The House is resuming the debate on amendment No. 4 which is grouped for the purposes of debate with amendments Nos. 37 and 38.
Protection of Life During Pregnancy Bill 2013: Committee Stage (Resumed)
The Minister is very welcome. I wish to speak on amendment No. 38 which seeks to insert: "(d) where the unborn is sixteen weeks gestation or older, an effective anaesthetic for pain relief shall be administered to the foetus before the medical procedure is commenced.” Truly, I regret that we even have to discuss this issue. However, we know what we are legislating for. We are legislating in order that terminations and abortions can take place, albeit in limited circumstances. If we must do so, the very least we should do is ensure the procedure will be pain-free for the little baby, the unborn, the foetus.
There is a lot of evidence to support the view that the unborn feels pain from 17 weeks onwards. Neonatal surgeons in the United Kingdom use anaesthetics in surgery on unborn children as they conclude they feel pain. A pro-choice professor, Professor Glover, called for anaesthetics to be used during abortions of unborn children from 17 to 24 weeks. She said that a foetus aborted between 17 and 24 weeks after conception may feel pain. To give her her due, she said she was pro-choice, which means supporting terminations and abortions, but she said that "one should not muddle the two". She stated, “One should think about how one is doing it in the most pain-free way.” What can the Minister tell us about foetal pain during a termination or abortion? Would he support me in saying that when a procedure must be carried out that will take the life of the unborn, it should happen in the most pain-free way possible? I plead with him to accept my amendment to enure the presence of an anaesthetist at every termination and abortion to ensure the baby, the unborn, will not feel pain.
According to Professor John Wyatt, consultant neonatal paediatrician at University College Hospital, London, and a member of the Commission of Inquiry into Human Fetal Sentience, anxiety is now stifling research. He said "no responsible scientist or clinician can publish work in this area without a certain degree of trepidation that it will be seized upon by spin doctors and propagandists from both sides of the abortion debate." In other words, he is saying we should forget about the spin doctors and look at the evidence. The evidence is that the foetus, the unborn, feels pain. Let us ensure the procedure is done in as pain-free and dignified a way as possible.
What is the Minister planning to approve in this jurisdiction? Will he accept my amendment providing that an anaesthetist should be present at every termination and abortion? It is the very least the Government could provide for. What does the Minister know about foetal pain during termination?
I will first address amendment No. 4. I do not propose to accept it, as the main purpose of the Bill is to restate the general prohibition on abortion in Ireland in line with Article 40.3.3° of the Constitution 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.
Section 22 sets out that it is an offence to destroy unborn human life intentionally. However, in order to regulate access to lawful terminations of pregnancy, exemptions are made under the terms of Bill where there is a real and substantial risk to the woman's life. I, therefore, do not propose to accept this amendment.
With regard to amendments Nos. 37 and 38, which concern the issue of viability, the Bill makes reference to a medical practitioner's reasonable opinion, which places a statutory duty on each medical practitioner forming an opinion to have regard to the need to preserve unborn human life as far as practicable. This imposes a clear duty on medical practitioners to make every effort to preserve the life of a foetus, where possible.
A failure to do so would place a practical practitioner in breach of the proposed legislation and subject to its penalties.
It is not the purpose of the Bill to regulate obstetric procedures which do not constitute termination of pregnancy or to dictate the practice of obstetrics. Standard medical practice will provide appropriate mechanisms for assessment of both the woman and the unborn. It would not be appropriate to include this or other details of medical treatment in legislation. In other words, as we have said elsewhere, we cannot be prescriptive in terms of how members of the medical profession carry out their duty. Best practice changes in line with guidelines from the respective educational facilities, institutes and college. Therefore, I cannot accept the amendments.
I do not support amendment No. 4 because it would reverse the entire intention of the Bill. It is unrealistic because there are clearly circumstances where it is important and proper to end the life of a foetus in preference to the loss of life of the mother. That might not be in line with the Constitution but, as I have said, that was a mistaken amendment. Everybody now knows it was a huge error.
I am much more in sympathy with the other proposals in this group. However, in regard to amendment No. 37, in the name of Senator Rónán Mullen, as I understand it, the provision contained therein is already the position in the legislation as it stands, namely, that when a foetus becomes viable, the effort will be made to preserve that life. That is my understanding of the legislation as it exists. I am sympathetic to the amendment, but it is redundant.
In regard to the first part of amendment No. 38, in the name of Senator Fidelma Healy Eames, I would make the same argument, that it is already covered. The second part of the amendment states: "where the unborn is sixteen weeks gestation or older, an effective anaesthetic for pain relief shall be administered to the foetus before the medical procedure is commenced". If this is an effort to generate political momentum behind the notion that the foetus is a complete and separate individual, I do not agree with it. However, if it can be demonstrated medically that the foetus is capable of experiencing pain, then of course it would be natural to administer an anaesthetic. I have no problem with that and hope doctors would do it in any case. I have no difficulty with either part of Senator Healy Eames's amendment, but the first is already covered and the second is presumably standard medical practice where it can be demonstrated that the foetus is capable of feeling pain. However, I would not like it to be taken as an opportunity to push the notion that the unborn - that is a very unattractive description which reminds me of "undead"; I do not like it - is a separate individual. Pain relief should certainly be administered where the foetus can demonstrably feel pain. One would do the same for an animal. In short, I have no real difficulty with this part of the amendment, with the proviso I have given, but if I have understood the Minister's response, it is not possible for the legislation to be prescriptive of medical practice to that level of detail.
