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Seanad Éireann debate -
Monday, 15 Jul 2013

Vol. 225 No. 1

Protection of Life During Pregnancy Bill 2013: Second Stage

Question proposed: "That the Bill be now read a Second Time."

I am pleased to introduce the Protection of Life During Pregnancy Bill to the House. Let us be clear: this Bill is about protecting the life of the mother and her unborn child. As all Members are aware, on 12 June 2013 the Government approved the publication of this Bill. They also will be aware of the considerable time that has been spent in constructively debating the Bill in the Dáil, time which I believe reflects the complexity of the issues involved, the emotive nature of the subject and the great interest of all Members of both Houses.

To clarify, the Bill aims to give effect to the Government’s decision in December 2012 to legislate in this area within the parameters of Article 40.3.3° of the Constitution, as interpreted by the Supreme Court in the X case, in order to implement the judgment of the European Court of Human Rights in the A, B and C v. Ireland case. At this stage, it is worth reminding oneself of the findings of this judgment. Three applicants, A, B and C, all of whom had crisis pregnancies, brought proceedings against Ireland before the European Court of Human Rights claiming violations of Articles 2, 3, 8, 14 and 13 of the European Convention on Human Rights. In its judgment delivered on 16 December 2010, the Grand Chamber determined there had been no violation of the convention with regard to the first and second applicants, Ms A and Ms B. The Grand Chamber determined there had been a violation of Article 8 of the convention in respect of the applicant Ms C. The court found that Ireland had failed to respect Ms C’s right to private life contrary to Article 8 of the convention, as there was no accessible and effective procedure to enable her to establish whether she qualified for a lawful termination of pregnancy in accordance with Irish law. The aim of the Bill is to provide such clarity and a procedure. However, it is worth noting again that the issues at stake here are extremely complex and engage with fundamental rights.

I will begin by stating definitively that the main purpose of the Protection of Life During Pregnancy Bill 2013 is to restate the general prohibition on abortion in Ireland, while regulating access to lawful termination of pregnancy in accordance with the X case and the judgment of the European Court of Human rights in the A, B and C v. Ireland case. Its purpose is to confer procedural rights on a woman who believes she has a life-threatening condition in order that she can have certainty as to whether she requires this treatment. I wish to emphasise that the Bill provides for existing rights, that is, within the constitutional provisions and the Supreme Court judgment in the X case; it does not confer any new substantive rights to a termination of pregnancy.

I will now take Members through the Bill, section by section, to clarify its provisions. The Bill is divided into three parts and includes a Schedule. Section 1 of the Bill makes standard provisions setting out the Short Title of the Bill and arrangements for its commencement. Section 2 deals with the interpretation of the Bill and defines the meanings of some of the terms used for the purposes of the Bill, including appropriate institutions, relevant specialty and medical practitioner. This section was amended slightly by the Government during the Dáil debates to remove the definition of "reasonable opinion" from section 2 and incorporate it, where appropriate, into the text of sections 7 to 9, inclusive, and 13 instead. The definition places a statutory duty on certifying medical practitioners to preserve the life of the unborn as far as practicable, in a situation in which a decision is being made about whether there is a real and substantial risk to the life of the woman. The amendment provides clarity, in that including the definition of "reasonable opinion" in each section concerned means that one does not have to refer back to the definition section for a full understanding of what it means and its statutory intent.

Section 3 defines what is meant by "appropriate institutions" for the purpose of the Bill. Pending the introduction of licensing legislation, provision of terminations of pregnancy will be allowed only in public health care facilities where they can be duly monitored and investigated, should the need arise. Locations for the delivery of this treatment will be limited to public obstetric units or, where needed, large public multidisciplinary hospitals with critical and intensive care facilities. This definition widens the definition of "appropriate institutions" somewhat from that set out in the general scheme published in April. This was deemed necessary from the information provided by the Institute of Obstetricians and Gynaecologists to the Oireachtas committee and the Department of Health. It had indicated that a small number of pregnant women with severe illness, such as cystic fibrosis or congenital heart conditions, require delivery in locations with immediate access to intensive and critical care facilities that are not available in some obstetric units. For this reason, the definition of "appropriate locations" now includes a small number of large multidisciplinary hospitals with intensive and critical care.

Section 4 allows me, as Minister, to make regulations to bring the legislation into operation and other such procedural matters. In this regard, I will be making regulations to set out the way in which medical practitioners will certify their opinions regarding the risk of loss of life to the woman, and whether a termination of pregnancy is required. These regulations will require, for example, certificates to indicate the clinical grounds for the opinion and other relevant details of the case at hand. Under the legislation, any such regulations will have to be laid before the Houses of the Oireachtas for approval.

Section 5 repeals sections 58 and 59 of the Offences against the Person Act 1861 as they are replaced by the provisions made in sections 22 and 23 of this Bill. Under the Offences against the Person Act 1861, a woman can currently be prosecuted for an unlawful abortion, the penalty for which is "to be kept in penal servitude for life".

Section 6 allows that approved expenses associated with the administration of the Bill may be paid for from public funds.

Chapter 1 concerns the risk of loss of life of the pregnant woman. Sections 7 to 9, inclusive, deal with medical procedures permissible under this Bill. The Government made slight changes to these sections in the Dáil, again for the purpose of clarity. While the substance of sections 7 to 9, inclusive, remains unaltered, the order of the requirements in sections 7 to 9, inclusive, was switched to ensure that it was crystal clear to all concerned that the medical procedures in question would be permissible only if they meet the test laid out in the X case judgment. Some technical drafting amendments were also made to ensure that the order in which the provisions now appear is consistent throughout the Bill.

Section 7 deals with the risk of loss of life from physical illness. It provides that it is not an offence for an obstetrician or gynaecologist to carry out a medical procedure in the course of which or as result of which unborn human life is ended under certain circumstances. These are that the procedure is carried out in an appropriate institution and two medical practitioners registered on the specialist division of the Medical Council register, having examined the woman, have certified that in their reasonable opinion there is a real and substantial risk to the life, as opposed to the health, of the pregnant woman arising from a physical illness that can only be averted by this medical procedure.

On a point of order, is the Minister's title Minister for Health?

That is not a point of order.

It is. We should be informed. If he is unconcerned about the health of the woman, it is a most extraordinary position to take as Minister for Health.

The Minister is to be allowed to continue without interruption.

The process requires an assessment on medical grounds to determine whether the test set out in the Supreme Court judgment in the X case is met. The Supreme Court held that the correct test was that a termination of pregnancy was permissible if it was established as a matter of probability that there is a real and substantial risk to the life of the mother, and that this risk can be averted only by the termination of her pregnancy.

I have previously mentioned the definition of "reasonable opinion" given in the Bill, and I would like to expand on its explanation here.

The definition of “reasonable opinion” requires that this opinion must be formed in good faith, and must have regard to the need to protect the right to life of the unborn and preserve unborn human life where practicable. The emphasis on preserving unborn human life means that a doctor will be obliged, as far as practicable, to end the pregnancy in such a way as to preserve the life of the unborn. The registered medical practitioner(s) will be obliged to record this opinion in writing if certifying a procedure that will end unborn human life.

One of the two medical practitioners involved in the certification process will always be an obstetrician-gynaecologist and the other will be a medical practitioner in a specialty relevant to the risk to the life of the woman - for example, an oncologist, cardiologist or another obstetrician. As indicated in the definition of reasonable opinion, the test requires a clinical diagnosis in relation to the risk to the life of the pregnant woman and a foetal assessment. Therefore, the expertise of an obstetrician will always be required in ensuring patient safety, as well as in accessing services.

In addition, the Bill now makes it the duty of the obstetrician involved to deal with the issuing of the required certification in order that the medical procedure may be carried out and they will also be responsible for making such arrangements with the appropriate institution.

Provision is also made in the legislation for consultation with the woman’s GP in the course of the diagnostic process, where she has given her permission and where it is practicable and feasible to do so.

Section 8 deals with emergency situations, where there is an immediate risk of loss of life arising from physical health conditions only. In an emergency, the opinion of one registered medical practitioner will be sufficient for the termination to be lawful. Doctors should not be prevented from saving a woman’s life in a situation of acute emergency because, for example, the required numbers of doctors are not available to certify, or the woman in question arrives at a health facility that is not covered as an appropriate institution under this Bill - that is to say it is not a public obstetric unit or a large public multi-disciplinary hospital. Therefore, in emergency circumstances, the reasonable opinion of one medical practitioner is required to certify that the termination is immediately necessary to save the life of a pregnant woman, but the medical practitioner who carries out the procedure will be required to certify the reasons for his or her actions. If necessary, the certification for the procedure may be issued by the medical practitioner after the medical procedure has been carried out, but in any event no later than 72 hours afterwards. Again, this opinion must be formed in good faith and have regard to the need to preserve unborn life where practicable. The emergency "exception" will not apply in the case of a risk to life from suicide.

Section 9 deals with a risk to the life of the pregnant woman from suicide. There are recognised clinical challenges in accurately assessing suicidal ideation, for example, the absence of objective biological markers. Therefore, this assessment requires that more safeguards are put in place. In these cases, three medical practitioners registered on the specialist division of the Medical Council register must certify that in their reasonable opinion there is a real and substantial risk to the life of a pregnant woman arising from suicide that can only be averted by a termination of pregnancy. One of them must be an obstetrician-gynaecologist practising in an appropriate institution, and the other two must be psychiatrists, one of whom must practise in an appropriate institution, and the other must practise at an approved centre, and-or for or on behalf of the HSE. In addition, the Bill specifies that at least one of the psychiatrists must have experience in providing mental health services to women during pregnancy, childbirth and after delivery.

This section contains similar provisions to those made in section 7 regarding the duty of the obstetrician involved to issue the required certification for the medical procedure and for consultation with the woman’s GP with her consent where practicable.

I am aware that questions have been raised around the role of the obstetrician in this assessment. However, the test in this case will always be multi-disciplinary in nature, as it requires a clinical diagnosis in relation to the risk to the life of the pregnant woman as well as a foetal assessment. Therefore, the expertise of an obstetrician will always be required.

The establishment of a formal framework providing for an accessible, effective and timely review mechanism is one of Ireland’s obligations under the judgment in A, B and C v. Ireland.

The purpose of the formal medical review process is to provide a mechanism for a woman who requests access to a review of the clinical assessment made by the original doctor or team of doctors. In practice, this will only arise where the woman's request for a termination in line with the X case criteria has not been granted or when she has been unable to obtain an opinion in this regard. The review process is provided for in Chapter 2 of the Bill at sections 10 to 15. It is important to note that this formal review pathway is in addition to and not in substitution for a woman's option to seek a second opinion as in normal medical practice.

Section 10 sets out the process for applying to have a medical opinion reviewed. The woman or a person acting on her behalf must apply in writing to the HSE for a review of the relevant decision.

Section 11 provides for the establishment of a review panel by the HSE, which may be drawn upon to form a review committee. The panel will consist of at least ten relevant experts for the purposes of the formal medical review, all of whom must be medical practitioners within the meaning of the Bill. Members will be nominated by the Institute of Obstetricians and Gynaecologists, the College of Psychiatrists of Ireland, the Royal College of Surgeons in Ireland, the Royal College of Physicians of Ireland and the HSE. The HSE will draw from the panel when it needs to establish a review committee to consider an application for a review made under the Bill.

Section 12 deals with the establishment of review committees. The Health Service Executive will act as the convenor for the purpose of the formal medical review process. As soon as possible and no later than three days after receiving a written request from a pregnant woman, the HSE will establish and convene a committee drawn from the review panel to consider the relevant decision. The requirements for the composition of a review committee will exactly mirror the requirements set out in sections 7 to 9, inclusive.

Section 13 specifies that the committee shall complete its review as soon as possible and no later than seven days after it is established. The section further provides that the committee must inform the woman of its decision in writing as soon as possible.

Section 14 sets out the procedures of review committees. It provides for the woman or a person authorised to act on her behalf to be heard by the review committee. It also aims to empower the review committee to obtain whatever manner of clinical evidence it requires to reach a decision and to call any relevant medical practitioners to give evidence in person. Section 14 provides that the HSE will make administrative arrangements for the operation of the committee, including provision for facilities and expenses. Section 14 also provides that failure to comply with a direction issued by a review committee is an offence for which a fine may be imposed.

Section 15 provides that the HSE must submit a report on the operation of review committees to the Minister for Health not later than 30 June each year. An amendment was made to the Bill in the Dáil to specify that such reports will be laid before the Houses of the Oireachtas, which is necessary in the interests of transparency. It is appropriate that reports on the operation of the legislation should be viewed and discussed in the Houses. It is my hope that the amendment reassures my colleagues that the Oireachtas will continue to have an overview of the area once the legislation is passed. Information which must be included in a report includes the total number of applications for reviews, the number of reviews carried out, the reasons reviews were sought and the outcomes of such reviews. This information is required to monitor the implementation of the legislation and to ensure the principles and requirements of the system are being upheld. Section 15 clarifies that any information which might identify a woman who has made an application for a review shall be excluded from the report by the HSE. An amendment made by the Dáil further provides for the protection of the identity of doctors who are lawfully complying with the legislation.

Part 3 of the Bill deals with miscellaneous matters. Section 16 deals with consent and states that nothing in the Bill will affect the law relating to consent to medical treatment. The intention is that the provisions of the Bill will operate within the existing legal provisions on consent to medical procedures.

Section 17 concerns conscientious objection. Professional health personnel, namely medical and nursing personnel, will not be obliged to carry out or assist in carrying out lawful terminations of pregnancy if they have a conscientious objection, unless the risk to the life of the pregnant woman is immediate. Where a doctor or other health professional has a difficulty in undertaking a required medical procedure, he or she will have a duty to ensure another colleague takes over the care of the patient, as is normal in current medical ethics.

I should note that the right to conscientious objection is a human right which is limited to persons only and which cannot be invoked by institutions. The prohibition of conscientious objection for institutions was removed from the wording of the Bill, since the provisions make it clear that this right is limited to persons involved in the delivery of the treatment.

Section 18 reaffirms the rights of freedom to travel and freedom of access to information as per the thirteenth and fourteenth amendments to the Constitution for the avoidance of doubt.

Section 19 deals with certification and states that it must be made in the prescribed form and manner and must contain the prescribed information, which must include the clinical grounds for carrying out the medical procedure. An amendment was made to this section in the Dáil. It was solely aimed at altering this section to mirror the provisions made under the reporting system in section 20.

Section 20 provides for a notification system for all terminations of pregnancy carried out under the terms of this Bill. I consider it very important to record the number and nature of terminations of pregnancy in order to monitor the Bill’s correct implementation and to detect any potential abuse of its provisions. Accordingly, the legislation includes a clear requirement on providers to notify me, as Minister for Health, of all terminations carried out under this legislation within 28 days.

Amendments were also made to this section in the Dáil. The legislation included provisions for notifications since its inception and specified the information to be provided for the purpose of notification in the Bill. This is to maximise transparency in the operation of the legislation by enshrining principles and policies in primary legislation rather than providing for it in secondary legislation when it is not necessary to do so. An amendment was made to this section to include the Medical Council registration numbers attached to the doctors who have certified terminations. The notification specified in section 20 will contain the Medical Council registration number of the medical practitioner who carried out the procedure; the grounds for carrying out the procedure; the Medical Council registration number of each of the certifying medical practitioners involved; the name of the institution, or other location in emergencies; and the date on which the procedure was carried out.

This section also contains a requirement for me, as Minister for Health, to prepare and publish an annual report on the notifications received. Following Dáil amendments, the report will be laid before the Houses of the Oireachtas. This will be done without disclosing the identifying information on the women concerned. Following one further Dáil amendment, the identities of the certifying doctors and the doctor who carried out the procedure will be similarly protected.

Section 21 amends section 9 of the Health Act 2007. These amendments were necessary to permit me, as Minister for Health, to suspend relevant medical procedures in an institution when an investigation is being undertaken by the Health Information and Quality Authority, HIQA, in a serious risk of failure by an institution to comply with the provisions of this Bill. Such medical procedures may be suspended until I am fully satisfied that the institution in question is compliant with the legislation.

Section 22 sets out the offence of intentional destruction of unborn human life. This updates the law in this area, which, as I mentioned earlier, was until now governed by the 1861 Offences against the Person Act. The penalty for the offence is now up to 14 years' imprisonment, or a fine, or both. While it is recognised that the potential criminalisation of a pregnant woman is a very difficult and sensitive matter, this provision reflects the State’s constitutional obligation arising from Article 40.3.3°. It would also be inequitable to have, as a matter of course, a significant penalty for the person performing a medical procedure but none at all for the woman who is willingly undergoing such a procedure. From a review of the main categories of criminal offences on the Statute Book, the term of up to 14 years was considered appropriate by my Department and the Department of Justice and Equality. However, a prosecution may only be brought by or with the consent of the Director of Public Prosecutions, who would use his or her discretion. If a case is taken, the sentence to be applied in any particular case is a matter for the courts involved, which would also show discretion.

