only part of the picture; education, advice, care and compassion are, in many ways, much more important. That is why a comprehensive approach is being adopted on three different planes – constitutional, legislative and caring practical intervention.
I accept that the proposals to address the constitutional and legislative issues will have little, if any, impact on the Irish women who choose to travel abroad for abortions. I also acknowledge that a comprehensive range of compassionate, supportive and non-judgmental services is vital to provide women with the support they need to deal with a crisis pregnancy and to make decisions about the options open to them. It is for these reasons that, having considered the recommendations of the All-Party Committee on the Constitution, the Minister for Health and Children has established the Crisis Pregnancy Agency, which will have the task of drawing up a national strategy to address crisis pregnancy and overseeing its implementation.
The Minister has appointed Ms Olive Braiden, who has a distinguished record in the fields of human rights and women's health issues, as chairperson of the agency. The management board had its first meeting yesterday. Initial staff have already been seconded from the Department of Health and Children to enable the agency to become operational. The Government will provide funding of €6.5 million to the agency in 2002.
The prevention of crisis pregnancy 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. Much concern has been expressed about the need to make women more aware of their options should they have a crisis pregnancy and to enable them to consider these carefully and to assist them before they make decisions about the course of action they want to take. This is another major area to be addressed.
Women who have had an abortion, either recently or some time ago, have particular needs also, which is another matter the agency will be asked to address. We need to ensure that these women are treated with compassion and understanding and that both their emotional and physical health needs are attended to. The establishment of the Crisis Pregnancy Agency will 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 to ensure that women who find themselves in this situation will have available to them as much assistance as possible.
Let us consider briefly the constitutional and legal background to the proposals contained in the Bill. In 1983, the people decided by referendum to insert into the Constitution Article 40.3.3, which declares:
The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.
No laws were ever enacted on foot of this amendment and the provisions in the Offences Against the Person Act, 1861, remained the basic law in relation to abortion. This left open the possibility that Article 40.3.3 would have to be interpreted by the courts because, apart from the 1861 Act, there was no legislation that made clear what was permissible under the law should there be a potential conflict between the right to life of the mother and that of the unborn.
As Members will be aware, subsequent to the insertion of Article 40.3.3, cases have indeed arisen in the course of which the substantive issue of abortion has been considered by the courts. In the X case of 1992, a majority of the members of the Supreme Court held that if it were established, as a matter of probability, there was a real and substantial risk to the life, as distinct from the health, of the mother and that this real and substantial risk could be averted only by the termination of her pregnancy, such a termination was lawful. The stated risk to the mother's life in this case arose because she had threatened to commit suicide if she had to continue with the pregnancy.
Some of the dicta of the majority in the Supreme Court also indicated that the constitutional right to travel could be restrained to prevent an abortion taking place in circumstances where there was no threat to the life of the mother. The right to travel did not take precedence over the right to life.
In November 1992, constitutional amendments were proposed to deal with different aspects of the X case judgment. In relation to the "substantive" issue, the wording put forward by the Government was intended to recognise that there could be circumstances where, to protect the life of a pregnant woman, medical intervention would be necessary which could result in the death of the unborn child, but that these circumstances would not include the risk of suicide. The people rejected this amendment. In the C case of 1997, the High Court accepted that, where evidence had been given that the pregnant young woman involved might commit suicide unless allowed to terminate her pregnancy, there was a real and substantial risk to her life and that termination was therefore a permissible medical treatment of her condition where this was the only means of avoiding such a risk.
Mr. Justice Geoghegan also made remarksobiter dicta about the issue of travel. He believed that a court, in considering the welfare of an Irish child in Ireland and considering whether on health grounds a termination of pregnancy was necessary, must be confined to considering the grounds for termination which would be lawful under the Constitution and could not make a direction authorising travel to another jurisdiction for a different kind of abortion.