The Minister has been at pains for many months, as has the Taoiseach, to tell us that this Bill is about the protection of both mother and baby. Those comments are either the truth or they are lies. They cannot be both. I am prepared to accept the Minister at his word, to accept that he believes what he is saying is true. That is why I tabled amendment No. 4. The medical procedures envisaged under this legislation are not defined in the definitions section, but they include the prescribing by a medical practitioner of any drug or medical treatment. We all know what those procedures are in the context of abortion as it is understood globally. I have described one such procedure, based on Dr. Anthony Levatino's evidence to a committee of the United States Congress, and I challenge the Minister to say whether anything in that evidence is wrong.
I was asked by my colleague, Senator Darragh O'Brien, to clarify whether this amendment could in some way impede the workings of section 7 or 8 of the Bill. There is no way, in my opinion, that it could do so, nor is it my intention that it would. The medical evidence we heard over the six days of hearings by the Joint Oireachtas Committee on Health and Children clearly set out current medical practice in dealing with situations where complications in pregnancy put the mother's life at risk. There was unanimous evidence from all the medical practitioners that they were not inhibited by the current constitutional or legal framework in ensuring they give every possible treatment and are able to intervene in appropriate ways to save the mother's life.
Most of the opposition to this Bill relates to section 9.
The Senator must speak to the amendments. These points have already been made.
I am outlining why I tabled this amendment. I did so because the evidence given in regard to section 9-----
It is a matter of clarity.
The Senator has already spoken to this amendment.
I will tell the House what I said when I spoke about the issue yesterday.
The Senator cannot repeat it today.
I said that in claiming that the Title of the Bill means exactly what it says, the Minister should then have no difficulty accepting my amendment. I left it at that because I felt there was no need to press the case further. I am doing so now because of the Minister's response and, with respect, I am entitled to do so.
I am concerned that a situation will arise where a physically healthy mother presents with a physically healthy baby and is certified as having suicidal intent. All of the evidence from the psychiatrists who presented to the committee hearings was that an abortion would be no treatment for such a woman and her medical condition. That was the clear evidence, even from the pro-choice psychiatrists. One need only study Professor Veronica O'Keane's evidence to the committee to clarify that issue. What is proposed under section 9 represents a significant change to the law. We are moving from a situation where the saving of the life of the mother sometimes has the unfortunate consequence of the baby dying to one where a physically healthy woman can present and there will now be an intent to kill her unborn baby on some sort of pretence that an abatement of her condition will be thereby achieved. We know the consequences-----
On a point of order, we agreed that language in the Chamber would be respectful. There is immense repetition in the Senator's contribution and he is veering well off the amendment.
That is not a point of order.
We know the consequences of it. It was described at the committee hearings and elsewhere. We also know that a baby has a heartbeat at around 20 days gestation and brain waves at 40 days or so.
The Senator is being repetitive. All of these issues were raised not only in respect of this group of amendments but also in the context of previous amendments. The Senator is making the same argument again. I ask him to adhere to the amendment.
I am adhering to the amendment. The Minister's failure to accept it speaks volumes for his intentions. I am asking him directly if his statement that this Bill is about protecting the life of the unborn is true or not. If it is true, is he not conceding the untruth of it by agreeing there will be intentional killing of a baby in circumstances where all the medical evidence clearly indicates it will do nothing for the woman and may indeed have serious adverse effects for her subsequently?
I would also like to ask about medical procedures, because this amendment proposes to define and confine medical procedures. In the opinion of the Minister, what medical procedures will be applied in order to achieve the intention of aborting the baby?
I wish to wait until the Minister has responded on this amendment.
The Minister has responded already on this group of amendments.
I do not have the grouping list with me. Perhaps the Chair will assist me and tell me which of my amendments are in this grouping.
We are dealing with amendments Nos. 4, 7 and 38.
With regard to the amendment proposed by Senator Healy Eames, I have always been of the view that there are great sensitivities around two issues - how the reality of abortion changes according to different stages of gestation, and the issue of foetal pain. These are very relevant issues, particularly for those of us who see the need for two lives to be protected at all times, as far as practicable. For example, the issue arose previously regarding the display of images of aborted children and whether that is appropriate and sensitive. I am aware that Senator Walsh - I do not criticise him for this - caused a degree of controversy with his very frank account of what abortion can involve. That, perhaps, had the indirect, but desirable, effect of a discussion on radio, where people got to hear about some of the realities. Life deserves to be protected, regardless of the means of its ending.
There is no doubt that in terms of mere discussion, the ending of an unborn child's life at an early stage of pregnancy is not as evocative or as disturbing as that of the late-term ending of the unborn child's life. I have often felt that RTE is greatly to be criticised in this regard. While I would not suggest or ever support the random display of disturbing images - I have always been against that - I have always felt that we should be able to display some images, in the same way as we are invited to contemplate the effect of famine, on occasions, with appropriate warnings to people that the images they may see are likely to be disturbing. It seems strange and bizarre that as a public service broadcaster, RTE has never, over the years, introduced us to the reality of what abortion involves in clinics abroad, in Britain and America in particular.
We are dealing with the amendments.
On a point of order, the Chair should be acting independently, not taking his lead from the Minister.
I am acting independently. Much of what is being said is repetitive.
Bear with me. I have no desire to be repetitive and I will not be repetitive today.
The Senator must stick to the amendments also. I am fair to everyone.