While a subsection was initially included in the Bill to clarify that the offence does not apply to a medical practitioner carrying out a procedure as laid out in sections 7 to 9, inclusive, this was amended in the Dáil. While it was initially thought that this subsection was necessary for the avoidance of doubt, subsequent advice has proved that this is not the case and the subsection was deleted. Section 23 provides for the offence by a body corporate.

A Schedule is appended to the Bill setting out the names of appropriate institutions for the purposes of the Bill. Technical amendments were made to it in the Dáil to set out the correct legal names of the institutions in question for the avoidance of doubt and to clarify the position from a legal standpoint.
I reassure the House again that the only purpose of this legislation is to clarify what is lawfully available by way of treatment in cases in which there is a real and substantial threat to the life of a pregnant woman and to set out clearly defined and specific circumstances in which this medical procedure can be lawfully provided. In connection with the operation of the Bill, I note that my Department has already commenced a consultation process with the relevant professional bodies, including the College of Psychiatrists of Ireland, the Institute of Obstetrics and Gynaecology and the Irish College of General Practitioners, with the ultimate aim of developing guidelines for their members on the implementation of the legislation following its enactment. It is expected that a multidisciplinary committee to develop these clinical guidelines will be established before the Bill is enacted and asked to complete its work as soon as possible.
As Members will be aware, a very significant amount of work has gone into producing and refining the Bill. As I alluded to, the public hearings held by the Oireachtas Joint Committee on Health and Children informed the composition of the Bill. I express my gratitude to the Chairman, Deputy Jerry Buttimer, and members of the committee for its invaluable contribution to the issue and the assistance it provided for me and my officials. I thank all those who came to the committee meetings and hearings for their contributions and Members of both Houses for the very respectful debate we have had to date. We have been able to express our own strongly held beliefs, but, equally, we have all been able to hear each other's beliefs. That has been very helpful to us in formulating a Bill which I know does not go far enough for some and goes too far for others, but it is a Bill that I believe is necessary to meet our obligations, to clarify for women what it is they are legally entitled to and, most importantly, how they can access that service and to provide professionals who must provide the service clarity on what is legally permissible and what it is their obligation and duty to provide.
I commend the Bill to the House and look forward to working closely with my colleagues in the Seanad as we discuss the legislation.

I pay tribute to the Minister for giving so much time to the House on an ongoing basis. Regardless of the legislation in question, he has always come before the House in his own right. As somebody who has probably called for his resignation more than once, it is something that needs to be said and it is appropriate that it come from somebody like me who is seen to oppose much of what he is trying to bring forward. It is genuine to say that in the time he has given to this House he has not only shown a great understanding of the legislative process and the importance of this House but also his belief that it is necessary to come here with an open mind, listen and, at times, change legislation. We genuinely thank him for this. He might have a word with his colleague, the Minister for Jobs, Enterprise and Innovation, who does not share the same understanding and appreciation of the House and its workings, as exemplified in his contribution on national radio today.

It is the intention of Fianna Fáil to have a free vote, as happened in the other House. It is also the view of all of us that the debate should be respectful and appreciative of everybody's views, regardless of what they may be. Unlike many of my contributions, I hope to reflect this now. When this issue was discussed at the hearings in this Chamber in January, I attended every minute of them. My colleague, Senator Jim Walsh, substituted for me at the later hearings on my behalf and that of our party. During that time and probably for about six months beforehand, it was a great briefing source for me because I must admit that I was the typical man of 40 odd years with a couple of young kids who had enjoyed a good social life when he was young and had not particularly read into this issue as the major issue of the day that I had to consider.

In the last year or so I have done that and I found the expert hearings last January very informative, to which I went with an open mind. As a Catholic, people would probably assume I went with a loaded agenda, but I did not. While it may be in line with Catholic teaching, I approach this issue from a secular point of view. I listened to the medical evidence from the most eminent names, whether in obstetrics, psychiatry or the legal profession, as well as from what we might call vested interest groups such as the pro-choice lobby, the pro-life lobby and so on. From listening to it objectively and not with a particular agenda, eminent members of the medical field were saying we absolutely had to legislate in this area, while others in the same field said we absolutely did not have to do so. We heard the legal people say we had to legislate, while others said we absolutely did not have to do so. There were varying points of view given by the psychiatrists on the broader issue, but they seemed to be in agreement that abortion was not a treatment for people suffering from suicidal ideation. There seemed to be absolute unanimity on that issue. They also used statistics on which I asked them to elaborate; it was the only question I asked, but I asked it of each group. They mentioned that for every 100 people who were suicidal in treatment and who they predicted would commit suicide, there would actually be only three.

I know that people have other views; this is just mine. I asked for an explanation outside the House also. I am not saying it is acceptable to lose three people, but notionally does that mean that, albeit how rare this is, if we could put 100 people together, would the statistics be the same? Would we be prescribing a termination in these 100 cases to save three women such that 97 abortions might be unnecessary? That was the question I asked and I was told that this could be the case.

I will oppose the Bill for one reason, which is that I have continuing concerns that a termination of pregnancy on the grounds of suicidal ideation is not evidence based. There is evidence from the experts who support the Bill and also from those who oppose it that abortion cannot in any way be regarded as a treatment for somebody who is genuinely suicidal. The bottom line for me is that I want to protect life. That is the bottom line for everybody in the room, but I suppose we have different interpretations of how that is best achieved. I know that we have had many debates in the last year which have informed all of us, but I have seen so much for and against from the top names, people in this House on all sides and inside and outside my party whom I respect and who are persuasive in their arguments and have provided expert medical and legal opinion to back up both sides of the argument. Therefore, the onus is on me to make a decision based on what I think is the best way to protect life. There is much in the Bill with which nobody would have a problem. I have a wife, two daughters, sisters, many neighbours and friends who are women. Nobody should think I would not want them to have the best possible treatment available to them at all times, including while they were pregnant. That is a no-brainer for me. Perhaps in my naivety I thought that care was available.

There were instances in the media that were covered very well such as the Savita case. Regrettably, these issues have been linked. On reading the Bill, I fear a case of death by misadventure or medical neglect could still happen. The debate has linked these issues, but they are not linked. However, I would like the best for my wife, daughters, sisters, neighbours and so on. There is much in the Bill that formalises what obstetricians and midwives have been taught since the 1950s and that is admirable. In isolation, I can imagine that everybody could support the Bill. However, I cannot support it because the suicide clause is included. We have the issue of the Supreme Court judgment in the X case and that is why we must legislate, according to some. However, there were eminent legal minds on both sides. In a professional capacity, if I were to engage Senator Ivana Bacik and other colleagues from that profession and was paying their fees, they could tell me what argument to make to win it. The evidence in the X case on the suicide question was not contested and I know that, according to some of the eminent experts, one of whom was Dr. Cahill of UCC, it did not constitute a precedent. We certainly heard these opinions and in including it, at a minimum we could be wrong. That is my fear.

I have only had ten minutes and think we would all be able to speak for 20 minutes or more on this issue. I respect everybody's right to hold a different position from mine. I hope the debate will be respectful. All of the experts divide into two camps and there are very few in the middle. I have had to take my own decision. While I appreciate that some are saying the floodgates will not open, I fear that they might. It might not happen today, tomorrow, next year or even in ten years, but we might look back and say it was a mistake to include it. I feel it is a mistake and I have listened more to the experts than many of those who will participate in the debate, having attended the various hearings.

I wrote the Fianna Fáil policy paper on suicide prevention and Senator Mary M. White also did substantial work in that area. I am not trying in any way to belittle that work. It is the major silent crisis facing society and we have only ever dealt with in a superficial way and paid lip service to it. We cannot do enough to deal with it because it will kill 600 people in the next 12 months. By this day next week, nine more people will be dead by suicide and six of those will be men. I do not want to belittle the issue of suicide in any way, but I am afraid I cannot and will not support the Bill, specifically because of the inclusion of the suicidal ideation clause.

After following all of the expert advice on both sides, I had to take my own decision because the advice was conflicting.

I welcome the Minister to the Seanad debate on the Protection of Life During Pregnancy Bill 2013 which has already been subject to considerable scrutiny in the Dáil and at the Select sub-Committee on Health. The discussions leading to this debate began over eight months ago with the publication of the expert group's report on the judgment in the A, B and C v. Ireland case. The Government took a decision that it would move forward by the introduction of legislation. The health committee arranged and held three days of public hearings in January, on foot of which the Minister for Health produced the heads of the Bill. A further three days of public hearing were held in May, at which over 50 experts gave evidence on how we should progress the matter.

Members here and in the other House have strong views on this issue and it is important that these are respected. However, we have a duty, as legislators, to deal with the issues which have arisen and, in particular, the failure to put in place legislation which should have followed on from the amendment of the Constitution in 1983. It was Mr. Justice McCarthy in the Supreme Court in the X Case who said on Article 40.3.3°:

I think it reasonable, however, to hold that the people when enacting the amendment were entitled to believe that legislation would be introduced so as to regulate the manner in which the right to life of the unborn and the right to life of the mother could be reconciled.

He went on to criticise the Legislature for failing to put in place legislation. He stated:

Failure by the Legislature to enact the appropriate legislation is no longer just unfortunate, it is inexcusable. What are pregnant women to do? What are the parents of a pregnant girl under age to do? What are the medical profession to do? They have no guidelines, save what may be gleamed from the judgments in this case. What additional considerations are there? Amendment, born of public disquiet, historically divisive of our people, guaranteeing in its laws to respect and by its laws to defend the right to life of the unborn, remains bare of legislative direction.

That judgement was delivered over 20 years ago and it was followed by the judgment of the European Court of Human Rights in the A, B and C v. Ireland case. In this case the court confirmed that Article 40.3.3° was not inconsistent with the European Convention for the Protection of Human Rights and Fundamental Freedoms. It found there had been no violation of the rights of Ms A and Ms B under the convention and dismissed their applications. It found, however, that there had been a violation of applicant C's right to family and private life contrary to Article 8 of the convention. It held that there was no accessible and effective procedure to enable her to establish whether she qualified for a lawful termination of pregnancy in accordance with Irish law.

There are some who believe no legislation should be put in place, leaving everything as is. The difficulty with that line of thinking is that we are giving a free hand to the courts to put their own interpretation of Article 40.3.3° in place. In Magee v. the Attorney General in 1974 Mr. Justice Walsh, when referring to the Constitution and the changes that could occur, stated:

According to the preamble, the people gave themselves the Constitution to promote the common good, with due observance of prudence, justice and charity so that the dignity and freedom of the individual might be assured. The judges must, therefore, as best they can from their training and their experience interpret these rights in accordance with their ideas of prudence, justice and charity. It is but natural that from time to time the prevailing ideas of these virtues may be conditioned by the passage of time; no interpretation of the Constitution is intended to be final for all time. It is given in the light of prevailing ideas and concepts.

In the State (Healy) v. Donoghue, Mr. Justice Higgins said:

In my view, this preamble makes it clear that rights given by the Constitution must be considered in accordance with concepts of prudence, justice and charity, which may gradually change or develop as society changes and develops and which fall to be interpreted from time to time in accordance with prevailing ideas. The preamble envisages a Constitution which can absorb or be adapted to such changes. In other words, the Constitution did not seek to impose for all time the ideas prevalent or accepted with regard to these virtues at the time of its enactment.

It is quite clear from these extracts and the judgment in the X case that it is open to the Supreme Court to give its interpretation of what was intended by the 1983 amendment of the Constitution. The legislation put forward by the Government and the Minister for Health, Deputy James Reilly, clearly sets out how this complex issue is to be dealt with into the future in a structured manner. It is not the role of the courts to take on the role of the legislator. This was very much underlined by Mr. Justice Geoghegan in the case of A and B v. Eastern Health Board in 1998. He stated:

Furthermore, I think it highly undesirable for the court to develop a jurisprudence under which questions of disputed rights to have termination of pregnancy can only be determined by plenary action in the High Court. The High Court undoubtedly has a function in granting Injunctions to prevent unlawful terminations taking place, and it may in certain circumstances properly entertain an action brought for declarations and consequential orders if somebody is being physically prevented without just cause from having a termination. But it would be wrong to turn the High Court into some kind of licensing authority for abortions, and indeed it was for this reason that I have rejected the suggestion made by counsel for C in this case that I should effectively convert the judicial review proceedings into an independent application invoking the inherent jurisdiction of the High Court and grant leave for such a termination to take place.

The Bill also repeals sections 58 and 59 of the Offences against the Person Act 1861 and puts in place new provisions which provide that it shall be an offence to intentionally destroy unborn human life. There is a view that if the 1861 Act were challenged, it would be held to be unconstitutional as it fails to recognise the implied rights of Article 40.3.3°. If this were to happen, there would be no criminal sanction for the termination of pregnancy in any situation. This is a further reason the Bill requires to be passed into law and the new provisions set out in section 22 should be put in place. By bringing forward the Bill, the Government and the Minister for Health, Deputy James Reilly, are putting in place a legislative framework which is in accordance with Article 40.3.3°. The Bill is putting in place a detailed structure with very strict criteria. Chapter 1 deals with the risk of loss of life of a pregnant woman under three separate headings. The Bill also provides for the establishment of a review panel if the pregnant woman is not happy with the decision taken. Sections 10 to 15, inclusive, set out the procedures which must be followed. This issue has been debated extensively in the past seven months. The Bill, as proposed, closes the vacuum that has been there since the passing of the amendment to the Constitution in 1983, over 30 years ago. It deals with all of the issues raised in both the X case and the A, B, and C v. Ireland case. It is important, therefore, that we now proceed to approve the Bill and bring it into force as soon as possible after it has been approved by both Houses of the Oireachtas and signed by the President into law. I commend it to the House.

Cuirim fáilte roimh an Aire go dtí an Teach.

As the first member of the Independent group of Taoiseach’s nominees to speak on the Bill, each has his or her own individual perspective on it. We are Independents in the best sense - independent of the Government and each other in the position we adopt in the course of our office work.

We have diverse views on a lot of issues including this Bill and this afternoon I speak only on my own behalf and according to my beliefs and point of view. I look forward to hearing the deliberations of my colleagues as the Second Stage debate ensues.

The history and context of this issue has been told and retold again today in this House; therefore, I will not repeat it. However, I commend the Minister in being as honest and as forthright as he possibly can in presenting this Bill. This Bill is about legislating for the judgment in the X case, which was delivered to us over 20 years ago. The Minister is not going to please everyone, including me, but with all the talk of political reform, a service was done to the citizens of Ireland by not guillotining the debate on this legislation. It is important that all of us as citizens hear and listen to all sides, from experts to politicians, on this most sensitive of issues.

In this instance I also commend Deputy Jerry Buttimer who as Chairman of the Oireachtas Joint Committee on Health and Children held two sets of public hearings to discuss the report of the expert group in January, and later the draft heads of the Bill. This is what should happen to all legislation and I hope the Government has begun to trust the art of politics and not the blunt edge of the guillotine when it comes to parliamentary democracy and law-making. It certainly assisted me in my deliberations. I spoke in this Chamber last December in response to the report of the expert group on the judgment in the A, B and C case. It offered the Government clear choices arising out of the need to legislate for the X case. The lack of action for over 20 years by successive Governments and the Oireachtas established a legal vacuum. No matter what side of the debate we may be on, I am sure that, as law-makers, we can all agree that inaction is bad governance which, in turn, leads to ambiguity and lack of clarity for Irish women.

The main purpose of the Protection of Life During Pregnancy Bill is to restate the general prohibition on abortion in Ireland. As far as I can see, it does not confer any new substantive rights to a termination of pregnancy. Abortion in certain circumstances was made legal, in my opinion, 21 years ago by the Supreme Court and with the embarrassing legal prod of the European Court of Human Rights, the Oireachtas has had to act accordingly. This Bill clarifies what medical procedures are permissible and under what circumstances. If anything, between the number of medical consultants and the certification process, it has made the availability of limited abortion in Ireland even more restrictive, one could argue. The Bill also repeals sections 58 and 59 of the Offences against the Person Action 1861 which removed the legal ambiguity and a threat of imprisonment to both the pregnant woman and her doctor. This repeal should remove somewhat what the European Court described as the chilling effect for both women and doctors.

I do believe that the Bill is narrow in its scope and that the Minister has lost an opportunity to provide leadership on behalf of women in Irish society. True, it does as the Minister said, namely, provide for existing rights. This Bill for the first time gives pregnant women in a medical emergency legal clarity and certainty about their human rights. It is the first time that women whose pregnancies endanger their lives have options, albeit limited, enshrined by law. The Minister has done exactly, and no more than, what the expert group recommended. As Frank Callanan described it during the public hearings "the Bill is a vessel negotiating a narrow strait".