There has been a view that, arising from the judgment in the X case, and subsequently the C case also, there is unfinished business requiring a response in terms of constitutional or legislative change or both. In light of the difficulties which have surrounded previous efforts to address the issues, the Government has devoted considerable effort to facilitating and informing public debate about them. The Bill before the House represents the latest step in a careful and logical process designed to explore the issues, to enable the many people and organisations who wish to express their views on the protection of pregnant women and of unborn human life in pregnancy to be heard and to consider ways of moving forward for the future.
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 all-party committee's proceedings and its detailed report, published in November 2000, were fair, balanced and of great value in educating and forming public and political opinion.
The Government has carefully examined the different proposals put forward by the all-party committee and the approach being adopted is based on one of three possible approaches identified by the committee. Stated briefly, it will protect best medical practice, while providing for a legislative prohibition on abortion and underpinning such legislation with an amendment to the Constitution. The Government is satisfied, on the basis of all of the expert medical evidence which has been presented, that there are rare life-threatening conditions or illnesses, either associated with pregnancy or exacerbated by pregnancy, in which, to save the woman's life, it may be necessary for doctors to consider taking action in the course of which or as a result of which unborn human life is ended. The Government does not believe that a risk of suicide is a valid basis on which to provide for medical intervention and the legislation envisaged in this proposal will not permit the termination of pregnancy on this basis.
The experience in the 1992 referendum attests to the difficulty of providing in a relatively short constitutional provision for a clear prohibition of abortion, while ensuring that there is no obstacle to pregnant women receiving all the care and treatment they need. In the Government's view, the terms of Article 40.3.3 and the courts' interpretation of that Article demand a legislative response from the Oireachtas. Indeed, in 1992 one judge of the Supreme Court criticised the Oireachtas for its lack of action in this regard. There is no simple sentence or paragraph that can be inserted into the Constitution which, by itself, would amount to a balanced, effective, legal response to the complex issues which surround the protection of human life in pregnancy. The proper place to strike that complex balance is in legislation, not in the Constitution.
The proposals contained in the Twenty-fifth Amendment of the Constitution (Protection of Human Life in Pregnancy) Bill provide a practical legislative response to the issues raised by the 1983 constitutional amendment and by the X and C cases. The proposals will not satisfy the wishes of those at different ends of the spectrum, as they are aimed at achieving a reasonable compromise which will enjoy the support of the middle ground of opinion. The Government hopes that this Bill will be seen as an honest and genuine attempt to provide an acceptable and workable solution to this complex issue.
The purpose of the Twenty-fifth Amendment of the Constitution (Protection of Human Life in Pregnancy) Bill is to provide a secure and effective constitutional basis for a legislative approach to the protection of human life in pregnancy. The proposals are designed to ensure that women can continue to receive all necessary medical treatment during pregnancy, while at the same time ensuring maximum protection of the unborn and maintaining a clear prohibition on abortion.
It is proposed that a referendum shall be held to approve the insertion into Article 46 of the Constitution of the text of proposed amendments to Article 40.3 of the Constitution. Firstly, a new Article 40.3.4º is proposed, to provide that the life of the unborn in the womb will be protected in accordance with the Protection of Human Life in Pregnancy Act, 2002. Secondly, a new Article 40.3.5º will provide that any future proposal to amend or repeal the Protection of Human Life in Pregnancy Act, 2002, will have to be approved by the people in a referendum. If the proposal is accepted by the people, the amendments to Article 40.3 will have effect only if a law containing the text of the envisaged Protection of Human Life in Pregnancy Act is enacted by the Oireachtas within a period of 180 days; otherwise the amendment in its entirety is nullified.
The proposed changes are designed to have a sound constitutional basis, so that the careful balance struck will not be subject to legal challenge. It is important that people are reassured that they will be consulted if changes are proposed in the future. It has been suggested that the mechanism being used is not valid because Article 46.4 of the Constitution states that a proposal for a constitutional amendment shall not contain another proposal. Any such assertion is incorrect and is based on a misunderstanding of Article 46.4 of the Constitution. There is only one proposal in the Bill to amend the Constitution, namely to insert into the Constitution the text set out in the First Schedule. The text of an envisaged criminal statute, as set out in the Second Schedule, is not a proposal within the meaning of Article 46.4 of the Constitution. The Bill to amend the Constitution does not propose that the Schedule containing the envisaged legislation should in itself have any legal effect.