I hear that. There is a real and serious coherence to these points. This is a life and death issue and I want to develop this point because it is important and relates directly to the issue. I ask the Chair's indulgence.
My point is that I have always felt that appropriate information should be given to the public. I do not think RTE has fulfilled its duty as a public service broadcaster in the way, for example, that programmes such as "Panorama" in Britain have done. We heard from doctors in Britain who are very disturbed at the fact that in one part of a hospital they may be trying to save a pre-term child who is at the cusp of viability while in another part of the hospital a similar child might have his or her life destroyed because that child is not wanted. These are the serious realities that are confronted-----
I do not see anything about information in the three amendments that have been grouped together.
They are about medical procedure.
It is not all about soundbites.
It is about procedures, not about giving information.
With the greatest of respect, sometimes the argument must be laid out. The point is that there are appropriate moments to discuss issues people find disturbing and that this must be done in an appropriate way, with particular respect for the vulnerability of children and people's sensitivities. I would never enter a discussion about this issue without first warning people or asking them if they were ready to hear something I might have to impart to make a full presentation of the issues.
The same issue arises in regard to the issue of foetal pain. We are acquiring knowledge in this area. As a non-medical person, I am very slow to speak on this issue until I have checked with medical experts. However, Senator Healy Eames has raised a real issue. The Minister would be the first to tell us we are operating against a constitutional background which still provides, even in its flawed state, the full and unqualified guarantee to respect the equal right to life of the unborn and the duty to defend and vindicate that right as far as practicable. If that protection is to have meaning, then even in situations in which one is sure of the death of the unborn child as a result of procedures the Minister proposes to protect through this legislation - I accept the legitimacy of some of those procedures, but not others - his duty to protect unborn human life also encompasses a duty to honour and respect the dignity of that life, even in moments when that life is being compromised.
Whether the Minister is going to accept this amendment - if not, I hope he will accept one on Report Stage - what I want to know more than anything else is how much he knows about this matter. Has he researched the issue of foetal pain? Have his officials researched the issue of foetal pain? Is that the reason there does not appear to be any of them behind him? If he is not fully briefed - I know he trained with the Irish Family Planning Association and we know what it has been up to in terms of bringing the A, B and C case-----
That is an uncalled for accusation.
I made no accusation. I only commented on matters that are on the public record. My point is this-----
What does the Senator know about what the IFPA has been up to?
Senator Rónán Mullen to continue, without interruption, please.
We heard in this Chamber of an investigation that revealed that IFPA counsellors were telling women to mislead their GPs-----
That is hearsay.
On a point of order, the rules of this House require us to stick to the topic at issue, which is the amendments under discussion. This Senator is veering well off those amendments and making allegations about other parties.
He is not veering that far off them, but-----
On a point of order, who is the Cathaoirleach in this House?
Senator Rónán Mullen to continue, without interruption.
On a point of order, Senator Bacik constantly decides to act like the Chair from the floor.
Only when she does not like what she hears.
That is completely inappropriate.
I have ruled on the matter.
It would be a great development in the House if Government Senators, the Deputy Leader in particular, led by example and did not abuse the facility to make a point of order in order to make political points. I will try to imitate that also.
I hope the Senator will and that he will stop making generalisations. He should take his own advice.
Senator Rónán Mullen to continue, without interruption. I ask him not to use the names of Senators who are not in the Chamber to defend themselves.
I hear the hostility coming from Senator Marie Louise O'Donnell and I am disappointed by it.
There is no hostility coming from me. Stick to the facts and stop making up stories.
Does Senator Rónán Mullen have a question for the Minister?
Yes. My point is that the Minister told the Dáil last week that he had undergone some training with the IFPA. I would not expect the IFPA to be up to date on the issues around foetal pain, but I would expect the Minister and his officials to have researched the issue. If he has not researched the issue - I am not saying he has not - I will be very pleasantly surprised if I hear him expatiate on the subject with respect for the serious issues at stake. However, so far the Minister has not shown any inclination to engage with this serious dimension. Will he reassure us that he and his officials know something about these matters, have considered them and will seek to protect the unborn child from pain in any situation in which he or she might be exposed to it as a result of procedures which will be made lawful under this Bill?
I want an answer to the questions I put to the Minister on the issue of pain. We are all human beings in this House. We understand pain. I have outlined the evidence. There is evidence that the foetus feels pain from 17 weeks onwards. It is unbelievable that they do not feel pain before that, but that is the science I am bringing to the Minister.
I ask the Minister to answer these questions directly. Will an anaesthetist be present at the termination with the obstetrician? Will an anaesthetic be administered so the foetus does not feel pain during the termination? Surely it is fine for us not to be cruel to a little defenceless mite who has no say or choice in this. I know, to be fair to the woman who is in great difficulty, that she would not want that little mite to feel pain either. Will the Minister tell us whether a pain-free procedure will be administered in Ireland? Will an anaesthetic for pain-free termination or abortion be administered? Please answer that question.
I want to second Senator Healy Eames-----
The Senator can do that when we get to the amendment. We are only discussing the amendments.
I want to speak on the issue of pain. We have medical evidence from 17 weeks onwards. I cannot for the life of me understand why the Minister will not put this in the legislation. He said earlier in his reply to Senator Healy Eames's first contribution that he did not want to prescribe rules for the obstetrician. This legislation is certainly prescribing what to do for the obstetrician because, if we have a suicidal woman who simply cannot cope and has to have a termination, gosh golly, the obstetrician in Ireland who never had to take a baby's life before in a case in which a woman was suicidal will now have to do so. I think that is prescribing a rule for that particular doctor.