In reflecting on the contents of the Bill and the debate on all sides of the argument, I must approach this issue about and for women with my own conscience, my own sense of justice and with respect to all concerned. Pregnant women must be trusted, and as a man, father, partner, Irish citizen and Senator I believe in women's right to bodily integrity. The purpose of the Seanad in theory - I hope it is exemplified today in practice - is to have a calm, measured and reasoned debate on a broad range of issues, including this difficult debate about abortion. As I have witnessed in the past two years, all of us in the House have shown an extraordinary and diverse range of expertise and engagement and I trust that the quality of our debate today will be no different.

It is our duty, as legislators, to give effect to the will of the people who have spoken on the issue in three separate referenda, two of which expressly related to the question of suicide. This Bill does allow the legal termination of pregnancy if there is a threat to a woman's life as opposed to her health, and suicide is one of those threats. I believe in equality and therefore this defines me as a feminist. To me, and in this legislative context, that means that men and women should have equal access to the highest attainable standard of health care and to justice. This Bill could enshrine an inequality in Irish law. By failing to legislate for abortion in the face of a substantial threat to the health of a woman and in cases of pregnancy resulting from rape and incest, women in Ireland could remain second-class citizens. Rape and incest are crimes against women. Should a woman become pregnant because of a crime committed against her by a man, I would support giving her a choice, with appropriate and regulated medical advice, to terminate that pregnancy. My conscience dictates that I do not have the right to intervene as a man or a legislator to prevent this choice. I welcome the repealing of the relevant sections of the Offences against the Person Act 1861 but it has not completely removed the so-called "chilling effect" from the Statute Book. There will be a new offence of a fine or imprisonment of up to 14 years or both for any person who has an illegal abortion in Ireland or her doctor. I strongly believe that this chilling factor will ensure that we continue to export our problems abroad and that, if women can afford it, they will travel to the UK to terminate pregnancies rather than risk extreme punishment. A woman who has become pregnant because of an illegal act such as rape or incest will suffer greater punishment than the perpetrators of these heinous acts. Men will get away with lesser sentences, potentially. Legal clarity was supposed to help remove the chill factor not reinforce it, as the threat of 14 years in prison will certainly do.

I heard the Minister's response and understand the issue of discretion but we as law-makers could clarify the discretion in the Bill before us. My colleague, Senator Marie-Louise O'Donnell, spoke eloquently in the Seanad last December about the D Case, a case that was not covered by the report of the expert group. Why not? The State argued in the European Court of Human rights on the right to terminate a non-viable pregnancy. The Minister knows of these cases and the tragic, barbaric, inhumane experience of women who had to travel abroad to seek compassion, understanding and a regrettable termination because of fatal foetal abnormalities. The Government could have also legislated for the D case. It could have shown leadership here. We now know of the sad and distressing story of Deirdre Conroy's pregnancy, the D case. She published a remarkable article in The Irish Times on 31 May describing her experience of having to conceal the fact that she had a termination and four years later being told by the State that she should have gone to court to seek permission for treatment. This has had a chilling effect on her trust in legislators. The effect of the stigma in this country attached to any form of termination for any reason cannot be underestimated. Imagine how much worse it is to endure that stigma when your wanted baby has fatal chromosomal defects. This Bill should provide for fatal foetal abnormalities.

I have been struck by the accounts of the tragedy of families whose foetus had a fatal abnormality and how these couples had to endure the torture of either being faced with bringing that pregnancy to full term, with all the questions being asked of them such as "When are you due?" and "How are you getting on?", or travelling to England like outcasts, if they can afford it. I know that the Minister was moved by this when he met some of these people. He could have looked at a definition of "unborn", particularly in light of the D case, and his lawyers, on behalf of the Irish State, argued for this. If, factually, it had been established that the foetus had no realistic prospect of being born alive, then an argument could have been made to the effect that this foetus was not an "unborn" for the purposes of article 40.3.3° and not compatible with life. We can discuss this in greater detail on Committee Stage when Senator O'Donnell and I hope to table amendments on fatal foetal abnormalities.

I bring this up again because yesterday the Minister's colleague, the Minister for Communications, Energy and Natural Resources, Deputy Rabbitte, all but confirmed that the Labour Party will not press for any further extension to abortion laws such as providing for fatal foetal abnormality or cases of rape or incest during the lifetime of this coalition. There are approximately 1,500 such cases in Ireland each year and it is estimated that in 80% of such cases, a termination is carried out abroad. The Minister could have provided compassion and leadership through legislation. A massive 83% of people in a recent IPSOS MRBI The Irish Times poll believed that the scope of the Protection of Life During Pregnancy Bill should cover fatal foetal abnormality, while 81% felt similarly about cases of rape and incest.

While I welcome the fact that this Government and this Oireachtas are finally about to legislate for the X case, it feels like the minimum and an opportunity has been missed to provide leadership and to catch up with what Irish citizens have already accepted. My concern with the restrictions in this Bill is whether it will in any way reduce the number of women who travel to England to have terminations, when we should be supporting choice and support for pregnant women of all backgrounds and faiths here in Ireland.

I welcome the Minister for Health, Deputy Reilly, to the House and greatly welcome the introduction of this Bill. The debate on this Bill in this and the other House is truly historic because it represents the first time that we as legislators have faced up to our responsibility to women in crisis pregnancies by directly addressing the issue of abortion, instead of leaving it to the courts or to the people for law-making by referendum. Never before in the history of the State have legislators addressed the issue directly through legislation.

The Joint Committee of Health and Children held lengthy hearings on the issue, in which I participated actively and I pay tribute to the Chairman, Deputy Jerry Buttimer, as others have done. We will have a respectful and intense debate in the Seanad on the terms of the Bill.

I very much welcome the start of the debate in the Seanad 30 years after the insertion of the eighth amendment to the Constitution in 1983, and 21 years after the X case at which time Mr. Justice Niall McCarthy said the failure to legislate by then was already unfortunate and inexcusable. We will finally provide legal clarity for women and for their medical advisers as to when abortion may be carried out to save women's lives. This is in line with a long-standing Labour Party commitment. I am very proud as a Labour Party Senator that this Government is finally taking this action and that we as legislators will introduce this Bill now. I am also personally proud as a person who some 24 years ago, when I was a student union officer in Trinity College Dublin, was threatened with prison for providing desperate women in crisis pregnancy with information on where they could access abortion in Britain. I certainly will be voting in accordance with my conscience in support of the Bill in this House.

As a mother of two daughters and a pro-choice feminist I would like to see the law go further and see abortion being made available in Ireland under the sort of legislation that operates in almost every EU jurisdiction. However, I accept we must operate within the parameters of the Constitution under the eighth amendment, Article 40.3.3°, and within those parameters it is long overdue for the Oireachtas to pass legislation to protect the lives of women and girls.

I remind colleagues that once we have legislated for the most extreme situations of pregnancy threatening women's lives, we know that 4,000 women a year will continue to travel from Ireland to access abortions in England under the 1967 Abortion Act that is lawful there. Those numbers represent the women who give an Irish address. We know others give addresses in Britain and we know others travel to other jurisdictions. We know there are women and girls who may seek to carry out abortions in Ireland by purchasing abortifacients over the Internet. This is a real issue. We all know these women. Some 80 women at a minimum travel each week. I believe as legislators it is our duty to look to address the real reproductive health needs of these women. I think we can only do that ultimately by repealing the eighth amendment.

There is clear public support for the sort of legislation I am talking about which would allow abortion on the grounds of rape or incest, of risk to health and for fatal foetal abnormalities. The silent majority are well ahead of politicians on this issue. The Minister for Communications, Energy and Natural Resources, Deputy Rabbitte, may not speak for all of us in the Labour Party on it. It is arguable that we could have gone further with the legislation even within the terms of the Constitution, and indeed in June 2012 I co-authored a letter signed by a number of Deputies and Senators, including my colleagues Senators Hayden and O'Keeffe, asking the Minister for Health to consider the inclusion of fatal foetal abnormality in the legislation based on an analysis of the European Court of Human Rights case of D v. Ireland in which the Government had argued that Article 40.3.3° might well allow for abortions in cases where the foetus had an abnormality incompatible with being born alive. Having made that argument in one case, it is certainly arguable that the State should now be including fatal foetal abnormality within the terms of the legislation. I think there will undoubtedly be domestic litigation on this issue. I accept that including it in the Bill would have put the Bill at risk of not withstanding constitutional scrutiny and would have made its status less certain. It is something we must return to following the passage of this Bill.

Similarly I regret that we are including in the Bill the criminalisation of the woman or girl who seeks an abortion. There is an alternative legal approach to take within the confines of the Constitution, as Dr. Ruth Fletcher argued very powerfully during the Joint Committee Health and Children hearings in May. I accept that the Attorney General's advice to the Government was otherwise and to have left out the criminal provision might again have rendered the Bill less robust constitutionally. I very much welcome the fact that between the Heads of the Bill and the final version a change was made to the drafting of the criminal offence. Dr. Frank Callanan pointed in the joint committee hearings that the wording of the offence was too broad in its previous inception. I am glad to see that has been narrowed somewhat.

Essentially, this is a conservative, restrictive Bill that is very carefully crafted to be well within the terms of Article 40.3.3° in the X case judgment. For those of us who are pro-choice we must accept there are many arguments that will have to be made on another day in terms of providing for abortion on wider grounds. For today and the rest of this week and next week we will be debating the terms of this Bill and the fact that we have a duty under the X case of 1992 and a duty in accordance with the wishes of the people to uphold that case as expressed in the referenda in November 1992 and again in March 2002.

It is also worth saying that the Supreme Court itself has upheld its judgment in the X case on two separate occasions, in 1995 and again in 1997 when it could have revisited and indeed changed the X case precedent. We have an international duty as others have said in accordance with the decision of the European Court of Human Rights in A, B and C v. Ireland in December 2010 when the court found that Ireland was in breach of the European convention in failing to provide an accessible and effective procedure whereby a woman whose pregnancy posed a risk to her life could access a lawful abortion in Ireland. Following that judgment and this Government's commitment to look at how to implement it, we saw the publication of the expert group report at the same time as the understandable and justifiable public outrage at the tragic death last October of Savita Halappanavar in Galway University Hospital. Her death certainly highlighted the lack of legal clarity over when doctors may intervene to terminate a pregnancy which poses a risk to a woman's life. It highlighted the grey area currently existing for doctors as many obstetricians and consultants put it so eloquently. The publication of the expert group report confirmed what we should already have known and it should not have taken a death to show us that we needed to legislate to provide for legal clarity. I urge colleagues who have not done so to date to read the expert group report in full because it sets out a very clear blueprint for the legislation we are currently debating. It points out for example that procedural rights need to be provided for by the Government. That is what the Bill does. As the Minister stated, it provides procedural rights.

The Bill also addresses a number of questions that have arisen during the course of the debate and that have arisen already today. First, the specific issue of suicide risk. As the expert group points out it would simply be unconstitutional to seek to legislate for the X case without including risk of suicide as a potential risk to life, on which a pregnancy might be terminated. Many anti-abortion activists have been critical of the X case judgment, notwithstanding the fact that it has been confirmed by the people on two occasions and by the Supreme Court itself on two other occasions. They have been critical of the judgment arguing that it is too easy to fake suicide risk and that it would somehow open up the law to abuse, the slippery slope argument we have heard. This argument is profoundly demeaning to women, suggesting that women are so deceitful they will be queuing up to pretend we are suicidal to get an abortion. It is demeaning to psychiatrists who have professional training in assessing suicide risk and who informed us very clearly of that during the hearings of the Joint Committee of Health and Children. It is highly restrictively framed.

There has been some argument that the Bill is similar to the British 1967 Act, but anyone who looks at the 1967 Act will see that the ground of mental health is more broadly defined than the ground of real and substantial risk to life set out by the Supreme Court in the X case. We know that it is simply not true to say that pregnant women and girls are never suicidal and again we heard evidence of that. It may be rare but it certainly arises that women or girls may become suicidal during pregnancy. This is not just due to mental illness and if we look at the X case, there was no suggestion that X had any sort of psychiatric illness, that her suicidal ideation arose because of the circumstances of the pregnancy. To those who say that abortion is not a treatment for suicide, there is no treatment for suicide. We have heard this time and again from psychiatrists, and from the College of Psychiatrists of Ireland's representatives, Dr. Anthony McCarthy, Professor Veronica O'Keane and others. There is no treatment for suicide. What psychiatrists do is assess risk of suicide and ways to prevent that risk. There may be rare cases, but cases have arisen such as the X case, in which the only way to prevent suicide is to terminate a pregnancy, where the pregnancy itself is the cause of the risk. I urge colleagues to look at the compassionate and eloquent words of the Chief Justice, Mr. Justice Finlay, in the X case, in which he speaks about the clear psychological evidence offered to the court as to the extraordinarily severe risk of suicide faced by that young girl. The evidence in that case was not challenged by the State and was agreed.

The only issue that has been raised and I know we will be dealing with, is the issue of term limits. We are legislating for the most restrictive form of abortion, namely, abortion only where necessary to save a woman's life. We cannot insert term limits because it would endanger the lives of women to say that an abortion can only be carried out to save their lives up to a certain time. What we can do and what we know from what Dr. Rhona Mahony and the Institute of Obstetricians and Gynaecologist told us, is that where the foetus is viable or may be viable then of course doctors must make every effort to ensure the vindication of the life of the foetus. Instead of performing an abortion, they will deliver the baby early. That is current medical practice and I can refer colleagues to the words of Dr. Rhona Mahony and Professor Fionnuala McAuliffe during the health committee hearings. The expert group report sets that out very clearly as well. The clear duty and the clear medical practice is to ensure early delivery and the subsequent appropriate neonatal care.

We know that legislation is essential to ensure that women's lives are protected.

Sadly, we have learned in the past year the true cost of legislative inaction. I see the introduction of this legislation as a real step forward for women. It is highly restrictive. Most women will continue to travel to England but it will provide a clarity of procedure for the very small number of cases where women's lives are put at risk by the continuance of their pregnancy, particularly young girls in care who cannot make the journey or make the arrangements for the journey themselves. It also marks a key moment in the relationship between Church and State with the legislators facing down intimidatory tactics of clerics and also, for the first time, marks the issue being brought into the Oireachtas. I see that as significant progress and commend the Bill to the House.

This is a nasty, timid and shame-faced piece of legislation which I will be reluctantly forced to support. I am really disgusted that still at this stage we, as a people, are apparently unable - certainly in political terms - to face reality, honesty and truth. I believe the people are well in advance of the Government. At least the Minister did not say that the Seanad was responsible for the mess. I am surprised he did not, in view of the mendacious attitude obtaining throughout the entire Cabinet.

I pay tribute to Senator Ivana Bacik. I remember very well, over 20 years ago, when the Senator was involved in the students' union in Trinity College Dublin, that she promoted honesty and integrity in this area and was threatened with jail. I was never threatened with jail but I handed out advice and I am glad I did because that saved a number of people who would otherwise have had abortions. The irony is that the more honesty and integrity there is, the fewer abortions there will be. The sanctimonious people would drive young women out of this country. I make no apology for using this kind of language. There is all this drivel about respectful this and that and all the rest of it and that we must be very courteous. That is rubbish. The very people who say that never are. What about the people outside the gate with the photographs? This is disgusting stuff. A photograph of an appendix operation or a tooth extraction would look bloody awful too. It does not prove anything. It is emotive. It is going on outside the gates. Why should people not be outraged? I am outraged. I am absolutely outraged by what is continuing to go on in this country. If we are respectful, why is Senator Fidelma Healy Eames, who has tabled a reasoned amendment, with which I completely disagree, listed as No. 24 on the list of speakers? That does not show very much respect for democracy. I do not happen to agree with her views and will be voting against the amendment, but it is not very respectful. Let us not have hypocrisy. I do not mind people using heated language. In fact, I think we should use heated language in this area when fertilised eggs are referred to as citizens. One would need to be Jonathan Swift to deal with that kind of tripe. I will not be respectful of a farrago of nonsense. Why should I?

In page one of his contribution the Minister said the main purpose of the Bill was to restate the general prohibition on abortion in Ireland. To a certain extent I could understand that from an old fellow like myself. When I was young, this was the most horrible thing on earth. It was whispered, it was a violation, it was the most outrageous criminal thing one could possibly do, it was the complete negation of motherhood.

Senator Colm Burke asked what are pregnant women to do. This Bill will not solve it. The Taoiseach, Enda Kenny, actually had the gall to say - as if he was proud of it - that this Bill will change nothing. Well, if he is telling the truth, that means that Savita Halappanavar would die again. Is that something to be proud of? Well, I certainly do not think so.