If the people vote to amend the Constitution, effect will be given only to the constitutional amendment involved. The terms of the legislation on the protection of human life in pregnancy can become law or have effect only through a subsequent decision by the Oireachtas to enact such legislation. The proposed amendment was drafted deliberately to avoid containing two proposals and it does not contain two proposals. The legislation, the text of which is set out in the Second Schedule, is not being enacted at this stage. The electorate is merely being asked to accommodate that legislation in the Constitution if the Oireachtas, at a later stage, passes it into law.
It has been claimed that the current proposal is effectively the same as that put to the people in 1992. Questions have been asked as to why it should be acceptable to the people now, given that it was rejected nine years ago. In 1992, however, the people voted on the proposed wording of the constitutional change itself, but not on the legislation which would have followed had the amendment been passed. On this occasion there has been a detailed process of examination of the issues since 1997, particularly by the All-Party Oireachtas Committee on the Constitution. The Government is committed to allowing the people to decide, not only on the principle, but also on the detail of what is proposed. The people have a right to be consulted on the fundamental issues involved in the abortion issue and the amendment process set out in this Bill recognises that right.
I will now turn to the detail of the proposals. The Bill provides for the operation of a mechanism whereby proposed changes to Article 40.3 of the Constitution and the text of envisaged legislation on the protection of human life in pregnancy will be put to the people in a referendum. The Bill itself provides for the amendment of Article 46 of the Constitution so that the text of the First Schedule to the Bill will be inserted after the existing section 5 of that Article.
The First Schedule contains the proposed text of the amendment of Article 46 of the Constitution. The proposed text to be inserted as Article 46.6.1º in turn contains the proposed text of Articles 40.3.4º and 40.3.5º of the Constitution.
The text proposed as Article 40.3.4º provides that, in particular, the life of the unborn in the womb shall be protected in accordance with the provisions of the Protection of Human Life in Pregnancy Act, 2002. The use of the term "in particular" makes it clear that the statute envisaged by the amendment, if enacted, is not intended to be a restatement or redefinition of the term "unborn" as used in Article 40.3.3º. The effect of the text proposed as Article 40.3.5º is that any Bill containing provisions to amend the Protection of Human Life in Pregnancy Act, 2002, must be referred to the people in a further referendum. The existing Article 40.3.3º, as amended in 1992, will also remain.
The effect of the text proposed as Article 46.6.2º is that if the Protection of Human Life in Pregnancy Act, 2002, is enacted and amendments are made to Article 40, the amendments to Article 46 will no longer appear in the official text of the Constitution and the amendments to Article 40 will take effect, appearing in the appropriate place within that Article. This is because, once the amendments to Article 40.3 take place, it would be undesirable for the new Article 40.3 to appear in more than one place in the Constitution, namely, in Articles 46 and 40.
The text proposed as Article 46.6.3º contains a mechanism whereby, unless a law is enacted within 180 days in exactly the terms of the text seen and approved by the people when they vote on the proposed amendment, the whole of Article 46.6 will cease to have effect and the Constitution will revert to the form in which it existed before the referendum.
The text proposed as Article 46.6.4º states that the Bill regarding the protection of human life in pregnancy is excluded from the terms of Articles 26 and 27 of the Constitution. This is because, if the people in a referendum decide that the Protection of Human Life in Pregnancy Bill, 2002, should be enacted, it would be inappropriate that this legislation should, nonetheless, be subject later to the provisions of these Articles and the mechanisms they provide for the referral of Bills to the Supreme Court and to the people, respectively.