To me, it is a no-brainer amendment. Senator David Norris said earlier he did not like the word "unborn". Neither do I. I like the word "baby". Anybody here who has had a baby in their tummy knows they are babies. We have medical evidence that these babies can feel pain after 17 weeks. We all know what pain is. We know what a headache is like or what it is like to have a needle stuck into us. This is a tiny little baby. All we are asking for is that we legislate to have an anaesthetist present. If we have to do what we have to do, let us do it in as humane a way as possible, and treat these little people with dignity and kindness. Let us stand over being Irish. If we have to put this legislation through, which I believe we do, I appeal to the Minister to hear us on this issue. It is not good enough to leave it to the obstetrician because-----
They cannot provide an anaesthetist unless it is provided for by the State.
The Cathaoirleach can correct me if this is not appropriate, but I believe we have the same issue with the fact that there is no gestational term in this legislation. We are talking about 17 weeks with regard to pain but, again, we do not want to make any rules for the obstetrician, so does he opt for 22 weeks, 23 weeks, 21 weeks or 24 weeks? When does he decide? Why does this poor man or woman - the obstetrician - get to decide whether this life is viable?
I support my colleagues on the amendments before us. I spoke on the matter to the Minister of State, Deputy Alex White, when he was here yesterday. He simply dismissed our views, which is not surprising because he did say during the course of this debate that he was not open to any amendments except what he described as "technical amendments". These are more than technical amendments. These are amendments about the philosophy behind the Bill and where we wish to take the country. They go to the very core of what the legislation is truly about, as opposed to the mantra and spin we have had in the past few months, namely, that it is about saving women's lives. As I said, everybody in this House and in the other House, everybody in this country, wants to save women's lives. However, to use that spin to put through an abortion Bill is a very inappropriate way of practising politics.
A most convincing case has been made for these amendments, particularly with regard to the need to provide some type of anaesthetic for the baby whose life is being ended. Senators Mary Ann O'Brien, Healy Eames and Mullen have made a very substantial case.
In trying to accept the concept behind all of this legislation, we have to remove ourselves a little from reality. Many young children, when their mother is due another baby, believe the stork somehow comes and delivers the baby. Of course, they grow up from that sort of fantasy land. We are actually trying to introduce a new sort of fantasy whereby, when an abortion happens, the stork comes along and somehow the baby disappears - that there is actually no procedure, no pain, no stress, no duress. Let us not live in that fantasy land. Let us face what is actually happening. Let us deal with the inconvenient truth mentioned by Senator Walsh two days ago, which appeared to cause huge distress. We are talking about life and death. We are talking about all the gory details of this procedure, and let us not pretend otherwise. At least, however, as a so-called civilised society, let us try to put in place some type of pain alleviation. I am not an expert in that field but many of the Minister's colleagues are. In particular, I would be very interested in a response to the question raised by Senator Mullen as to whether the Department of Health has reflected upon this issue. My understanding is that this amendment was not tabled in the other House.
This is the first time.
This is a Seanad amendment, not a Dáil amendment. However, if the Minister's officials have not yet reflected on this amendment, will they let the Minister know? No Minister and no Government can know everything. Will the Minister's officials let him know what evidence and studies are available to them to reflect upon the pain element of abortion, and what we can do to at least try to alleviate it? Will the Minister at least assure us that he and his officials will sit down and come forward with the studies and scientific papers, and we can then reflect on it on Report Stage? That would at least be a sign of good faith. How can any civilised society anywhere, not just in this country, justify the opposition to introducing pain relief?
Having listened to the debate, I know all of us here have different emotions and that there are different sensitivities and perceptions. It is important that we do not try to create uniformity in the debate. I have always felt that heckling and interruptions in this House on any subject are not acceptable. I am glad to say that in 16 years I have never done it.
In this particular case, in the early part of the abortion debate, I spent a lot of time reflecting. I said very little, perhaps, except on Second Stage, but I always reflected on what exactly it meant to the unborn child to be aborted. I started initially in the context of the status the unborn child has in our Constitution, but I also went further than that with regard to an issue that is being expanded on here today, that of foetal pain. There is a temptation to avoid that discussion. To some extent I can understand its avoidance out in the media, but I cannot understand our avoiding it here, in a House of Parliament, where each of us individually must respond to the knowledge we have accumulated and also to the values we hold. If we do not do that, the feeling at the end of the day will be that we did not act as good legislators.
I also reflected on what that abortion meant. The contribution made in the Chamber by Senator Jim Walsh did not shock me at all. We are in a House of Parliament. It might have shocked me on the "Late Late Show" or "Prime Time", or if it had been used as propaganda methodology in a publication. That is not where we are; we are in a House of Parliament. Each piece of understanding we requested, whether from the Minister or from someone who holds a different view, is very important. I accept the fundamental issue is that we are denying an innocent human being of the opportunity to achieve his or her full potential.
The question of foetal pain is a very important one for us. It is not a matter of changing other people's minds but of helping us to make up our own. I know nobody in this House would deliberately inflict pain on another human being and I respect each person for that. However, we may ignore some information if we do not endeavour to tease it out. Very relevant questions were put to the Minister today; it is for that reason he is present. The Department has the resources. The questions put by Senator Mullen are very relevant. What information does the Minister have on that point? What is the medical evidence? Is that not why we are here today? It would certainly help me to understand. Obviously I am anti-abortion and would be an advocate for the unborn child but I would still like to know if there is pain involved in an abortion. That is all we are discussing and we should be able to do so in a courteous, tolerant and understanding way in this House.