We have heard much about evidence-based tests. This is an entirely new lingo, along with the respectful stuff. Where were all these people who are so interested in evidence-based tests when I challenged another section of that Bill? The Government, in the words of Mr. Justice Henchy, signally failed to provide any evidence at all. I did not hear a squeak from any of these people who have subsequently cropped up and described themselves as pro-lifers. What I want to say - I have said it repeatedly in the past 20 years and I am glad it is beginning to catch on - is that we must never allow these people to colonise the language. I am pro-life. I am pro-choice. There is no contradiction whatever. I suppose it is a debating point, but it horrifies me that a Minister for Health could actually put in his speech, as a point of pride, that the Bill only deals with the situation in which there is a real and substantial risk to the life, as opposed to the health, of the mother. The Minister is Minister for Health. I know his heart is in the right place, but probably his Cabinet colleagues do not have the guts of a burst gooseberry. He will have doctors here and doctors there and doctors all over the place and he will have pro-life doctors, as they call themselves, and pro-choice doctors. What happens if two of them cancel each other out? Doctors differ and patients die.

On the last page of his script the Minister said " is recognised that the potential criminalisation of a pregnant woman is a very difficult and sensitive matter..." That is a very peculiar way of describing it. It is revolting; it is utterly revolting. Let me say, I listened to all this waffle brought out about the constitutionality aspect. I think I have solved the Minister's problem because I have tabled an amendment proposing that the fine should not exceed a maximum of 50 cent and the maximum term of imprisonment should be one day, reduced by a maximum of 18 hours for good behaviour. That would solve the Minister's question of whether he is still criminalising abortion, but it shows up the farce that is involved.

Governments have always been very shifty about this area - not just this one but the whole damn lot of them. I was around in 1983; I was not a Member of this House but I campaigned on this issue. That was a squalid little sectarian amendment that was introduced; it was virulently sectarian and it expressed the position of the Roman Catholic Church post-1869. I am very grateful to Patsy McGarry for his wonderful article in The Irish Times that shows that the position of the Roman Catholic Church up to 1869 was that abortion was perfectly all right up to 166 days because it was at that point that the soul entered the foetus. I do not know how they knew that. I would love an objective, evidence-based test to show me when the soul enters the foetus. Let us have the evidence on that particular one.

We then had a colleague of mine, for whom I had great affection - I will not name him - sidling around behind people's backs at the time of the Maastricht treaty, or one of those treaties, and this little group of self-appointed people went off and got a commitment from the Government that it would introduce into the treaty a protocol on abortion without consulting either House of the Oireachtas or the Irish people. How democratic is that? Then we refuse to listen to the people, who have spoken in two referendums. That is quite extraordinary.

I respect people whom I regard as misguided but are really wonderful, decent people. There was a man on the radio today who was a real hero. He was the carer of the year. I cannot express my admiration for that man and the wonderful work and the sacrifices he has made. One of his children has Down's syndrome and he seemed to give the impression that if this law was passed the life of that child might be threatened. I do not believe that for one second. I would never stand over an abortion that took place simply because the foetus had a diagnosis of Down's syndrome. That is utterly revolting and wrong. What is equally revolting is people who come along and say to a woman carrying a foetus with a fatal abnormality that she must carry it to term. I place on record my admiration for Deirdre Conroy, who, all those years ago, wrote that powerful, passionate letter. Now she has emerged from the background with a new and vital message. I would like to ask all the men who tend to speak on these issues to consider a situation in which a woman is pregnant with what amounts to a cluster of cells which will develop into a large piece of tissue that has no head, no brain, no spinal cord, no capacity for anything whatever. Would they say the woman concerned must carry that to term? How could one not be outraged by that and the violence that causes? What about incest and rape? What about a girl who is gang-raped? The Government is prepared to collaborate with the forced colonisation of her body.

I would respect any woman who says, "No, I respect life so much I am keeping this.", but I would also understand the psychology of somebody who had been violated repeatedly by thugs and could not bear this. Of course, there is outrage.

This Bill is being presented as an Irish solution to an Irish problem. I remember when the late Taoiseach, Mr. Charles Haughey, came out with that one and I defied him over it. I said: "What an insult to the Irish people." This is yet another insult to the Irish people.

As if we did not know this stuff about fertilised eggs-----

-----I am ending on this point, do we not know nature is profligate? Nature sheds millions of fertilised eggs every day. Do people not believe in God? Would they not leave to God the question of the soul and the ensoulment, whether it is at three days, 169 days or whatever? God is well able to look after a soul, wherever it comes from and wherever it is going to, and it is an impertinence for us to cause fellow human beings to suffer because of our self-righteousness. It is too bad if that is not respectful enough.

Like most, if not all, Members of the House, I am pro-life. I do not want to vote for legislation that introduces abortion on demand or liberalises or may open the floodgates on abortion in Ireland.

I carefully followed the extensive debate that has taken place since the beginning of the year on this matter and during this process, new information came to light about the termination of pregnancy practices in the country. In January last, at the committee hearings, we learned that terminations of pregnancies are taking place in Ireland. The Master of the National Maternity Hospital in Holles Street, Dr. Rhona Mahony, estimated that between ten and 20 terminations of pregnancy take place every year to save the lives of mothers. Her counterpart in the Rotunda Hospital, Dr. Sam Coulter-Smith, estimated that the figure was between 20 and 30 each year. It is clear that we do not know how many terminations of pregnancy took place in Ireland last year. Neither do we know what procedures were followed to ensure that these terminations were lawful, that they were necessary to save the life of the mother. The identities of the medical professionals who certify that a termination of pregnancy is necessary are not being recorded.

We have also learned that six children who were in State care were assisted in travelling abroad for terminations since 1992. In each of the six cases, a psychiatrist was involved in providing an assessment of the child. We do not know whether this is the same psychiatrist on each occasion. Neither have we any information on whether the unborn baby was viable outside the womb when the termination of pregnancy took place.

It is now clear to me that there is a legal vacuum surrounding our termination of pregnancy laws. As matters stand, there is no clarity around the issue of terminations of pregnancy in Ireland. This means that, according to the Constitution, as interpreted by the Supreme Court, a termination of pregnancy can be performed by any doctor anywhere in Ireland at any gestational stage if he or she believes that suicidal risk can only be averted by a termination of pregnancy. It is now clear that the provision of terminations of pregnancy in Ireland since the X case judgment has evolved in such a way that we do not know how many terminations have been carried out since the X case judgment; we do not have accurate figures on the number of terminations that were performed in Ireland last year; we do not know whether one hospital is responsible for a disproportionate number of these procedures or whether a small number of doctors carry out a disproportional number of terminations; and, we do not know whether the uncertainty over the terminations laws is being abused.

The Protection of Life During Pregnancy Bill changes this. There will be legal clarity that any terminations of pregnancy are only carried out where the risk to the woman's life has been fully assessed and certified by specialists as being the only option available to avert that risk. Medical professionals will be provided with clear guidelines detailing where and when a termination of pregnancy can take place to save a woman's life. Information on these rare terminations of pregnancy will become publicly available.

Pregnant women with suicidal ideation will only be entitled to an abortion if, after being assessed by two psychiatrists and an obstetrician, it is considered to be the only measure that can save the life of the woman. The registration numbers of these medical professionals will be recorded.

In the rare cases where this Bill will apply, the equal right to life of the unborn is upheld. A woman does have a right to have a termination of pregnancy if the unborn child is viable outside the womb. Importantly, this results in the delivery of a baby, not in an abortion.

If it becomes apparent that unusual practice is taking place, the Minister will be aware, through monthly reporting, that this is happening and can suspend that service. If the same doctors are certifying cases all over the country, that will become apparent also and can be dealt with. If this law is abused, the Minister for Health has the power to suspend an abortion service and Deputy Reilly has assured me and the House that he will not hesitate to act in such an instance.

I am satisfied that the Protection of Life During Pregnancy Bill 2013 does not confer any new substantive rights to a termination of pregnancy. This legislation is about saving lives - the life of the mother and, wherever possible, her child.

I note that many Members of the House have strong views on this Bill. Some are totally opposed to it; others feel that it does not go far enough. I respect the Members' views. For my part, I firmly believe that this Bill is very restrictive, more restrictive than the position which exists currently. I am aware that some Members of this House will disagree with me but I hope that they will respect my views, as I respect theirs, despite our differences. I hope the debate in this House will be a useful and constructive one and will be carried out in a dignified and respectful fashion at all times. I commend the Bill to the House.

Cuirim fáilte roimh an Aire go dtí an Seanad inniu freisin.

I expect that virtually everything that could be said has been said on this exceptional piece of legislation. There has been widespread debate on this and one could see the manner in which people became energised in this debate. It also attracted considerable media coverage and each person can decide whether that coverage was impartial. There were many questions raised during the debate. Some were answered, some were fudged and some were merely ignored.

In a way, we must keep reminding ourselves, even though certain comments are made about the church and religion and persons being sanctimonious, etc., that what we are really talking about here is the human right to life. That is the basis of the discussion.

We have learned certain things during the debate. First, it is widely acknowledged that Ireland has the safest medical environment for an expectant mother. Second, treatment is not withheld where the life of the mother is in danger even if it does necessitate the loss of life of the unborn child. Third, we learned, as the debate went on, that Europe did not require or demand that we introduce this type of legislation, simply clarification. In so far as possible, certain sections of the Bill, clarification is forthcoming and that must be welcomed.

The Minister, rightly, mentioned that "conscientious objection is a human right". Nobody could disagree with his comment but many people were surprised that conscientious objection did not extend to Members of the Oireachtas and that the Whip was ruthlessly used against people who wanted to express their own view. Early in the debate we were told to leave personal opinions aside and even went as far as telling us to leave our conscience outside the gates of Leinster House. The second part was gradually watered down because it made no sense. How could anyone think that we would come in here like vegetables and not, in some way, be influenced by our opinions and not wish to make a contribution based on our outlook and experience - the idea that people who wanted a free vote on something so fundamental to them was denied. Even worse, for the first time that I can remember in the history of the State, not only did they face immediate excommunication from the party, they were told that their careers would also end. The wording used was that they would not be allowed to go forward under a particular party colour in the future. I can never recall that measure being taken before.

We must accept that there was a degree of intimidation and coercion that was unhelpful. As so many people have said over many months, this issue is sensitive and complex. We called for respect and tolerance but not much was shown for the views of those people. Being told that champagne corks will pop when the legislation is passed does not help the situation either. Today, we are speaking about human rights for all people, irrespective. We do not make a distinction regarding human rights even though the legislation will make a distinction. I remind Members that Bunreacht na hÉireann does not make a distinction. If champagne corks will pop then we should remind ourselves that, in this case, many an unborn child will never celebrate a first birthday. They will never hear champagne corks pop at a graduation ceremony or marriage. If we do not say that then we will have ignored the fact that we are speaking about two lives here.

There is one name that will be enshrined in the minds and hearts of people for many years to come, Savita. It is the tragic case of a young woman who lost her life, lost her potential and devastated a husband. Again, one can see the compassion of the Irish people and the manner in which they responded to the terrible tragedy. It is regrettable that some people used a terrible tragedy to promote a particular agenda, even before an investigation was held. Even when the findings came forward and it was quite clear in the findings that there was a failure of systems in the hospital we were able to forget that fact. I think it was wrong to invoke such a tragedy to promote any agenda whatever that may be.

I wish to comment on the use of language during the debate. Commentators wrote that people who would stand up to express their genuinely held views on the legislation but oppose it were in some way not "progressive". That is the word they used. That begs the question. What is meant by "progressive"? I can only speak from my point of view and I have seen nothing progressive in targeting, unnecessarily, the life of an unborn child. I do not want to go into history but I have read the 1916 Proclamation and even back then we talked about "cherishing all the children of the nation equally." We are not cherishing all the children equally, particularly in regard to the suicidal ideation clause that most people have focused on.

I attended the Oireachtas hearings. I was also anxious to inform myself and there were certain questions that I needed to have answered. I was particularly interested in the evidence given by the psychiatrists during the hearings. If those hearings were meant to be meaningful and the intent was to inform ourselves and Government policy, the psychiatrists were quite clear that abortion is not a treatment for suicidal ideation. If I read it correctly then we are asking medical practitioners to involve themselves in a procedure that is not evidenced-based. If we are prepared to throw the evidence-based concept out of the window when it comes to medical practice then we know full well that the move will come back to haunt us in future debates and discussions.

All people are entitled to express their views. I was disappointed during debates here on the abortion issue that people were prepared to bring another agenda to bear, to have a swipe at the church and to tell the bishops not to get involved. That is not democracy. They, too, have an organised grouping and are quite entitled to bring forward their views. I think people here just wanted to create confusion. It is undemocratic to suggest that the churches and bishops are not entitled to their view. I have seen efforts being made at the pro-life rally of 50,000 people to try, in some way, to diminish the numbers and demonise their intent. I do not think that is necessary. It does not matter if there is 1 million people or ten people because they went to the trouble of expressing themselves in a peaceful manner. I have a question for those of us who have received letters and communications. Do we resent getting letters? Do we resent people communicating with us? We would not do so on economic issues, on housing or on roads. Are we suggesting that people cannot communicate with us or do we demonise that communication? Many of the communications that I received were well thought out and not just two or three sentences. The communications came from professionals, psychiatrists, psychologists, doctors, teachers and the general public. I was glad to receive them, read them and tried to integrate their comments into my thinking.

I have never in any debate here made a personal comment and never attributed anything to people other than that they were entitled to put their views on the record. I hope that is the way the debate will finish. However, I cannot support the Bill because I do not accept that the suicidal ideation clause should be included. The clause is unnecessary and could have been handled in a different way. We will all have an opportunity to vote. At least, we have a democracy where we can express our views for or against and long may that continue.

I welcome the Minister to the House for what is an important debate. Like every other Member of this House, I am well aware of the responsibility on me, as a legislator, to think long and hard on matters of deep concern to the people. This Bill concerns a very sensitive matter, as Senator Labhrás Ó Murchú pointed out, namely, the termination of a pregnancy. Like other Members, I have been canvassed by those who oppose the Bill and by those who favour it and I would say to Senator Ó Murchú that much of the correspondence has been measured but a lot of it has not been and some of it has been downright abusive.

In addition to listening to the views of those who have canvassed us, I was fortunate enough to attend the hearings of the Oireachtas Joint Committee on Health and Children and was privileged to hear the views of the various professionals working in the fields of obstetrics, gynaecology, psychiatry and medical ethics. Having listened to all of those views, I believe the crux of the matter before us is not the liberalisation of abortion law in Ireland but the protection of a pregnant woman's life and we need to stick to the point.

I was quite interested in Senator David Norris's illustration of the different positions which have been taken by the churches over the years. He is correct that at one point in time, it was said the soul did not enter the body until a particular point in the gestation but, ironically, the soul entered the male body earlier than the female body. Female children did not acquire souls until after they were born.

I do not have to go back as far as 1916 as I was brought to see "The Shoes of the Fisherman" for my confirmation - a gruesome occasion - in which a Pope Francis-type, a plain man, walking the streets of Rome was thrust into greatness as pope. He had one sister who was giving birth and, as pope, he was forced to choose between saving the life of the mother or the child. As pope, he was consulted on this and he determined in great angst, of course, because it was cinema, that he must save the life of the child because it has not yet been baptised. He chooses the life of the unborn child over the life of his own sister. As an impressionable 12 year old, it left an indelible mark on me and, dare I say as a practising Catholic, a deep suspicion sometimes of the church's teaching in regard to the equal rights of women.

To get back to the topic, 70,000 women give birth every year in Ireland and, fortunately, for the vast majority of them, it is a good experience with a healthy outcome for both the mother and the child. However, as we are aware and as has been made abundantly clear, there has been a lacuna in the law for many years. The position of a pregnant woman who experiences a risk to her life is not certain. It is a matter of grave concern not only to the woman but to her partner, mother, father, sisters, brothers, friends and to a great many people. Evidence of that concern was very clear around the Savita Halappanavar case. If there was that level of certainty in Ireland about the treatment of a pregnant woman, we would not have seen the national outcry we saw over the Savita Halappanavar case.

There should never be a doubt in regard to a pregnant woman and she should receive every assistance to protect her life, including the termination of her pregnancy. Indeed, I would go further and say that if there is a significant threat to her health, it should be treated in the same manner. However, I accept that is not the matter before us and we are not dealing with that.

This Bill puts it beyond doubt that the medical profession is empowered to do what is necessary to protect a pregnant woman's life in the event of a serious threat. It gives certainty to those treating a pregnant woman that the law will protect them if they act in the best interests of a woman. It was clear during the committee hearings that the medical professionals sought that clarity.

We all know, as Ireland is a small country, that some hospitals are preferred by women over others because they believe their lives will be protected to a greater extent in those hospitals. I am well aware, as are other women, of the fact that some women have instructed their husbands, if they are being taken by ambulance, to bypass particular hospitals. That is the reality but this should not be the case. All women should know that, irrespective of where they live, their lives are just as important and will be protected. The days when a woman was considered as a mere vessel should be well behind us and this legislation will go a long way to making that so.