The Second Schedule to the Bill contains the text of the envisaged Protection of Human Life in Pregnancy Bill. When, following the referendum, the Oireachtas comes to enact this legislation, it will not be able to amend the Bill for that legislation in any way. Therefore, the substantive debate on this envisaged legislation is taking place in the course of the passage of the Bill to amend the Constitution.
The new law, when enacted by the Oireachtas, will not become a formal part of, or be written into, the Constitution. Its terms will simply have constitutional protection and recognition. It will be open to subsequent amendment like any law, but only if the people approve the amending legislation.
Irish maternity services have a deservedly high reputation when it comes to the care of pregnant women and their unborn children. The Government wants to put in place for the first time a legislative framework which will ensure that there are no legal doubts surrounding the provision of medical care during pregnancy. The Act will remove any doubt there may be about the legality of treatment which doctors may consider necessary where some women, during pregnancy, are suffering from certain rare, life-threatening medical conditions. It will provide certainty for doctors who may have feared that some interventions, although accepted medical practice in such situations, might nonetheless be unlawful. The lives of women will be protected during pregnancy and the developing human life within a mother's womb will also be protected.
Section 1 defines abortion for the purposes of the Act as "the intentional destruction by any means of unborn human life after implantation in the womb of a woman". It provides exemption from the definition as abortion of a medical procedure carried out by a medical practitioner at an approved place, in the course of which or as result of which unborn human life is ended, where that procedure is, in the reasonable opinion of the practitioner, necessary to prevent a real and substantial risk of loss of the woman's life other than by self-destruction.
In the course of the hearing of medical evidence by the All-Party Oireachtas Committee on the Constitution, it became clear that in a very small number of cases of strict and undeniable medical necessity, intervention by doctors to safeguard the mother's life can entail or result in the ending of the life of the unborn. On reading the testimony to the all-party committee, it becomes apparent that, while there are differences of language and of interpretation among members of the medical profession, their approach to the care of pregnant women and their unborn children is essentially the same. That is, their objective in all cases is to ensure that women receive all the medical care they may need and that the health of their unborn children is afforded the maximum protection also.
There can be no doubt that in rare situations, in order to save a woman's life, it may be necessary to intervene in a way that results in the death of the unborn child. These situations are very rare, but they can and do occur. Dr. Peter McKenna, Master of the Rotunda Hospital, told the all-party Oireachtas committee that "possibly once a year a woman would be seen in this country who, if her pregnancy is not terminated within a matter of probably hours or days, will die from a complication".
It is also apparent from the evidence to the committee that many doctors would not consider that such a procedure constitutes abortion. Professor John Bonnar, Chairman of the Institute of Obstetricians and Gynaecologists, said "It would never cross an obstetrician's mind that intervening in a case of pre-eclampsia, cancer of the cervix or ectopic pregnancy is abortion. They are not abortion as far as the professional is concerned, these are medical treatments that are essential to protect the life of the mother."
The new law, therefore, will define abortion in a way that clearly excludes such ethically legitimate procedures from being termed an abortion for the purposes of our criminal law. Doctors may provide any medical treatment which, in their opinion, is necessary to safeguard the life of a pregnant woman. The doctor's opinion must be formed in good faith and there is an explicit requirement that regard be had to the need to preserve unborn human life, where practicable. It is important to emphasise that doctors, when treating a pregnant woman, make every effort to safeguard not only her life, but that of her baby also. This will not change after the passage of the Act.
I emphasise that these proposals do not seek to address the question of protecting the unborn outside the womb and Article 40.3.3º of the Constitution will remain in place. In relation to issues such as in vitro fertilisation and embryo research, the Commission on Assisted Human Reproduction has been established to consider and prepare a report on the possible approaches to the regulation of all aspects of assisted human reproduction. The Government will consider these issues when the commission makes its report.