Although I support this Bill, I believe Senators Healy Eames, Bradford, Mary Ann O'Brien and others have made a good point. I have a question for the Minister. In an abortion procedure where women are put asleep, would it not also be feasible to expect the foetus is also put asleep? Even if that expectation-----
That is a very good point.
Even though some of my colleagues might think I am interruptive, in regard to this point I am not. I would just like to have that answered. Is it not feasible that the foetus would also be put asleep, as the woman is?
I will wait for the Minister's response but will put this point to it. I will not put the amendment to a vote at this time if I get an assurance from the Minister, but will resubmit it on Report Stage when the Minister might return with answers to the questions we asked around pain and evidence of pain felt by the foetus. I have put quite a bit of evidence on the record. Would an anaesthetist be present at the termination? As Senator O'Donnell said, then at least that little mite, that foetus, that little unborn baby could be put to sleep. It is good practice in this country at the end of life to have good palliative care. Guess what - that is the end of the unborn baby's life. Surely we want to give them the same dignified ending, if one could so call it.
On the amendment-----
I will not withdraw it but will wait for the Minister's reply.
I thank the Senators for their contributions. The Bill is what it says it is - the Protection of Life During Pregnancy Bill, for both mother and unborn child. I can only restate what I have said, namely, the Bill cannot be prescriptive of medical practice. Some have pointed out that we are telling doctors what to do, but we are not. We are clarifying the legal situation for them concerning the service they are obliged to provide and what is legally permissible. We are not telling them how to do that service or how to practise and I certainly do not believe we should. Medical practice changes and there are now so many different facets of medicine, not only in Ireland but generally. Advances are made and new techniques are brought in all the time.
I cannot accept these amendments because I am not prepared to be prescriptive. I return to what others mentioned during the course of the debate. We have to trust our doctors and nurses, who give of their best on a daily basis to keep us and our fellow citizens safe. They practise with care and compassion. For me to prescribe precisely how they should do that would, first, be wrong, and, second, be a very dangerous place to go.
I understand what the Minister means when he says he cannot be prescriptive because it would lead to a huge accretion of unnecessary detail in the legislation. The Minister is a doctor with good experience in the medical field. Will he comment on the very interesting observations made by Senator O'Donnell? I have no difficulty, being strongly pro-choice, but it seems to me that if the foetus is capable of experiencing pain of course one would give it an anaesthetic. It is very interesting, and probably true as Senator O'Donnell noted, that if the mother is fully anaesthetised so is the child, the unborn, or whatever they call it nowadays. That seems reasonable. Could we have a clarification on that point? I do not expect an absolute one because, as I understand it, the Minister has not practised as a gynaecologist. I wonder if there is any knowledge that could be made available to the Seanad that would set at ease the minds of people such as me, who are reasonable and pro-choice. Is what Senator O'Donnell noted true? It sounds eminently sensible to me. If not, is it general practice to ensure the foetus does not experience pain if it is capable of so doing? That would set my mind at rest. Otherwise I will be forced to vote in favour of the amendment on Report Stage.
In his response to me and others the Minister said he did not wish to be prescriptive and does not want to tell doctors what to do. I can accept that. What will the doctors do? That is what I want to know. What will they do in the course of a termination-abortion? Will an anaesthetist be present to ensure the baby is given an anaesthetic so that when its life is ended it is ended pain free? I do not know any human being, any Senator in this Chamber, who would not want that.
Just because this amendment was never presented in the Dáil does not mean we should not have open enough minds. Ours is not a barbaric country. I ask the Minister to give us a chance and open his mind. I am not looking for him to do anything except to tell me what the doctors will do. Will they deliver an anaesthetic in order that the baby's life is pain free as it is being ended?
I have a second point. I understand the Minister is bringing out regulations in conjunction with the Bill. Where are the regulations and when will we see them? Will they include information about the actual termination, how it will be carried out and whether an anaesthetist will be present to ensure the ending is pain free?
I have not spoken on amendments Nos. 37 and 38 but that is no indication I do not agree with them. I agree fully with what is being said in this regard. It concerns me because we regard ourselves as humane.
I understand the Minister's indication that he does not want to be prescriptive, and some obstetricians and gynaecologists would have asked him not to legislate because they feared it could inhibit their current best medical practice in saving the life of a woman. The Minister chose to legislate and we are faced with the repercussions. I am sure any further prescription in the Bill could perhaps be counterproductive, particularly in cases where the mother's life is at risk from a medical complication or emergency. I appreciate that.
I have a concern which I will mention particularly with regard to amendments Nos. 37 and 38. If a woman presents who is suicidal, the clear evidence given at the health committee was that she would be suicidal not because she is pregnant but because she does not want to have a baby. The idea is that the only way of abating her suicidality is for the baby not to be born. If we are not prescriptive, could a woman present late in the term, at 20 to 32 weeks, for example, with a pregnancy and get certification and entitlement to abortion? The Minister will be familiar with some of the abortion procedures, particularly partial birth abortions, where the baby's legs are pulled from the womb, with the head remaining inside the womb. A scissors is then jammed into the back of the skull and it is used-----
The Senator is being repetitive. All of this has been said before.