I was very struck during the committee hearings by the views expressed by many members of medical profession that there should be no difference between the threat to the life of a pregnant woman arising from medical reasons or from mental health reasons. It is very clear that the people increasingly recognise the seriousness of mental health difficulties and the increasing rise in the number committing suicide as a result. We should remember that it is 21 years since the Supreme Court decision in the X case, which recognised that the threat of suicide was a threat to a pregnant girl's life. No matter how much those who would like to pretend that was not the decision and who would prefer it did not stand, it still stands. I, for one, have confidence in the psychiatric profession to put the best interests of their clients first and to consider all available outcomes for their clients, as they are required to do under the proposed legislation. Whether termination is ever a solution is not a matter for this House but for those charged with protecting the life of the pregnant woman or, indeed, a pregnant child.

I believe pregnancy can lead to suicide. It is not that long ago since this House discussed reports setting out child abuse in this country, including abuse within families - rape and incest - abuse within institutions and abuse within the church. It is not a proud record. I have no doubt that many of those who were abused and who subsequently became pregnant may well have ended their lives. In 1983, we passed the constitutional amendment prohibiting abortion but in 1984, a 15 year old girl, Ann Lovett, died giving birth underneath a grotto. Can we doubt that there were pregnant abused children in this country who chose to jump into a river or take some other way out? I have no doubt that has happened.

I am aware there are concerns regarding the time limits on termination in the case of suicidal intention but I, like Senator Ivana Bacik, was reassured by experts, such as Dr. Rhona Mahony, master of National Maternity Hospital, regarding medical practice in these situations. It is set out very clearly in the legislation that the life of the unborn child must be protected. It is also clear that the right of a woman to have her life protected is not time limited in respect of either a medical threat or a mental health threat, nor should it be.

It is worth remembering that in excess of 4,000 women with Irish addresses travelled to England and Wales last year for a termination of pregnancy. We do not know enough about these women and their reasons for seeking a termination. I was surprised, for example, by the number of women over 40 years of age who sought terminations. I have no doubt that if we knew more about their reasons for seeking terminations, it would not be a surprise that many of those terminations were sought on the grounds of health. I fear this legislation will not change that situation and women will continue to vote with their feet. However, what is important about this legislation is that women who find themselves too ill to travel or children in the care of the State will have their needs better protected than currently. That we continue to ignore the needs of women who must leave this country for a termination and have done so over many decades is a disgrace and one that will continue for the foreseeable future.

This legislation is measured, as many other speakers have pointed out. Indeed, the Leader has gone further and suggested that far from permitting the opening of the floodgates, it will limit those seeking terminations. It will give reassurance to women in Ireland that medical professionals can put their best interests first. I regret, as many other speakers have said, that this legislation does not go further. We have failed Irish women, in particular in the area of fatal foetal abnormalities. However, that is a matter for another day.

The serious threat to a woman's health leaves her in a position where she is not equal to an Irish man. An Irish man can have his medical issues addressed without fear but a woman cannot have her medical issues addressed if she is pregnant and where is an issue in regard to her health.

It is worth bearing in mind when looking at the Bill that it will change nothing. It goes back to what the Minister said very eloquently at the beginning of his speech. Since 1983, when we introduced a prohibition on abortion, well over 120,000 Irish women have travelled for a termination. We have gone nowhere towards addressing the real issue in Ireland, which is that the country is ignoring the needs of a very substantial number of Irish women. It is not for today or tomorrow and may perhaps be a matter for a future Government but, ultimately, we will have to address this issue by way of a further constitutional referendum.

Every year, 4,000 to 5,000 Irish women go to England or other European countries for abortions. Those are the ones we know about as they provide their names and addresses. They are single, married and divorced women. They are of all ages and come from all parts of the country. They go for 4,000 to 5,000 individual human reasons. Over the last 30 years, at least 120,000 to 150,000 women have left the island to have abortions. I have a very simple question about this. If the facility to have an abortion in England or elsewhere had not been available off the island, how many of the 120,000 women would have been in the nearest river? Answer that very relevant question. Such abortion facilities save women's lives and have over the last 20 to 30 years saved many women's lives and prevented suicide. If one believes their lives are about their mental, emotional and physical health, such facilities may have saved their lives. Without the availability of medical abortions off the island, the consequences over the last 20 to 30 years might have been catastrophic for some women.

If, as many claim, women are devastated for life after an abortion, where are the 150,000 mentally unstable, devastated women hiding? Certainly, they are silent because of the profound privacy of their actions. Over 18 years of age, their actions are nobody's business but the business of the individual women and their partners. Certainly, it is not the business of the Catholic hierarchy, the less about which I say the better. In all the years I have lived and worked on the island, I have never met a woman who has had an abortion without understanding the enormity of the mental anguish of the decision, the enormity of the emotional excavation of the decision, the personal human loss, the private human need, the intimate human fear, the mortal human terror, the fragile human tragedy, the subjective human relief and the universal and personal nature of her individual subjective reasons for her decision and action. Never have pornographic terms and tired, medieval clichés such as "opened floodgates", "free-for-alls", "abortion on demand" or "culture of murder" entered their heads. It is the language of righteous extremism masquerading as reason.

There has been talk around the House about conscience. There have been speeches about conscience and sleepless nights about conscience. We hear about being ruled by one's conscience and counselled well by one's conscience. The suggestion is that as a major supporter of the Bill, I am not being counselled by my own conscience and am being ruled by something opposite. If so, I would like to know what it is. I will tell the House simply what I am ruled by. If abortion was not available for the 4,000 to 5,000 women who have travelled outside the jurisdiction for abortions they wanted or needed for whatever reason, including rape, incest and fatal foetal abnormality, and for the women who will continue to travel for abortions outside the restrictions in the Bill, my conscience tells me that many of them would be in regional rivers. If one of them ended up in one such river, the legislation is correct and we should pass it without a second thought. While I do not think it goes far enough, that argument is for another day.

I welcome the legislation and congratulate the Government for bringing it to this point. The Minister and Minister for State at the Department of Health, Deputies James Reilly and Alex White, the Taoiseach and members of the Joint Committee on Health and Children, chaired by Deputy Buttimer, have done an enormous amount of work. The information that was provided to all of us following the Oireachtas hearings has been a valuable reference.

The decision of the European Court of Human Rights of December 2010 referred to the uncertainty generated by the lack of legislative implementation of Article 40.3.3o and, more particularly, the lack of effective and accessible procedures to establish the right to an abortion. The court found that the failure by the State to implement Article 40.3.3o constituted a failure to respect Ms C's right to her private life and a violation of Article 8 of the European Convention on Human Rights. The court also found that the lack of an effective procedure to effectively determine her right to a lawful abortion in Ireland caused her considerable anxiety and suffering. She feared her life was threatened by her pregnancy and an uncertain legal situation. Article 46 of the convention sets out the duty of the State to abide by the judgment of the court. As we know, the implementation of the judgment is now being monitored by the Committee of Ministers of the Council of Europe, to which the Government is reporting on a regular basis.

The programme for Government committed to establishing an expert group which published in November 2012 a report considering the implications of the State's obligations on foot of the judgment of the European Court of Human Rights. The expert group stated clearly that, arising from the judgment, Ireland is under a legal obligation to put in place and implement a legislative or regulatory regime providing for effective and accessible procedures whereby pregnant women can establish whether they are entitled to a lawful abortion in accordance with Article 40.3.3o, as interpreted by the Supreme Court. The expert group's report sets out clearly the options open to the Government, with legislation constituting its strongest recommendation. The expert group indicated that guidelines would not have binding force and would not, therefore, satisfy the Committee of Ministers of the Council of Europe or the requirements of the European Court of Human Rights. Guidelines are non-binding and do not have the force of law. Measures which affect human rights in a democracy must have a secure legal basis. At the hearings of the Joint Committee on Health and Children, Mr. Frank Callanan, SC, supported that view. He referred to Tysic v. Poland, a 2007 ECHR case in which attempts to regulate abortion rights through medical regulation and guidelines failed. Ms Justice Catherine McGuinness agreed at the joint committee hearings that the State should legislate for the X case to satisfy the European Court of Human Rights judgment.

Bishops have written to all Members and in Cork letters have been sent from bishops stating guidelines would be sufficient. Have they read the report of the expert group? Have they seen the legal evidence and submissions clearly stating guidelines would be insufficient? The Government would be careless and not be abiding by its duties if it tried to opt out and went down the route of guidelines which would not satisfy the European Court of Human Rights which has already stated this in another case. We would be back before it if we were to rely totally on guidelines.

In his submission to the Oireachtas hearings Mr. Frank Callanan, senior counsel, also referred to the Supreme Court's judgment in the X case and outlined how it had been affirmed in subsequent cases. He made the point that this established beyond question the status of the X case judgment as a constitutional precedent. Whether one agrees with the Supreme Court's judgment, it is lawful. It is a judgment of the courts and we cannot cherry-pick the decisions we like. We are obliged to abide by them and the Supreme Court has clearly stated abortion is lawful where a woman's life is at risk and that includes a risk of suicide. The proposal for which we are now legislating will be more restrictive than what is in place, as the Taoiseach said. The legislation will mean that this will be a safer place for women and their unborn babies. We have clear guidelines on how the mother's life can be saved if and when an unfortunate situation arises. If the life of the mother is at risk, there will be more than one medical consultant to support her. As the Minister outlined,there will be a register of terminations, indicating why they took place and the circumstances involved. The report will be sent to the Minister and laid before the Oireachtas.

There is no doubt that the risk of suicide, provided for in section 9, has dominated the debate and there are differing views on it. That points to the need to legislate, provide leadership, certainty and clarity. Dr. Anthony McCarthy, president of the College of Psychiatrists of Ireland, said suicide in pregnancy was a real risk. He outlined how the role of psychiatrists was not to predict but to assess the patient's mental state, mental health and the risk of killing herself. There are uncertainties in this area, but there are also well understood clinical markers and symptoms that are regularly used. A range of submissions were made to the Oireachtas committee, most of which showed that one could not predict suicide, but one could manage the risk and help the patient and ensure she was in a safe place. There is a small but real possibility of suicide in pregnancy and that is what we are dealing with and legislating for.

We must treat women with respect. I regularly hear people in this debate casting aspersions on the issue of suicide. We must trust women and the medical professionals. That is what the legislation is about. Abortion is not a reasonable treatment for suicidal ideation. No one said it was and it is a misleading statement to suggest it is. The question is not whether abortion treats suicidal ideation but whether there is ever a case where a woman can kill herself because of an unwanted pregnancy and, if so, what can be done to save her life and whether that could mean having a termination. A small number of very real cases have been cited.

I was amused when the Dáil passed the legislation and a cartoon by Martin Turner appeared in The Irish Times on Thursday, 11 July 2013. In the cartoon the phrase spoken by Neil Armstrong when he set foot on the moon was used: last week was one very small step for mankind in Leinster House but it was the same story for the 4,000 women who must make the round trip to the UK every year. Coincidentally, in my office I have a Martin Turner postcard dating from 1992. It captured the moment, suggesting 17 February 1992 marked the introduction of internment in Ireland for 14 year old girls. Nothing is really changing for the 4,000 women who will travel from Ireland to the United Kingdom every year. Dr. Anthony McCarthy agreed with that point in an interview on radio last week. He said women would not be coming to him and envisaged that those who were fortunate enough to do so would continue to take the route to England.

I am not pro-choice and I am certainly not pro-life in the way the term has been abused. I do not want to associate myself with the term. I support life and protecting life, but I am a legislator, a realist and a pragmatist. Article 40.3.3° has led us to this situation and we need to act to ensure the uncertainty, which is unsatisfactory and unfair to pregnant women and medical professionals, is righted.

Like all Members, I find this issue very difficult to handle. I am the fortunate father of five children and the fortunate grandfather of 16 children. I look at this from the point of view of born and unborn children rather than from the other point of view. I welcome the opportunity to contribute to the debate on the Bill. Like others, I am concerned that its wording is so open to differing interpretation that it will open the door to much more widespread access to abortion. That is of concern to me. I apologise for not having welcomed the Minister of State. Like others, I am concerned about the inclusion of the threat of suicide as a means to have an abortion. It is not what can be termed the correct treatment for a person who may be considered suicidal. If someone justifies abortion on the basis that if she is not allowed to have an abortion, she will commit suicide, it leaves the door open. I would hate to think something for which we had legislated would open the door to automatic abortion on that basis.

Other Oireachtas Members have mentioned how medical professionals are split on the issue. The position needs to be reiterated. It is regrettable that political parties are coercing their members to vote in a certain way such that they face serious consequences if they vote with their conscience. Is it right that someone has to choose between a profession and his or her conscience? It is not a good advertisement for our system and it is an anti-democratic move.

It is interesting to look at what is happening in Italy which is similarly known as a Catholic country. I am not looking at it from that point of view, but, as RTE recently reported, Italy has had a relatively liberal abortion regime since 1978. A specific law permits medical personnel to refuse to carry out abortions on conscientious grounds. The report highlighted that the number of medical personnel doing so had risen dramatically, with one MP saying the number of doctors and gynaecologists objecting had reached nearly 80% across Italy. Even though Italy permits abortion, there is a growing trend towards anti-abortion views. One of the foremost objectors is a man called Dr. Romano Forleo. He is Italy's most eminent gynaecologist and a former Senator and has been practising obstetrics since the early 1960s. He has never performed an abortion and says some people believe the embryo, especially at the beginning, is not a person but he believes it is.

I have listened to the debate on this issue today and before our grandchildren were born, we were able to see a photograph of each of them inside the womb. In my mind, what horrifies is the thought of someone killing that child. I am arguing from the point of the unborn. Most of those who have spoken today and who spoke the other day have spoken and spoke about it from the point of view of the mother-to-be.

However, I would like to concentrate on the unborn child. It is worth heeding this, as this Bill provides for conscientious objections by "any medical practitioner, nurse or midwife" only. It excludes others who may be obliged to co-operate in providing services related to abortion against their conscience or religion. If one objects, he or she is obliged to hand over the operation to someone else. That means medical personnel are complicit in an abortion whether they like it or not. If we are to introduce legislation, we should give them a real choice where they could be compelled to do something against their conscience. Currently, they are not given an alternative, which infringes on the pledge to preserve life.

There is also support in Italy to include more financial support to encourage women to go through the pregnancies rather than to seek termination and this would be worthwhile examining in the wider context of abortion. I cannot support the Bill, as presented, because its construction leaves a lot to be desired and it does not do enough to consider all lives equal during pregnancy and may well create a system where abortion becomes a norm. That is the concern I have.

Senator Healy Eames said she intends to table a reasoned amendment later today or tomorrow. I am pleased to support to it. I gather she will move it but I cannot, although I can second it. I gather I cannot second it until she has moved it. The use of a reasoned amendment is an unusual procedure but it is amply justified by the unusual nature of the legislation and gravity of the consequences if passed. The amendment invites us to reject the principle on which the Bill is based, which is where a woman is suicidal during pregnancy, it is appropriate to offer an abortion as a form of treatment to remove her suicidality. If we pass the amendment, it will impose on the Lower House and the Government a 90-day period of reflection. That would be useful given the deep flaws in the Bill and the unseemly haste with which Report Stage was conducted in the Lower House. Such a period of reflection can only be beneficial. The amendment lays out the reasons the Seanad - a reasonable, thoughtful and responsible part of our Legislature - should decline to give the Bill a Second Reading. I understand I cannot second the amendment until Senator Healy Eames moves it.

That is correct.

I assume someone else will second it. Is it possible for me to move the amendment now and for her to second it?

The Senator would need Senator Healy Eames's permission.

I have just received permission. On that basis, I will move the amendment on the assumption that she will second it. If I am not allowed to do that, she will have to get somebody else to second it when she moves it.

The amendment recognises the inadequacy of the Government's argument that a judgment applied to the particular circumstances of the X case should be applied generally regardless of the consequences and it recognises that the Oireachtas is free and has the responsibility to decide for itself on the basis of evidence duly considered whether and how to legislate on any given issue. It recognises that the European Court of Human Rights "does not oblige Ireland, as a matter of either Irish or international law, to make lawful, or to maintain as lawful, a right to abortion on grounds of suicidality". It spells out specific dangers that attend any attempt to create a statutory framework for the provision of abortion as a means of suicide prevention. These include the absence of evidence that abortion has any positive effect on women's mental health or that it has any positive effect in preventing suicide; the absence of evidence to suggest that abortion may have a negative effect on women’s mental health and is associated with an increased risk of suicide; and the clear and prudent public policy reasons for not making suicide the means by which additional rights or services may be acquired or accessed or by which the rights of others may be infringed.