I wish in particular to address the question of threatened suicide in pregnancy as I know it is of concern to many people. Threatened suicide during pregnancy was a central issue in the X case and the C case, to which I already referred. The effect of the proposed Act will be that a threat of suicide will no longer be a ground for legal abortion in the State. I know this is a difficult issue for many people and that there are those who believe it is appropriate and feasible to legislate to permit abortion where suicide is threatened. The Government believes the evidence considered in the preparation of the Green Paper, and also the testimony and conclusions in the report of the all-party committee, 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. Such studies as have been undertaken in other countries suggest that pregnancy has a protective effect. It is important, of course, to exercise caution when interpreting the epidemiological data from other jurisdictions with different cultures and where legal abortion is available on a range of grounds, and the Government's view is not based solely on these studies.
The key point where a threat of suicide is concerned is that, in contrast to the type of situation which will be covered by the Bill, it is very difficult to assess whether the risk is genuine. This is supported by the evidence of a number of eminent psychiatrists to the all-party committee. Dr. John D. Sheehan, consultant in perinatal psychiatry at the Rotunda Hospital, indicated there is no test or fail-safe way of saying 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 evidence heard by the committee also indicates that the medical response to a pregnant woman considered to be at risk of committing suicide would be to help and support her and to treat her underlying mental condition, not to offer her an abortion.
Providing for abortion where a woman's mental health may be at risk is one of the principal grounds on which abortion is permitted in other countries and experience elsewhere strongly suggests that a change in the law to deal on compassionate grounds with exceptional cases can be exploited to allow wide scale application. To take England and Wales as an example, data from the Office for National Statistics show that in 2000 over 175,000 abortions were performed. Of these, 134 were performed because of a risk to the woman's life but more than 162,000, or 92%, were solely on the grounds of risk of injury to the physical or mental health of the woman.
The Government is satisfied that, even though there is great public sympathy for the plight of women who find themselves with a crisis pregnancy, to provide for abortion where a woman in such a situation threatened suicide would not command widespread support and could, in effect, lead to abortions taking place on grounds other than where a woman's life was at risk.
The prescribing of emergency contraception is an accepted part of medical practice for many doctors in Ireland and has been for many years. However, the drug usually prescribed is an increased dose of the ordinary oral contraceptive pill, which is not licensed for use as emergency contraception. The all-party committee advocated in its report that any legal uncertainties that may exist in regard to the morning after pill, that is, post-coital or emergency contraception, should be removed. Under these proposals the use of emergency contraception in the form of the morning after pill and the post-coital IUD will not be prohibited.
It is important to stress that the use of any drug to end an established pregnancy will be prohibited under the Act. Drugs are now available, and others may be developed in the future, which are intended to bring about an abortion without surgical intervention. The licensing of such products in Ireland would not be permissible under the proposed legislation.
Bearing in mind that the envisaged legislation will require the holding of a referendum if it is to be amended in any way, it is considered appropriate to provide a more flexible mechanism for the approval of certain hospitals for the purposes of the Act. It is therefore intended that arrangements will be put in place to enable a Minister approve certain hospitals. The term "approved place" is intended to be applied to hospitals under responsible management and possessing adequate expertise in obstetrics, gynaecology and neo-natal care and in the treatment and prevention of life threatening diseases arising out of or complicated by pregnancy.
Section 2 deals with the prohibition of abortion within the State. The criminal offence of abortion is restated in clear, modern terms and the legal penalties are specified in terms which leave no doubt about the seriousness of the offence. It is important to stress that abortion is already illegal – other than in a case where the X case test is met – and any suggestion that new prohibitions and penalties are being introduced is not correct.
The rebuttable provision regarding the presumption of the natural and probable consequences of a person's conduct replicates the ordinary provisions relating to criminal intent in respect of homicide. This ensures that a person who, for example, administered a drug or performed a medical procedure the effect of which was to end unborn human life would be presumed to have intended this outcome. He or she could, however, rebut that presumption by establishing in a jury's mind a reasonable doubt as to whether he or she intended to end unborn human life, despite the fact that that was the natural and probable consequence of his or her actions.