-----in order that a catheter-----
He is ignoring Article 40.3.3° of the Constitution.
-----can be inserted and the brains sucked out of the baby.
The Senator has said all of this on a number of occasions.
That is legal in many countries. That is a late-term abortion.
The Senator should stick to the amendments.
Let me finish. That is legal in other countries.
I am not. I have never mentioned this.
The Senator has raised all of these issues before and the Minister is well aware of them.
You have not been chairing these meetings, a Chathaoirligh.
I must say I am unhappy. You were not here when I discussed these issues, as the Leas-Chathaoirleach was in the Chair.
I was here when the Senator spoke.
Perhaps those late-term abortions might not be allowed. If they are not to be allowed, will the Minister point out the part of the Bill forbidding them? What assurances can we get that this barbaric practice will not be allowed to happen, as it is in many countries where abortion is available? If it is allowed to happen, surely it would be an inhumane act, and the pain inflicted on the unborn baby would be absolutely appalling.
Although I support the amendments, I have gone a step back with my amendment. Senator Norris and others may have picked up the point incorrectly but it is not my intention to impede or interfere with any case arising from sections 7 or 8. The amendment will not do so. The Minister is not accepting it as it would, in effect, any abortion taking place under section 9, as it involves the direct and intentional killing of the baby.
With regard to foetal pain, at eight weeks which is very early in pregnancy, a child can make tiny fists, get hiccups and whatever else. That baby is evolving. At 11 weeks, the placenta continues to supply food and oxygen, and the child has legs and can make complex facial expressions and even smile. Current medical technology is able to prove this. That is the first trimester. At 16 weeks, the child can use hands to grasp, swim and turn somersaults. At 18 weeks, still in the second trimester and at a time when the baby would be regarded as not viable by many, he or she is active and energetic and can flex muscles. That is often the first indication to a mother as she can feel the baby in her womb.
We are talking about a mother's life but the Minister has rightly indicated the need to protect the unborn also. Surely to goodness we can do that by building in as many safeguards as possible. I do not see that within the Bill and, unfortunately, by leaving medical procedures open, we are leaving women open to a coterie of "medical procedures", although they are not in the medical interest of the child.
Will saline abortions, suction aspiration, dilation and curettage and dilation and evacuation be permitted under this Bill? I know the Minister does not want to be prescriptive but if we are voting on this Bill - particularly the people in the Minister's party who are supporting it - we should do it knowing what the Bill is about. That is why so many people have reacted to what I said on Second Stage. The Irish Times has campaigned strongly for abortion and I compliment the newspaper for at least publishing what is an abortion, although the reporter was disgusted. If anybody is disgusted with a description of what happens with an abortion, whether in this House, the medical profession, the Department, the HSE or elsewhere, they would be disgusted to a factor of 100 if they envisaged the procedure becoming a reality in practice. As Senator Bradford rightly stated, it is an inconvenient truth.
What procedures will be allowed if the Minister is not to be prescriptive in the Bill? If the Minister says it, it will at least given an indication to a court that would subsequently determine what is allowed; it would demonstrate the intention of the Minister for Health when he introduced the Bill to the Houses.
I am thankful for the opportunity to comment once again. I will reflect a little further on amendment No. 38 and particularly paragraph (d), the proposal that pain relief should be administered to the foetus before death. I appeal in particular to my colleagues in the Fine Gael Party, as they are members of a Christian democratic party, and ask how we could oppose such an amendment. How could we oppose putting in place a request that before an abortion takes place or an unborn child is killed, we would at least try to provide some degree of pain relief?
Will the Minister reflect on the decisions taken by his colleague in a different Department, the Minister for Agriculture, Food and the Marine, Deputy Coveney, who is monitoring veterinary clinics and providing animal welfare legislation? We all support the regulations he has correctly put in place to ensure animals in this country do not suffer. We spent weeks in this House debating the animal welfare legislation, and I am sure the Minister heard some of the discussion in the other House. The country put in place measures to look after animals, which is only right. We are proposing a modest amendment requesting that where an abortion is unfortunately taking place, we can ensure there will be pain relief for the child. How could any civilised citizen say "No" to such an amendment?
I concede that the amendment was not discussed in the Dáil and it is a Seanad amendment. The Minister's officials may not have sufficient time to reflect on it and they may not have sought the evidence that is freely available clearly showing that unborn children suffer pain, with at least some degree of a remedy available. We should not divide on it this afternoon but the Minister should give an indication that he is willing to think long and hard before ultimately saying "No". If there is any amendment in any section that makes a very profound statement about the legislation, us as legislators, our Government and our conscience, this is the one. The Minister should at least be willing to think and sit down with his officials over the weekend in order to examine the evidence and believe that as a civilised society, we will take this very modest step.
It is impossible to come up with even a reasonable excuse to say "No" to this amendment. Let us think about it over the weekend and come back on Report Stage. Let us prove that we speak for people born and unborn and can do so in a civilised fashion.
I did not do justice to my friend, Senator Marie-Louise O'Donnell. I do not think she was sending waves of hostility towards me. She was just following her own inimitable style. I felt my comments were entirely justified and on point.
I accept that.
I did not do the Senator justice, for which I apologise.
I am very unhappy with the Minister's response to what is a very reasonable proposal. Maybe he will give us more than he has done but I fear that the more he fails to engage with this issue, the more he is revealing the ideological heart of this Bill. If it not his ideological heart, then it is the ideological heart of people behind him, from the expert group onwards.