It is quite involved in this case but the amendment recognises that the failure of the legislation to respect the equal right to life of the unborn child in accordance with Article 40.3.3° renders it unconstitutional. It enumerates examples of how the Bill fails in this regard. These include the absence of any objective standard of reasonableness or evidence to guide the decision on whether an abortion is to be permitted; the absence of an expressed requirement that all alternatives to abortion be fully explored and exhausted before it is contemplated as a possible means to averting a risk arising from suicide; the absence of a stated term limit to the provision of an abortion on grounds of suicidality - this is a serious issue - or an expressed protection for a viable, unborn life; the absence of any provision for any medical procedure other than one during the course of which or as a result of which unborn life "is ended"; the absence of a provision to allow the unborn child to be represented by an advocate on his or her behalf such as that afforded to the mother. As with any other person who lacks capacity to participate in a consultation process, the best interests of the unborn child should be represented by a person acting on his or her behalf. I have not heard enough about that in this debate nor about the absence of adequate reporting requirements to ensure that the provisions of the Bill are being complied with in practice and to facilitate a proper review of its operation on an ongoing basis.

The amendment also exposes the failure of the Bill to adequately respect the right to conscientious objection for all persons who may be involved in carrying out an abortion. The Bill would provide protection for the rights of conscience that are much weaker than the statements and standards accepted in many other countries, including our nearest neighbour. The legislation represents a backward step in promoting and improving in hospitals the practice of the two-patient model of care during pregnancy, which ultimately best serves the welfare and safety of both women and their unborn children. We have a record of care for both of which we can be rightly proud. We should safeguard and defend this and not undermine it, as this Bill is likely to do. We are fortunate in Ireland that we still have a culture and respect for the humanity and equal right to life of the unborn child, which is under threat throughout the western world. This culture is grounded in the belief that an unborn human being deserves protection because he or she is so dependent, weak and vulnerable not despite the fact that he or she is so dependent, weak and vulnerable.

The legislation sends a message ungrounded in medical reality that the deliberate killing of an unborn child is sometimes acceptable and necessary to provide the best medical care to pregnant women and I have a difficulty with that. Enshrining this misrepresentation in legislation can only undermine the existing culture of respect for unborn life. This is something the House can help to prevent. The eyes of the country are on us as rarely before and we can choose to take a stand that we will not endorse flawed legislation just because the Lower House has done so and the Government desires it or we can pass the amendment and demand responsible and reflective legislation. It is Senator Healy Eames's intention to move the amendment. I will move it if that is in order and she will second it.

Does the Senator have written permission from Senator Healy Eames?

Yes, her signature is on this note.

She should be present to second the amendment.

She plans to second it when her turn comes.

She can second it and reserve her right to speak later.

She plans to speak. I gather she is No. 20 or No. 24. Senator Mary Ann O'Brien is also a seconder.

Will Senator Mary Ann O'Brien second the amendment?

I move amendment No. 1:

To delete all words after ‘‘That’’ and substitute the following:

"‘Seanad Éireann declines to give the Bill a second reading for the following reasons:

(1) The X Case judgment, correctly interpreted, does not create a binding precedent with respect to the application of the criterion for a lawful termination of pregnancy (i.e. the test of ‘real and substantial risk to the life of the mother’) to circumstances in which the risk to the life of the mother is one of suicide. The lawfulness from a constitutional perspective and the appropriateness from a medical and public policy perspective of extending that test to such circumstances was conceded by the parties to that case, was therefore not argued before the Court and, accordingly, formed no part of the ratio of the decision which is binding as a matter of precedent.

(2) Further, and independently of the foregoing, there is no legal obligation upon the Oireachtas, as a matter of Irish law, to enact any legislation dealing with the provision of abortion on grounds of suicidality, not least in circumstances where there are substantial ethical, medical and public policy reasons not to enact such legislation.

(3) The judgment of the European Court of Human Rights in A, B & C v Ireland does not oblige Ireland, as a matter of either Irish or international law, to make lawful, or to maintain as lawful, a right to abortion on grounds of suicidality.

(4) It is dangerous, irresponsible and unjust to legislate for the creation of a specific statutory framework for the provision of abortion as a method of suicide prevention in circumstances where:

(i) there is an absence of evidence that abortion has any positive effect on women’s mental health or that it has any positive effect in preventing suicide;

(ii) there is evidence to suggest that abortion may have a negative effect on women’s mental health and is associated with an increased risk of suicide;

(iii) there are clear public policy reasons for not formally recognising suicidality as a legitimate means by which additional rights or services may be acquired or accessed or by which the rights of others may be abridged or wholly over-ridden.

(5) The Bill is unconstitutional by reason of its endemic failure to respect the equal right to life of the unborn child in accordance with Article 40.3.3. This failure is manifest in several provisions and omissions of the Bill including:

(i) The absence of any objective standard (e.g. reasonableness, evidence-based clinical practice, relevant guidelines etc) by reference to which medical practitioners must form an opinion for the purposes of certifying an abortion in accordance with the Bill. This represents an unwarranted and unexplained departure from the usual standard of care required of clinical decision makers under existing medical ethics and Irish law.

(ii) The absence of any provisions expressly requiring that all alternative courses of action (including non-medical courses of action) are to be fully explored, offered and exhausted before abortion is contemplated as a possible means to averting a risk arising from suicide.

(iii) The absence of an unconditional entitlement on the part of medical practitioners who are asked to make a certification or to review the refusal of a certification to have access to all medical records potentially of relevance to the proper assessment of the risk to the life of the mother.

(iv) The absence of any express term limit to the provision of an abortion on grounds of suicidality.

(v) The absence of any express provisions prohibiting the certification of an abortion under section 9 in respect of a viable unborn life.

(vi) The absence from the Bill of any reference to or provision for any medical procedure other than one during the course of which or as a result of which

unborn life ‘‘is ended’’.

(vii) The absence of any provision to allow for the best interests of the unborn child to be represented by an advocate on his or her behalf in a manner similar to that afforded by the Bill to the mother by means of rights of appeal and representation. The unborn child is a legal person with a constitutionally recognised right to life and, it follows, a right to be consulted in an appropriate way before the taking of any decision which may directly affect his or her rights in a material way. As with any other person who lacks capacity to participate in a consultation process, the best interests of the unborn child should be represented by a person acting on his or her behalf for the purposes of any consultative process to which the unborn child is entitled as a matter of constitutional law.

(viii) The absence of adequate reporting requirements to ensure that the provisions of the Bill are being complied with in practice and to facilitate a proper review of its operation on an on-going basis. At a minimum the Bill should require the following particulars to be contained in the relevant reports: (1) the total number of notifications received by Minister/reviews carried out, (2) the clinical grounds for medical procedures carried out pursuant to section 13 certification, (3) the gestational age of the unborn child whose life is to be ended by a certified medical procedure, (4) the actual outcome for the mother and unborn child of every certified medical procedure.

(ix) The absence of any penalty for knowingly making a false or misleading statement in relation to the notification or reporting requirement (such as is found in the Mental Health Act 2001).

(6) The Bill fails to adhere to international precedent with respect to the recognition and protection of the right to conscientious objection for all persons who may be involved in the carrying out of an abortion, including non-medical or ancillary staff and institutions. The Bill equally fails to protect the constitutional and human right of medical and nursing personnel not to be required to assist in arranging for another medical practitioner to carry out an abortion.

(7) The Bill taken as a whole represents a backward step in terms of promoting and improving in Irish hospitals the practice of the two-patient model of care during pregnancy that ultimately best serves the welfare and safety of both women and their unborn children.

(8) There remains in Irish society a culture of respect for the humanity and equal right to life of the unborn child that is largely under threat across the Western developed world. This culture is grounded in the belief that an unborn human being deserves protection precisely because he or she is so dependent, weak and vulnerable and not despite the fact that he or she is so dependent, weak and vulnerable. The Bill taken as a whole sends a message, ungrounded in medical reality, that the deliberate killing of an unborn child is sometimes acceptable and necessary in order to provide the best possible medical care for women in pregnancy. Enshrining this misrepresentation in legislation can only undermine the existing culture of respect for unborn life.".

I second the amendment.

I welcome the Minister of State and congratulate him on the amount of work he has put into ensuring this Bill reached us successfully in the House.

As soon as I walk into this House, I feel I am no longer a private individual speaking from a private perspective. I am a public representative and my personal feelings on a substantive issue, whatever they may be, are irrelevant in this regard. They are irrelevant because this is a constitutional issue. If I were talking about ordinary legislation, my personal opinion would play a very large part in it, but the provisions of the Constitution, as it stands and as adjudicated on by the people, who spoke on this matter on two separate occasions, are not in line with our legislative position. There are only two options available to us; there is not a third. The first is to call for a referendum to bring the Constitution into line with existing law. I would not be in favour of that because we already have had two referendums on this issue. The only other option is to bring the legislative position into line with the Constitution. That is the intention of this Bill. I am here as a public representative, not a private individual. When I walk out the gates of Leinster House I will again be a private person, but when I am acting in the Legislature as a legislator my personal opinions should not enter into it at all. This is my genuinely held conviction and people might disagree with that. People need to allow for the fact that it is a genuinely held view.

The Supreme Court has ruled on the issue. People say its judgment is not binding legally. Whether it is or not should not make much difference because, as a democrat, I do not believe we have to wait to be told or be forced to legislate, by a court or anybody else. As mature democrats in a mature democracy, we need to take responsibility. For the past 21 years, successive Governments have failed to do so. It is past time that we did so.

I do not want to say that the debate thus far has not been comprehensive because it certainly has been. There were up to 24 hours of debate on this matter in the Lower House. Probably the same time is scheduled for a debate in this House. I do not want to say that the debate has been dishonest; it has not been, as people hold genuine positions, but the debate has, in many regards, been selective. For example, I have heard it said time and again that the Supreme Court did not hear medical evidence. It did not because that is not its duty. The court rules on points of law, not on points of fact; that is a very basic distinction. This has been missed in the argument. To say the Supreme Court got it wrong because it did not hear points of fact misses the point fundamentally and is to misunderstand its function.

I am loath to refer to the Savita Halappanavar case. I have heard it said time and again that the cause of her death was medical misadventure. It was not. The verdict in the inquest was medical misadventure but the cause of death was septicaemia. That is a very great distinction also. It was said at the inquest by an expert in this area that if Ms Halappanavar had been allowed to have a termination on the Tuesday, there would have been a good chance that she would be alive today. Despite this, it has been said in this House and many other places that there is no evidence to suggest that abortion is a medical treatment. Of course it is medical treatment. It has been said by an expert that it might have saved the woman's life had she been allowed to have an abortion on the Tuesday as opposed to the Wednesday, when her condition had deteriorated to such a state that she was, unfortunately, beyond help.

There are many other points that require clarity. One goes to the very core of what has been said on suicide, mostly in this Chamber and also outside it. I am a psychiatric nurse and have been practising in the area of acute admissions for 28 years. While I am not an expert on suicide, I have certainly come across it many times in my professional role and as a rapporteur on suicide for the Joint Committee on Health and Children, and, therefore, I have some understanding of it. The way in which suicide has been discussed in this House and in the wider debate shows great disregard for the seriousness of the issue. Suicidal ideation is as much a medical emergency as a heart attack; there is no question about that. To downgrade it by saying people are somehow making up suicidal ideation is scandalous. It annoys me to hear it. Who said, "Abortion is not a treatment for suicide"? Any professional consultant psychiatrist that would say such a thing needs to stop practising immediately. There is no treatment for suicide. If one removes the underlying cause of suicidal ideation, one removes the suicidal ideation, but to say that abortion is not a treatment for suicide is just wrong. I would challenge any consultant psychiatrist to put their name to the statement and make it public. It will not happen. People who keep suggesting that this is the issue are wilfully misunderstanding the position, at least.

The idea that we in Fine Gael and the Labour Party are supporting this legislation only because we are whipped or because we are some kinds of mindless automatons is not correct. I firmly believe this legislation is necessary. It is desperately sensitive and presents dreadful challenges to people. Those who find themselves in need of an abortion do not arrive at that position easily. It is a desperately difficult decision for any woman to make. We need to acknowledge the complexity of the issue. Let us try to get away from the soundbites. There are some lovely sound bites but they are dishonest. If this question were of such fundamental importance to people, what difference would it make if the whip were applied? If one feels so strongly about it, one should vote against the whip. If one hides behind the whip, that is all one is doing. A speaker said this morning that Members are whipped into line on this matter. It is just ungenerous to say such a thing.

I will not say any more. I look forward to discussing the legislation further on Committee Stage. I oppose absolutely and categorically the amendment proposed by Senator Quinn. The idea of excluding suicide has set back by years the progress being made in the reduction of stigma. One wonders whether the job we are doing in trying to reduce the stigma associated with mental illness is such that we are only pretending we are making progress. This debate has exposed the idea held by certain people and groups that suicidal ideation and mental illness are not real and somehow made up. There is a view that those affected can somehow snap out of it and that they can be minded. I have heard it said, "We will mind pregnant women." I have asked on several occasions what exactly it means to be "minding" pregnant woman who are suicidal but I have failed to find an answer. What does it mean? What is the logical outworking of the suggestion? We know, and I know from my from my job, that minding people who are suicidal sometimes requires, unfortunately, the detainment of people involuntarily in psychiatric hospitals. Detaining somebody in a psychiatric hospital involuntarily requires, under section 7 of the Mental Treatment Act, that the patient be suffering from a mental disorder. In the absence of a mental disorder, suicidality on its own is not sufficient reason to detain somebody in a psychiatric hospital. There are two approaches to this. With regard to the treatment pathways that I hear about – I do not know what they are – are we proposing to detain pregnant women who are suicidal in our mental hospitals? We do not have a very good history with regard to that in this country. The way around that, of course, would be to change section 7 of the Mental Treatment Act. I have not heard any proposal to do that. Perhaps another way around it would be to change the very meaning of the English language and contend that pregnancy is, after all, a mental disorder.

I will start by saying something I do not say very often. I genuinely commend the Minister for Health, the Taoiseach, the rest of the Cabinet and the two Government parties on bringing forward this legislation and the way in which they have handled the debates, both inside and outside the Houses. It is a credit to them. I welcome the opportunity to speak on what is an exceptionally important and pressing issue. More important, I want to go further and suggest that this is perhaps one of the most important issues to come before the House since the foundation of the State.

I say this because the denial of the rights and well-being of Irish women sheds an important light on the dysfunctional nature of our State apparatus. I have spoken before in the House about this country's historical disregard for women and the institutionalisation of their secondary status in virtually every area of life. This year alone, we have witnessed debates and discussions in both Houses and among the general population on the shocking and appalling treatment of Irish women by the State. I refer of course to the treatment of women incarcerated in the Magdalen laundries and the women who were brutally violated by undergoing the procedure known as symphysiotomy. Both of these issues are testament to the often subordinate position of women in Irish society, the patriarchal nature of the State's institutional apparatus and the role of oppression, fear and sometimes violence in maintaining political, socioeconomic and cultural control and dominance. There is no doubt that a tremendous amount of time, effort, work and energy has been expended over many decades since the foundation of the State to ensure women were kept in their so-called place.

Many of the harrowing and deeply disturbing issues we are dealing with today are a legacy of a dreadful and shameful past that is coming back to haunt us. The legislation we are discussing today relates to another of those issues. Successive generations of Irish people knew of the existence of the Magdalen laundries. How could they not, given that these facilities were located in almost every city and county? The fear and shame of pregnancy outside of marriage was omnipresent, as was the depiction of women who exhibited certain traits as wild and dangerous and thus in need of surveillance and incarceration. The State consciously and deliberately enshrined in its law and through its actions and inactions an institutional apparatus which embedded within both State and civil society the secondary status of women. It is worth remembering that this process only began in earnest with the foundation of the State in 1922 and reached its zenith with the endorsement of Éamon de Valera's 1937 Constitution. In the aftermath, women were effectively banished from formal participation in decision-making and in the nation's political and public sphere. In some respects, they still are.

Gone were the aspirations of a Republic which would treat both women and men with equality and a sense of justice and fairness. Instead, in the new Republic, women were treated in an infantile manner and brutally punished with loss of freedom and even loss of life for all types of imagined and invented transgressions. The fact that Hannah Sheehy-Skeffington, Mary MacSwiney, Constance Markievicz, Winifred Carney and many others had fought and died for an Ireland where equality and freedom would be at the core of the new Republic was all but obliterated from the political landscape. The fundamental fact that successive generations of Irish women had by their labour, both paid and unpaid, produced and reproduced key elements of the Irish nation state, namely, the family, a particular Irish way of life, cultural continuity, societal conformity and economic survival, was also airbrushed out of the collective psyche by a conservative male political elite. The truth is that without the work of women in the public and domestic spheres, the State would never have come into being. Irish women were and are actively engaged in a process of nation-building. The story of Irish women and their relationship with the State is in many ways a tragedy characterised by immense human pain and suffering, psychological torture, physical violence, fear and often despair. When we discuss issues to do with women, this is the historical cloth from which contemporary struggles are cut. As much as we may find the connection unsettling, this distorted and one-sided relationship between women and the State continues to shape the lives and futures of all women living in Ireland.