The existing law in the form of sections 58 and 59 of the Offences Against the Person Act, 1861, will be repealed by section 6. Under existing legislation, any person who procures an abortion is liable on conviction on indictment to be sentenced to imprisonment for life or any lesser penalty. The Act will provide for a reduced penalty of up to 12 years. The requirement in section 2(4) that a prosecution may be brought only by or with the consent of the Director of Public Prosecutions ensures that frivolous or mischievous cases cannot be brought before the courts.
The purpose of section 3 is to provide that a medical practitioner or any other person will not be obliged to carry out a procedure to which he or she has a conscientious objection, even though it may not constitute abortion under the Act.
Section 4 deals with travel and information. The Act protects freedom to travel and the right to information in accordance with the existing provisions in the Constitution, approved by the people in 1992. It also makes clear that a court shall not restrict a person from travelling to another state on grounds that his or her conduct there would be an offence under this Act were it to occur in Ireland.
I have already referred earlier to the issues about the right to travel in the context of the C case of 1997 and the Act will ensure that there is no longer any doubt over a person's right to travel abroad. There is no question of a person's right to travel outside Ireland being interfered with in any way by the State, whatever their circumstances or reason for travelling.
Section 5 deals with the arrangements for orders to be made under section 1 of the Act. The terms used are sufficiently flexible to accommodate changes which might well occur in the future, such as a change in the title of a particular Minister in the Government. An order made under this section of the Act, in addition to designating specific hospitals as "approved places" for the purposes of section 1(2) of the Act, may deal with the making and keeping of records of medical procedures. The draft of an order must be laid before the Oireachtas and must be the subject of a positive resolution of each House, before it can have effect.
A provision has also been inserted which requires the Government of the day to ensure that orders are made from time to time so as to enable the Act to have full force and effect. The arrangements enable orders to be changed where appropriate, for example allowing new hospitals to be designated, should this become necessary, without such a matter having to be the subject of an amendment of the Act, which would, of course, have to be approved in a referendum before it could have effect.
Section 7 deals with the Short Title of the Act and arrangements for its commencement. The period of at least two months between the passing of the Act and its commencement will allow for the making and consideration by the Oireachtas of the appropriate order or orders under section 5.
The proposals in this Bill represent a fair and reasonable attempt to resolve the constitutional and legal difficulties that have surrounded the issue of abortion since the judgment in the X case in 1992. They are also the culmination of a lengthy and detailed process of consultation and debate. The time has come to move on from this and attempt to resolve matters for the future.
A pregnant woman should be entitled to whatever medical treatment she may need, even where this may unavoidably place the survival of her unborn child at risk. Any legal doubt about what is permissible in such cases must also be removed so that doctors will be able to continue to provide the necessary treatment in accordance with established medical practice. The Irish health care system has an enviable reputation when it comes to the care of expectant mothers and their children and what is proposed in this Bill will protect current practice, not change it.
A simple constitutional provision with no legislative backing would run a major risk of subsequently being interpreted by the courts in a manner not anticipated. Therefore, the route the Government has chosen is, we believe, the best way of ensuring that safeguards are put in place which spell out, in straightforward terms, what is and is not allowed and which can be amended only if the people, in a further referendum, wish to do so. The proposed Protection of Human Life in Pregnancy Act spells out clearly what will be permitted under the law. The constitutional provisions which will govern any future amendment of the law mean that the electorate will have a clear understanding of the meaning and effect of the various provisions in advance of a referendum.
The amendment is designed to acknowledge that the abortion issue is one on which the people want to have the final decision while at the same time leaving the matter primarily in the legislative domain. It may be that no interest group or organised viewpoint will be entirely satisfied with every detail of the constitutional and legislative package. Nonetheless, the Government believes that it represents the middle ground of public opinion. It aims to be compassionate and realistic while also providing an honest response to the realities faced by many women. I hope this proposal will command general support as a prudent, workable, sensible, caring and compassionate approach to what is for everyone an emotive issue and, for some, the most important issue in their lives.
I commend the Bill to the House.