It is really not acceptable for the Minister to come into the House, act like the Borg and repeat standard lines like the idea the Bill cannot be prescriptive of medical practice. That sounds so reasonable until one realises it is just a mantra. Of course, the Bill is prescriptive of medical practice; it has to be. It is not prescriptive about the details of medical practice which must be left to medical practice.
Let us just look at the section which states: "It shall be lawful to carry out a medical procedure in accordance with this section in the course of which, or as a result of, which an unborn life is ended..." subject to there being two medical practitioners and their having to assess a real and substantial risk and their forming a reasonable opinion. That reasonable opinion is defined in a most unsatisfactory way. That is all prescription. The Minister should not play with language and try to pull the wool over our eyes.
The Minister is not in the parliamentary party now, where most people can be suborned because there are other issues like fear of party whips and so on. The Minister is in the second Chamber in which we have to ask him serious hard questions and where words have to mean something. This legislation is certainly prescriptive of medical practice; it has to be. This legislation is not the "doctors shall do whatever they see fit Bill". This Bill is quite prescriptive, rightly so.
The Minister says this Bill cannot be prescriptive of medical practice but he knows, I know and the world and its mother knows the question of whether a child is anaesthetised, in the context of an abortion, has nothing to do with and could not inhibit whatever a doctor has to do. The only thing I can conclude is that the Minister believes in the use of an anaesthetic because he thinks we are all under the ether here of easy soundbites like the Bill cannot be prescriptive of medical practice.
I ask the Minister to be a Minister and engage on behalf of the Government with the Legislature. Legitimate issues have surfaced here. I say in passing that if Senator O'Donnell is right in what she suggests - I think she asked it in a most helpful way and Senator Norris concurred with her - and if that disposes of the issue and we can be assured, that is fine but the Minister should not expect us to leave this issue alone when it has not even been ventilated in the Dáil and when we are operating against the background of a constitutional protection of the unborn. The Minister should not expect us to be neutral, blithe or uncaring about the question of whether an unborn child being aborted can feel pain and whether there ought to be a legislative duty on doctors and other medical personnel to ensure it does not happen. I ask the Minister for a better response than he has given to date.
It may be inconvenient for Senator Mullins, but the truth is the truth.
It is a helpful interruption.
The fact of the matter is that what we are legislating for is to bring clarity to a process of a determination. There is clarity around how the decision will be arrived at but not how the consequence of that decision should be carried out because that is to be prescriptive. There is no running away from that and no amount of language will cloud that or change that. That is why I will not be able to accept the amendment. I accept the Senator may want to withdraw it in order that she can resubmit it on Report Stage, so be it. However, I will not be in any way deceitful. I will be straight and clear. Doctors will make their clinical judgment and they will act to ensure safe and as pain-free as possible care. The Senator asked about the draft regulations and they will be on the Department's website this evening.
Senator Walsh talked about the viability of the baby. I am making it absolutely clear that if a viable baby is born, everything will be done to support that baby. A woman has a right in this country, as we speak and without this legislation, to a termination of pregnancy where it is the only treatment available to avert the real and substantial risk to her life. As I said earlier in this House and in the other one, no woman, no man, no citizen or no non-citizen in this country has a right to end the life of a newborn baby. That is infanticide and it is punishable under the law. Let us not try to confuse these issues and the idea of late abortions of a viable new born baby at 24 weeks onwards. Sadly, babies are not always viable at 24 or 30 weeks but in general they are. They will be looked after and given every support available.
I cannot prescribe to doctors how to carry out their treatments but we can, as a Legislature and as we are doing, tell them what treatments are legal. I expect that as medical practice becomes more innovative, sophisticated and complex, much of what the Senator talks about will become more prevalent.
In terms of there being an anaesthetist present at all times, I fail to see how occasions would arise in the general run of things where there would not be an anaesthetist available, except in an acute emergency and even then a lot of those emergencies would arise in the course of a surgical procedure where there would be an anaesthetist.
I accept the sentiment of what the Senator is bringing to this. Nobody wants to see any suffering of a mother or an unborn child. I believe the medical professionals involved will do everything to ensure this. I have to reiterate, inconvenient and all as it might be, that I cannot prescribe how doctors are to do their work.
I find that an appalling but unsurprising reply from the Minister. As part of the untruths that have been perpetrated on the nation and members of his own party for the past few months, presumably scripted for him by people in his Department, it sanitises what is happening. He failed to say clearly what type of medical procedures will be allowed. His failure clearly indicates that all current abortion procedures, many of which are barbaric, and one I described the other day will be allowed should the doctor have the discretion to do them. I would have expected the Minister to inform the House that most abortions are in the first trimester and most of those will probably be dealt with as medical abortions which involve taking drugs 48 hours apart and creating a situation similar to a miscarriage.
The drugs cause contractions and expel the unborn baby. It may take hours or sometimes days for it to happen. The Minister is a doctor and will be better informed than a Minister for Health who does not have that qualification. I understand that 8% to 10% of these will fail and a surgical procedure will have to be adopted. Surgical procedure involves suction aspiration, which uses a powerful suction tube with a sharp cutting edge which is inserted into the womb. It dismembers the body of the developing baby, sucking foetal parts into the collection bottle. Tell me if that is disallowed under the Bill. I am concerned because the taking of human life in whatever way is wrong. I ask the Minister to tell us whether that will be allowed either in the first or the second trimester.