When we come to discuss the Protection of Life During Pregnancy Bill, there is an onus on us as legislators to be cognisant of the major power imbalance that existed at the heart of the relationship between women and the State. I welcome the Bill, particularly the clarity it will finally provide to the medical profession. I am pro-women and, as such, I am greatly encouraged by recent opinion polls which consistently show overwhelming public support for this legislation. For anybody who has engaged with the evolution of this debate from the early 1980s, it is very clear that Irish society has not suddenly experienced some dramatic change of mind. What has happened, in fact, is a slow realisation, brought about in part by the repeated revelations of institutionalised abuse of women and children and the failure of the State to act against such abuse, that compassion and basic humanity are not always qualities associated with key and important areas of Irish life. This softening in the collective psyche of the nation is to be welcomed. It is a sign of maturity and yet another indication that wider society is far ahead of the political establishment on many important social issues. I genuinely believe the people of Ireland are likewise ahead of us on this issue.

Some of those opposed to this legislation have framed their concerns and objections within a discourse which stresses morality and conscience and covertly suggests that those of us who are in favour of it are not troubled by such matters. Nothing could be further from the truth. Let me state very clearly that my party and I are pro-life and it is this very stance which informs our support for the legislation. Furthermore, this is an issue of conscience for us too. As republicans, we are obliged to acknowledge that the State has failed successive generations of women. If we had chosen not to tackle this issue, as we have been instructed by the Supreme Court to do, we would be following in a long line of legislators and institutions which have failed to bring about equality for women in the State. I do not want to be part of the disempowering of women; I want to be part of empowering women and ensuring they have choices, that their health is protected and that when they use our maternity services, they will have every legal protection, as will the people who provide those services. That is what the Bill is about.

This legislation is 20 years overdue. I cannot support any amendment which seeks to delay its enactment by 90 days, 60 days, 30 days, one day or even one minute. We have already waited far too long and it must now be implemented. The Bill reflects the decision of the people in two referenda and decisions by the Supreme Court and the European Court of Human Rights. It is limited and specific in its provisions. It does not legalise abortion on demand, a term I do not like to use. Rather, its main function is to safeguard the lives of women in extreme circumstances and give certainty to the medical profession. The legislation also spells out clearly the right to life of the unborn and the obligations of medical practitioners in that regard. Unfortunately, the Bill does not deal with the issues of fatal foetal abnormalities or pregnancies which occur as a result of incest or rape. They are very difficult issues which must be faced up to by the State. These omissions are regrettable, but I accept that their inclusion would require constitutional change.

I support the Bill as a step forward by the State into the 21st century on this issue. As legislators, we have a duty to deal with societal realities. It is not good enough for us to ignore the fact that for some women, all of these issues are very real and a part of their stories. The X case and the A, B and C case are not just letters of the alphabet. These were real women who found themselves in terrible circumstances and with no protection from the State. We have a duty to do the right thing by the women of Ireland, who are our mothers, sisters, wives, daughters, cousins and friends. We have an obligation to all these women to support the Bill. I respect everybody's opinion, but the talk from people on the opposite side of floodgates opening is an appalling indictment of their view of women in this State, a view which says that women would manipulate the suicide provision or any other issue to obtain an abortion. That view must be challenged.

We have a job to do as legislators and I am proud to do that job in supporting this Bill.

I welcome the Minister of State to the House. As a member of the Oireachtas Joint Committee on Health and Children, I spent six long days in this Chamber listening to the testimony of various expert witnesses. There were various conflicting views among these experts, some arising from their professional capacities and others relating to their personal views. I have the utmost respect for everybody's view but, for me, this debate is about women, specifically pregnant women.

No one knows more about pregnancy than women. I know men play their part, but they do not become pregnant. I hope the female Members of this House support this Bill.

As a woman and mother of a teenager, I support this legislation for the X case. I know it is not always possible to save both mother and baby. We must protect our doctors in the rare event that the mother's life is at risk and a termination is required. The language of suspicion that surrounds suicidal ideation in pregnant women does a disservice to the women of this country. It shames vulnerable women. I commend Senator Gilroy for his speech today. I am aware his background means he knows what he is talking about. What he said was very true and I say "Well done". We must trust our doctors.

Senator Clune mentioned pro-life. I believe we are all pro-life, but I am quite disturbed by the behaviour of the pro-life campaigners, particularly in the past two days when they have asked Senators to reject this Bill in return for their vote to save the Seanad. I am very disturbed by that because we are talking about women's lives. I am a proud member of the Fine Gael Party and commend the Taoiseach and the Minister for Health for bringing forward this legislation. The Bill aims to protect women during pregnancy in the future and to save lives. It is not about killing babies, but about saving women's lives.

I hope we will all support this Bill because it is important legislation. In years to come, I will be proud to have been a member of a party in the Government that brought forward this legislation.

I dislike using a scripted speech, but this matter is too important for ad-libbing and I want to be sure I say exactly what I want to say.

I welcome the Minister to the House and welcome the opportunity to discuss this Bill and give my opinion on it. I have listened to the debate in the Lower House, I have assiduously followed the TV and radio debates and I have studied the various articles in the print media, including statements by medical professionals, psychiatrists, legal people and the churches. I have listened with respect to the views of my fellow Senators on both sides of the argument, have engaged with the community at large and have read most of the correspondence I received. I have drawn my own conclusions and intend to support the Bill.

I believe I can fairly state that on this issue I have what is known in the church as an informed conscience. I say this because there seems to be a suggestion that possession of a conscience is the sole preserve of those opposing the Bill. Conscience is an individual thing and it is up to each adult to do what he perceives to be right. Each person can consult and seek advice, but at the end of the day it is his or her decision. A person with strong conviction can try to persuade another to his point of view and I have no difficulty with that. Politicians know about pressure; it is in our job description. However, there are bounds to the amount of pressure and interference one person or organisation can legitimately exert upon another. Where pressure is continually and systematically exerted on any individual, it ceases to be pressure and becomes bullying. When I was a small boy I was bullied by a certain individual, until one day I hit back. I found out very quickly then the bully was a windbag with no centre to him. I am hitting back now at some of the activities I have witnessed and experienced in this anti-Bill campaign.

Some groups campaigning against this Bill have spent inordinate amounts of money getting their message across to Deputies and Senators. Some of these organisations are reputed to receive their funding from fundamentalist organisations, some of them secret, both in Ireland and abroad, particularly America. It is time that these organisations came out of the closet and declared what they are spending in propagating their fundamentalist views. They should also have to account for the source of their funding, just as we elected representatives are required to do.

Some statements by the Catholic Church in the course of the debate also come very close to bullying. As a Catholic I regret having to say that. It was Jack Lynch who proposed the removal of Article 44 from the Constitution, an article which gave special recognition to the position of the Catholic Church. Some eminent churchmen do not seem to have got that message yet. They have certainly not taken cognisance of it. Veiled threats of excommunication and the like are redolent of a different Ireland, an Ireland we have moved on from and to which we have no intention of returning. This is a republic and there are clear lines of demarcation between church and State. We are not some extreme Jihadist parliament that takes its orders from the clerics. I believe the people have no wish to revert back to the days when the infamous belt of the crozier put politicians in their place. If I had as clear a conscience about the rest of my life as I have about supporting this Bill, I would be on very good terms with myself when I go to meet my maker. I am not going to allow myself to be browbeaten by any group, secular or clerical.

As previous speakers have said, abortion has been legal in Ireland for 21 years, ever since the Supreme Court ruling on the X case. Furthermore, it has been lawful for a mother to have an abortion on the grounds of suicide in all that time. Was this right abused? We heard statistics from the Leader indicating a number of abortions were carried out, but was that right abused? Did the X case judgment open the infamous floodgates? The answer is "No". Why, therefore, should this Bill, which seeks to clarify, limit and restrict the existing right to abortion, usher in an escalation in abortions in the future? It seems logical to me that the opposite should be the case. I have great difficulty in understanding why others fail to see this. Some say that the experience abroad is that legislation for suicide ideation opened the door to abortion on demand. I am not concerned about other countries at this time, but I am sure this cannot and will not happen here. The reason I believe that is that we have a crucial and unique constitutional provision that clearly establishes the right to life of the unborn. Therefore, anything we do legislation-wise here, now or in the future, will be limited by that insertion, which can only be removed if passed by the people in a referendum.

Opponents of the Bill constantly describe the Supreme Court ruling as a "flawed judgment". That is entirely unacceptable and shows scant regard for the whole system of jurisprudence. We cannot pick and choose the legal verdicts we like as if we were choosing from a box of chocolates. The decision was made and the decision holds. The effect of that decision is that abortion is lawful, as was stated by none other than Professor William Binchy in November 2002. Therefore, we have a situation where abortion is lawful whether we like it nd it becomes the duty of the Government to legislate for it. That we have failed to do so is a singular disgrace for the Oireachtas. As renowned jurist, Mr. Justice McCarthy, stated "the failure of the Legislature to enact appropriate legislation is no longer just unfortunate, it is inexcusable".

There are still those who say we need do nothing and that some vague medical clarification will answer. They are wrong. Many of this Bill's strongest opponents were saying the very opposite in 2002. They were saying then that the current situation was extremely liberal and open to abuse. The record will show this clearly. That was when their strategy was for yet another referendum, but I believe not even the most extreme opponent of this Bill would want another referendum now, because they know the view of the people and know it well. Any new referendum would be resoundingly defeated and would probably be swiftly followed by a demand for a much wider and more liberal availability of abortion. That is why I detect a lack of enthusiasm and more than a little disingenuousness in those who have rather feebly put forward the referendum option again. It is a diversion and nothing more than a device to defeat the Bill.

I also believe the public would be outraged if we opted for referendum rather than legislation.

They would see it as a cop-out, as it would be, and their opinion of politics would sink even lower than it is. We, therefore, have a duty to act.

I do not say this is the best possible Bill. For example, it does not make any reference to the situation where a non-viable foetus must be delivered full-term by a mother, only to die immediately after birth. There are many who say the Bill is too restrictive, that it will probably prevent further debate on this issue for decades or even generations to come. A more suitable title might have been the "restriction of abortion Bill". In my view, however, it is the best possible Bill the Government could hope to accomplish in the current circumstances. It is the only possible Bill that could have gone through the Lower House and, I hope, could go through this House. For that reason I support it.

My party leader, Deputy Micheál Martin, whose opinion on this subject I share and support, decided to allow a free vote in the Fianna Fáil Party for the first time in our history. We are divided on the issue - very evenly divided; therefore, applying the Whip was simply not an option. Each of us must decide individually, without having any place to hide, which is probably good. I know that I am in a small minority among my fellow Fianna Fáil Seanad colleagues, which is a matter of real regret to me, as I have high regard for each and every one of them. However, I take no small amount of comfort and solace from the fact that I am standing in the company of our only two women Oireachtas Members, Senators Averil Power and Mary M. White. Ultimately, this has to do with women. It has to do with their bodies, pregnancies, health and lives. We talk about gender equality, but I am afraid there still is a cohort of men who privately believe women's place is in the home. They will not come out and say so publicly, however. There is something very unsettling about a group of male politicians presiding with great certainty on matters which are fundamental to the health and dignity of a woman and which concern her, first and foremost.

I do not wish to exaggerate the importance of the debate, but it is one that will define our time here. For me, it ultimately boils down to one central core issue - the kind of Ireland in which I believe. I claim to be a republican and I am proud to be following in the great traditions of Tone and Davis and the men and women of 1916. I believe in a progressive, pluralist Ireland which accommodates all religious opinions and their expression, which maintains equal rights for all citizens, men and women alike, and which treats everyone in difficulty with love and compassion. In a different debate at a different time Des O'Malley memorably stated he was standing by the Republic. At the time, the issue was the right of people to avail of artificial contraception - just imagine that - and Mr. O'Malley was expelled from Fianna Fáil for the stand he took, but, thankfully, he was able to continue to contribute to public life in a different party. Ireland has moved on a lot since, as has Fianna Fáil. For that reason, I do not anticipate any political difficulty when I reprise Mr. O'Malley's call to the Republic and say I will vote for the Bill.

Abortion is against the spirit of the people. However, as the life of the child is contingent on the life of the mother, where the life of the mother is at risk, it is necessary to protect and vindicate that life, bearing in mind, of course, the equal right to life of the unborn and, as far as possible, to protect and vindicate that life. That is the clear position I hold. The assessment of risk in this regard is one of measurement, not arithmetic. As no two people will ever measure in exactly the same way, there will be differences in this regard. However, on the medical risk to the life of the mother, there seems to be general agreement that any intervention necessary to save her life should be provided for. Recently on "Morning Ireland" I heard a spokesman say that in most situations this could be done by early delivery. What she was really saying was that in some cases it could not be done. The reality is that there is no difference in principle between the pro-life position, as it is called, and the Government's position on this matter, regardless of the rhetoric used at times to occlude this fact. The principle is established on medical risk and the positions are identical, in spite of the efforts of some to use language to cloud this fact. Let us be clear - all medical interventions necessary include a fortiori or, by logical extension, are covered by the word "all" or, if one likes, "any".

A third force recently entered the debate. It was realised quickly by some that the new position adopted was very similar to that of the Government. That third force which had as its core principle that a possibility did not equal a certainty referred back to a previously held position. This argument entered the debate probably about six weeks ago. It is the more traditional position of non-intervention at any significant level to save the life of the mother, a position that I believe could lead to the death of mothers. Personally, I reject this argument as being extreme. There are no absolutes in this world. I reiterate that the most significant fact about this debate concerns the movement of traditional opponents of intervention towards a more nuanced position. History will show this to be the case. "Where intervention is necessary" in regard to medical risk is now the default line.

I refer to the suicide issue. A very high ranking ambassador stated in Drogheda last week that the issue of suicide would lead to the establishment of a principle. It does not establish any principle, rather it is an extension of a principle already established, but it will now have legal certainty in regard to medical risk. It is a philosophically bogus argument to suggest this is establishing a principle. One can disagree with it - it is reasonable to disagree with the extension of a principle - but it is false, logically, to suggest it is establishing a principle. The Supreme Court, in its judgment in the X case, has ruled that where there is a risk of suicide, an intervention can take place. Regardless of the fact that those on the right and on the left came together in one of them, in two subsequent referendums the people rejected the opportunity to remove the suicide clause. The judges in the Supreme Court stated it would be impossible to exclude suicide. The Government must now give legislative effect to that constitutional provision.

Some people have said guidelines would be better but we are legislators and we would be failing in our duty not to legislate. Guidelines are for tins of peas, not for parliament. The risk of suicide is more difficult to measure than medical risk, the process is more rigorous, with three doctors, including two psychiatrists, involved. It is important to note that it is not the threat of suicide that is being measured but rather the risk, clinically assessed. I get the impression that it is not the suicide risk being allowed for in legislation per se that is causing major problems but rather that it will open the floodgates to a much more liberal position in this matter. The legislation, however, is tight. The fact that the legislation is based on the risk to the life, as opposed to the health, of the mother means that comparisons with other jurisdictions are not particularly valid. I realise that there are many who would like to see this legislation go further and even some who may see it as a first step. I would not be one of them. Charles Stewart Parnell once wrote:

No man has the right to fix the boundary of a nation. No man has the right to say to his country, 'Thus far shalt thou go and no further', and we have never attempted to fix the 'ne plus ultra'.

I hope that the ne plus ultra is set by this legislation.

I pay tribute to the pro-life movement as it is called. As someone said, we are all pro-life. I agree with that. Those people who would oppose this Bill in general took a balanced and reasonable approach even though I think they may have come under a lot of pressure to adopt a more hardline position. I pay tribute to them for protecting and vindicating the rights of the unborn down the years. I suggest to them that our difference is not one of principle at all but one of extension. Where there is a real and substantial risk to the life of the mother it is necessary to protect and vindicate that right. That is the core, while at the same time ensuring, as this Bill does, that every effort is made to protect the life of the unborn. This Bill does that. I will be supporting the legislation.

Our duty, as legislators, elected in accordance with the Constitution, is to uphold the Constitution. In Ireland, thankfully, we have a separation of church and State under the Constitution and our obligation is to uphold the Constitution. There are two serious issues before us which previous Governments have neglected - including those of my own Fianna Fáil Party - for many years. First, how doctors, faced with life or death decisions and in the absence of explanatory legislation, are to interpret the constitutional provision that abortion can take place only when there is a real and substantial threat to the life of the mother. This law before us, thankfully, sets out procedures and processes to guide doctors and protect them legally. Second, in the X case in 1992, some 21 years ago, the Supreme Court held that a threat to commit suicide can constitute a real and substantial risk to the life of the pregnant mother. The Supreme Court is the interpreter of our Constitution so its finding in the X case remains the constitutional position which we as legislators are duty bound to respect. We cannot as legislators have an à la carte approach to accepting the legitimacy of the Supreme Court. We accept as authoritative and binding its judgments, as issued regularly. It is not warranted to set aside its findings in the X case because they do not suit our personal disposition.

Let us not forget that the people have spoken in two referenda on this issue. In 1992, the proposal that the possibility of suicide was not a sufficient threat to justify an abortion was defeated. In 2002 the proposal to remove the threat of suicide as a ground for legal abortion in the State was again rejected by the people. As legislators I say we in this Chamber must respect the will of the people as demonstrated in these referenda.

For ten years, since the referendum in 2002, successive Governments led by our Fianna Fáil Party have failed to deal with these two issues, clarification for doctors of the permitted circumstances for abortion and legislating for the X case. In saying this I am aware that some of my colleagues have deeply held personal views on this sensitive issue. I encourage them to see their primary role here as legislators to uphold the Constitution. In The Irish Times MRBI poll on 30 June voters were asked if abortion should be permitted in six specified circumstances, 89% said that it should be allowed where a woman's life is at risk. When asked if abortion should be permitted in cases where the foetus is not capable of surviving outside the womb, 83% said it should. Some 81% of Irish people said abortion should be allowed in cases of rape or abuse, while 78% were in favour of it in cases where a woman's health is at risk. Asked if abortion should be allowed where a woman is threatening suicide, 52% said "Yes", 29% "No", and 19% had no opinion. Finally, when asked if abortion should be permitted where a woman deems it to be in her best interest, thankfully 46% said it should not, 39% said it should and 15% had no opinion. This clearly shows that legislators are, once again, behind the public on an important issue.

I humbly refer to the challenge posed to Senator John F. Kennedy when he was campaigning in 1960 to become the first Catholic President of the USA. At a critical point in his campaign, on 12 September 1960, he addressed the doubts of many Protestants as to whether his Catholic faith would allow him to make important national decisions as President, independent of the Catholic Church. His response was unequivocal. He said he believed in an America where the separation of church and State was absolute and he would uphold the Constitution of the United States. I commend President Kennedy's stance to all of my colleagues.

I thank the Government for having the courage to bring this Bill forward and I am confident that I represent the position of the majority of Irish women on this issue.

I welcome the Minister of State at the Department of Health, Deputy Alex White, and thank him and his colleagues for the work and effort that has gone into putting this Bill together. I welcome the Protection of Life During Pregnancy Bill. It may be overdue but it is very welcome. This has proved a very difficult time for many people as they wrestled with how to vote and what to say and I have complete respect for those who have found it difficult and continue to find it difficult.

I have complete respect for those people who have found it difficult and continue to find it difficult. I am very grateful to those people who have politely and sincerely left messages for me or called, e-mailed or written to me to express concerns on both sides of the debate. I have read and considered all of them.

I find it less easy to respect those people who have deliberately sought an incendiary approach to this debate through the use of various visual images, letters, e-mails, speeches, threats, twisting of the truth, mud-slinging, abuse and accusations that are less than savoury. It is momentous for the country that we are having this discussion and it is good that so far today this House has managed to maintain a sound and respectful approach to the debate. I welcome that. I sincerely wish this would extend beyond the walls of the House.

Making this decision is difficult regardless of whether we are legislators. It is not any easier for those of us who have opted to support the Bill, despite the impression given by some of those on the "so-called" pro-life side of the debate, who would like us to believe that they somehow have the sole monopoly on conscience and difficult decisions. That is an ugly and dishonourable approach on their part. The truth is we would all prefer some class of magic wand we could wave for a clear and easy answer to present itself. However, the truth is there is rarely complete clarity or any definitive or black and white solution when it comes to life and death.

When it comes to the life of a mother and the potential life of a child, it is more complex and difficult to legislate for that situation. However, as others have said, we are legislators and we are here to uphold the Constitution. This is a limited piece of legislation to give legal protection where there is a real and substantial risk to the life of a mother and to regulate access to lawful termination of pregnancy in accordance with the X case and the judgment of the European Court of Human Rights. The report of the expert group on the judgment of A, B and C v. Ireland found that the ruling of the Supreme Court is the law of the land. As a democracy, we must continue to recognise the authority of the courts in this matter.

The Minister for Justice and Equality, Deputy Shatter, said last week that he is puzzled by people who keep insisting that the ruling of the Supreme Court is not binding on lower courts. He said:

As a lawyer who has practised for more than 30 years I can say the X case is a clearly set out decision of our Supreme Court that binds the lower courts in this State, and the Supreme Court, until such time as it might formulate a different view. I do not know on what basis anybody can say the X case is not binding.

Of course, this has not prevented some people on the other side of the debate from saying it is not binding, perhaps to win some argument. However, it is binding.

The issue of risk has been raised. The risks will be measured, as per the Bill, by a number of medical practitioners. These will always include an obstetrician, to ensure patient safety. The opinion requires a clinical diagnosis on the risk to the life of the pregnant woman and there will also be foetal assessment at that point. The Bill makes it the duty of the obstetrician involved to issue the required certification and if there is a risk to the life of a child in the late trimester, that child can be delivered. Part of the argument put forward has been that somehow or other children who are viable will be murdered as a result of this legislation. This is untrue and unfounded.

One of the arguments put forward by the other side is that guidelines should have been issued, rather than legislation. The expert pointed out clearly in November 2012 that guidelines are by their nature non-binding and do not have the force of law. Both international and domestic courts have made it clear that in a democracy, measures which affect rights must have a secure legal basis. I am satisfied this Bill has sought to introduce the legal clarity required by the X case and has done that within the limits that exist. The Minister pointed out there are limits and we are all aware there are, but we will uphold the ruling made at the time.

We know people will continue to make the journey to the United Kingdom for an abortion and I will return to that issue later. One of the major issues I have with regard to this debate is the language relating to suicide. Many people here have already eloquently expressed their concerns in this regard and now I wish to add mine. There are two aspects to this. The first is that the impression is being created that queues of women will form presenting suicide as a reason for wanting an abortion. This suggests that women will lie or feign suicidal feelings in order to get an abortion. It suggests women are liars and are not to be trusted with their own lives and should have no say in their well-being. These are the implications of this argument, whether they are articulated clearly or not. I find them distasteful and insulting.

This argument also insults the psychiatric profession and suggests that some of its practitioners would be satisfied to dissemble in order to encourage or allow a woman to have an abortion, by giving her a false certification stating there is a real and substantial risk to her life. This shows enormous disrespect to the psychiatric profession and shows huge hypocrisy on the part of those who oppose the Bill, because they will choose to support those psychiatrists who agree with them. They cannot have it both ways. They cannot have half of the psychiatric profession considered okay because they support their point of view, but not the others who make a fair judgment for women. I find this aspect of the debate difficult to deal with.

The second aspect revolves around describing the provision of abortion for a woman with suicidal intent as, somehow, a treatment for suicide. Senator Gilroy alluded to this with great clarity and Senator Bacik pointed out that it is the risk of suicide that must be assessed. That risk of suicide can sometimes be caused by the pregnancy and it is those rare cases for which we are legislating. There is no doubt they will be rare cases, but the risk is a real risk. As Senator Gilroy said, anybody who says otherwise does not know what he or she is talking about. This demeans the debate on suicide we have had in the Houses over and again regarding our concerns for people who take their lives and the lack of resources for them. When it comes to pregnant women who may be suicidal, some people here seem to be prepared to throw what has been accepted regarding suicide to the four winds and say this situation is completely different.

Deputy Gilroy raised the issue of care for suicidal women. Would the solution be to put them in a room and give them a cup of tea? The suggestion seems to be that a cup of tea and a little chat might solve the problem. Anybody who has ever encountered anyone with a serious suicidal intention knows this is far from the right way to respond. That suggestion should not even be made. There appears to be a deliberate attempt on the part of people opposed to this Bill to occlude or obfuscate on the issue of suicide and to refer to abortion as a treatment for suicide. I never understood the X case judgment or the legislation in those terms. I do not believe anybody anywhere was intent on describing abortion as a treatment for suicide.

Suicidal feelings.

No matter how many times we stand up and say this, it seems to make no difference and it seems nobody is listening. I would like to refer to a report in the journal of the American Psychological Association which referred to the findings issued by a Professor Coleman. The association found that there were serious flaws in the figures she gave which indicated that more women who had abortions were vulnerable to suicide after the abortion. She had included women who had depression prior to any abortion and, therefore, the abortion was not the contributing factor. The review by the journal's editors showed there were errors in her report, yet it has been used by many people across the world as proof that abortion contributes to suicide afterwards.

Many women seek abortion and many thousands of women have had abortions. At some point we will have to have the debate on their behalf - on behalf of the life people lead, not the life we would like to believe they lead.

We stopped dancing at the crossroads many years ago. I believe we should have that debate in the future. Today, I welcome this Bill as a small step forward for the protection of women and those who care for them in the medical profession.

What lies before us today represents the first attempt to enshrine in statute law the idea that some human lives are less worthy than others. It is an affront to the fundamental equality of all human beings and the pre-eminence of the human right to life. The Taoiseach claims that in proposing this legislation his book is the Constitution. In reality, it is Labour's way. It is that party’s long-standing party policy that is being legislated for, not Fine Gael's pre-election commitment and certainly not best medical practice.

Ultimately, this Bill is not primarily concerned with clarifying necessary medical treatments available to women whose lives are endangered by complications in pregnancy. It does not offer a shred of further clarity on that point. The pre-existing legal and medical standard is simply restated in sections 7 and 8. The Bill merely addresses procedural clarity, not substantive clarity. Instead, the Bill's purpose lies in legislating for the X case where the intentional abortion of the child is contemplated. The only type of medical procedure contemplated is one "in the course of which, or as a result of which, an unborn human life is ended". No clarity or protection is offered by the Bill to a procedure whereby the child is delivered alive. No clarity is offered to medical professionals regarding civil liability arising from a neonate being disabled due to premature disability under section 9. Accordingly, clarity is a Trojan horse.

Orwell would have appreciated the Title given to this Bill. It obscures its contents and helps stifle critical and legally informed engagement. In reality, it is our first ever abortion Bill. As such it is a defeat for the human right which Article 40.3.3° seeks to protect, as well as for good, evidence-based medicine. Its motivation lies not in concern for clarity or protection but in expediency and abortion ideology. Bearing in mind that Britain has about 15 times our population but about 45 times our abortion rate - at a crude estimate we can say that it has three times our abortion rate - it is sadly clear there is an abortion culture in the western world. We should fear to go where Britain has gone but I fear that this legislation starts us along that road. It is no argument to say that those who might seek abortion under the suicide heading here might have gone to Britain anyway and that those children would not have lived. That is untrue. The law is an educator. The disparity between our abortion rates and those of Britain indicates there are people alive today in Ireland who would not have lived had abortion been legal. In the same way, we can say that children will die in the future who would not have died were it not for this law.

The Taoiseach, the Ministers and the Government should be thoroughly ashamed of themselves for bringing this cruel and corrupt legislation before us. I will exempt one former Minister of State from that criticism. I hope for their sakes that a day will come when they look back at deep regret at what they have done. That will be some small atonement for the lives that will have been lost or disabled, the hurt or regret in the lives of many women who will have undergone such abortions, the damage to social cohesion, the divisions within our medical profession, in people's hearts, within families and between men and women. If they do not regret their role in bringing these events to pass, that will be all the sadder reflection on them.

In pushing through this Bill, the Government is very keen to invoke the idea of legal obligation. However, we know that the A, B and C decision by the European Court of Human Rights, ECHR, did not require Ireland to provide for abortion on grounds of threatened suicide. That judgment required clarity for a cancer patient in ascertaining what treatment was lawfully available to her while pregnant. The Committee of Ministers of the Council of Europe, which oversees the execution of ECHR judgments, has repeatedly made it clear that member states have very significant discretion in determining how to fulfil their obligations under the convention. Where there is a will, there is a way. Where there is not a will, it is like this Bill.

In terms of our own constitutional law, there is simply no requirement that the Oireachtas legislate to give effect to a decision of a court. It is telling that proponents of the view that there is such a requirement have singularly failed to identify, either in the text of the Constitution or in constitutional jurisprudence, support for this requirement. Therefore, the Oireachtas has, as admitted by the former Justice Catherine McGuinness in this Chamber, the constitutional freedom to refrain from legislating for the X case. That is why John Bruton said, when he was Taoiseach, that he would not legislate for the X case because it would have the effect of bringing abortion into Ireland.

There are also those who argue that the failure of two attempts to overturn the X case by referendum means that there is a legal duty to legislate for that case, yet in constitutional law the defeat of a referendum proposal does not create a legal obligation to give effect to the express opposite of that proposal. This is not to mention that a very significant proportion of the "No" votes in 1992 and 2002 referenda were cast from a pro-life perspective. Therefore, let us not flunk both the law and history exams simultaneously. Further still, former judge Hugh O'Flaherty of the X case majority recently conceded that judgment was not a legally binding precedent. Indeed, part of the reasons for this may be that abortion on psychiatric grounds was conceded without argument and, therefore, did not form part of the ratio of the judgment, notwithstanding the subsequent application of the X case test in High Court decisions, a point that has confused some people. Hence, not only is the Government not legally obliged to legislate for the X case, but the courts themselves are not legally bound to follow that particular judgment as a matter of stare decisis.

We should consider whether the proposed legislation is in line with Article 40.3.3° of the Constitution? To recall that guarantee: "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." The express language of Article 40.3.3° is absent from the present Bill. Instead, the Bill defines "reasonable opinion" as including "regard to the need to preserve unborn human life as far as practicable". There is no mention whatsoever of the equal right to life of the unborn or of respecting, vindicating or defending that right. The Bill merely requires that regard be had to the need to preserve unborn human life, a need immediately qualified through the addition of the clause "as far as practicable", yet the constitutional guarantee that laws respect the right to life of the unborn is not so qualified. Further, a need to preserve life is a much more amorphous and much less legally established concept than a full-blown constitutional right to life. Thus the Bill grants a lesser level of respect to the equal right to life of the unborn than Article 40.3.3°.

There is a further equivocation in the Bill regarding the equal right to life of the unborn. The aforementioned reasonable opinion is not a reasonable opinion at all. It only requires an opinion formed in good faith. This means that the Bill requires a significantly lower standard of mental element than that of an objective reasonable opinion, which in turn greatly undermines the supposed safeguards offered by section 9, as well as the criminal provisions of section 22. Since the medical opinion need not take heed of relevant medical evidence and ordinary practice, the good faith test is also out of touch with the development of the tort of medical negligence from Dunne v. National Maternity Hospital onwards. It should also be noted that the entirety of the medical evaluation adheres to a good faith standard, including certification of a real and substantial risk to the woman's life. Further, and perhaps crucially, whether due regard is had to "the need to preserve unborn human life as far as practicable" is, according to the Bill, entirely a matter of subjective good faith. I cannot see how anyone could reconcile the Bill's provisions with the constitutional duty for laws to respect the equal right to life of the unborn - a duty framed in a categorically objective manner.

The subjective good faith standard pervading the Bill's provisions for medical assessments reflects the subjective grounds of suicidal ideation upon which the Bill provides for abortion. Therefore, in the complete absence of any empirical evidence that abortion makes women less suicidal, this Bill does not require that a medical opinion sanctioning an abortion on this very basis be based on anything more concrete than a subjective opinion. Imagine that.

That is ridiculous.

Further, the good faith test does not incorporate a duty to deliver a viable child from the womb alive. In other words, the reasonable opinion required imposes no duty to ensure that, where practicable, a viable child should be delivered alive rather than aborted. This will not really affect the operation of sections 1 and 8. In practice, and as a matter of law, it permits a section 9 medical procedure to effortlessly subordinate the need to preserve unborn human life to the statutory right to abort that child even where the preservation of unborn life is achievable as a matter of routine medical practice. Again, it is extremely difficult to equate all this with a guarantee to respect the equal right to life of the unborn, especially since it may in fact incentivise a medical practitioner to opt for an abortion instead of an early inducement so as to avoid questions over civil liability on foot of the disablement of a child.

Again, it is extremely difficult to equate all of this with a guarantee to respect the equal right to life of the unborn, especially since it may incentivise a medical practitioner to opt for an abortion instead of an early inducement in order to avoid questions of civil liability on foot of the disablement of a child. Such claims may well be contradicted in this House in the coming hours, but I do not believe they can be credibly contradicted. This legislation is an affront to human dignity and any normal conception of human rights. It is an affront to the great medical tradition which up to now has cared for two patients, respected and protected them and placed Ireland at the top of the world in providing the best medical care for women. I have heard people talk about situations decades ago where women were perhaps not respected in the way they should have been, but it is no argument to refer to the past and ignore our present high standards, standards the Government is now set to abandon to the tragic cost of the country.

I ask Senator Paul Coghlan to propose the adjournment of the debate. He will then be in possession.

I welcome the Minister of State. May I say a few words?

Acting Chairman Senator Pat O'Neill

Very briefly. Perhaps the Senator should propose the adjournment of the debate. He will then be in possession tomorrow.

Debate adjourned.

Acting Chairman Senator Pat O'Neill

When is it proposed to sit again?

At 10.30 a.m. tomorrow.