Saline abortion is another fairly common one. It involves the injection of drugs or chemicals which cause the death of the child and his or her expulsion from the uterus. The baby, as the Minister will know, breathes in, swallowing the salt, and is poisoned. The chemical solution also causes painful burning and the deterioration of the baby's skin. After about an hour, the child dies. It is chilling for me to read this out and, I am sure, for people to hear. Surely it is more chilling for the mother and the child that are going to be put through that experience. In particular, it is chilling for the doctors to whom the Minister will look to impose it. They have not had a difficulty in dealing with situations in which there is a medical emergency involving the life of the mother. They deal with the mother and as a consequence the baby may well lose his or her life. Nobody in his or her right senses disagrees with that. There is no good reason suicidality is being included in the Bill. We will talk about that in detail when we come to section 9.
The Minister has not dismissed for me the totally barbaric procedure that was introduced in the United States of America by President Clinton in the 1990s, which is partial-birth abortion. In this procedure, the baby is pulled so that the head is left in the womb, after which one sticks a scissors in, opens it wide and sucks the brains out. This is the type of thing that happened in the Middle Ages and should have no place in modern medicine. The Minister refers to such procedures as "medical procedures" in his Bill. I challenge him in the name of everything that is right and in the name of humanity to stand up here and tell us if those acts will be allowed under his medical procedures or not. He owes us that. He should not stick to a script with sanitised language. This is what we are talking about. This is abortion. The Minister must tell us whether those things are allowed. That is why I am moving and will press amendment No. 4.
With regard to viability and term limits, the Minister mentioned 24 weeks. That is where I have a problem. There is no term limit referred to in the Bill. I have a friend, to whom I can introduce the Minister, who is just graduating from Trinity College, Dublin. She was born at 23 weeks, but the Minister, who is a doctor, mentioned 24 weeks. We must go back to that. I acknowledge that we are leaving it to the medical profession, but I want to know when a person has a right to realise his or her potential and be born. Does one get terminated at 22 weeks or 24 weeks?
While I was very pleased to hear the Minister say that everything will be done to support the baby that is born viable, why did the Government promote the Bill without putting a national paediatric budget in place to care for babies who will be born due to the restrictions imposed by the Bill? There is no paediatric budget to look after babies with life-limiting conditions or multiple disabilities. While the LauraLynn Foundation and Sunshine Home exist, having been established by a woman who lost two children to cancer, there is no State provision to look after babies who may be born, particularly when their mothers do not want them. Even if the mother does want the baby, there is nothing to provide for his or her care.
I listened to what the Minister said and have to say-----
I do not wish to stymie debate, but some of the arguments are becoming circular. The Minister has a particular position and Senator Walsh has one, as is his right.
I am only speaking to amendment No. 38, my amendment on delivering a pain-free ending to the baby. That is the only one to which I am speaking. I am happier with what the Minister said in his reply. I will read the regulations over the weekend. None of my Fine Gael colleagues would want an unborn baby to feel pain as life is ended. No colleague would. I am giving the Minister and his officials time to ensure we do not have to use the Whip to whip good people to legislate for a cruel practice whereby a little mite - an unborn baby - has its life ended in pain. The Minister is not a cruel Minister. Equally, let us not ask people to legislate for a cruel practice. The ending of life is enough.
I spoke at the weekend to a gynaecologist who started working in Galway city after having practised in the UK. Now, when one is interviewed for a post in the UK, the first question one is asked is "Are you a terminator?". She just told me this.
Come on. This is getting ridiculous.
It is so ridiculous, I could not believe it myself. I doubt she was misleading me, however. She told me her most common procedure as a gynaecologist was TOP, termination of pregnancy.
Just because an anaesthetist is in the hospital, it does not mean he or she is present at the termination. Let us call a spade a spade and proceed in a humane, sensitive way to ensure that the little unborn baby's life, if it has to be ended, is ended with a bit of dignity and pain-free. That is all I am asking for. I will take the Minister's counsel and read the regulations. I will not press the amendment now, but will reserve the right to re-enter it on Report Stage.
Senator Walsh indicated that he would press amendment No. 4.
The Minister may wish to reply to Senator Healy Eames.
I do not want to add anything as it will not change anything. However, I do not want the Senator to be misinformed or under any illusion. The draft regulations relate to forms, etc., not the clinical guidelines, which must be agreed by the colleges. I will not be enacting the legislation until the clinical guidelines are put in place. I must qualify that by saying I cannot be held to ransom by any institute or college that refuses to agree guidelines. That will not happen either.
I acknowledge that people have strong views, but every medical practitioner in the hospital system is committed to providing the best possible level of care for both the mother and the baby. Everything possible is done to protect them both. That should not be lost in the debate. It was clear from the evidence in the public hearings that they will do everything possible to protect both lives. The legislation does not change that position.
I agree with Senator Colm Burke in some of what he said. We have an exemplary medical profession in private and public practice. Of course, their responsibilities are governed by the medical procedures prescribed in law.
What we are going to do is bring in a new medical procedure to deal with suicidal ideation in women. It is a new procedure that is not legal in this country until the Bill is passed. Every doctor takes the Hippocratic oath which is, first, to do no harm and, second, to do no harm. If that is the case, will doctors have the opportunity to refuse training in abortion procedures? Will new doctors and midwives have the opportunity to refuse training in abortion procedures or will they become part of compulsory qualifications training for them? The amendment tabled by Senator Jim Walsh on medical procedures is critically important and goes to the core of the Bill. Will the procedures and drugs used in countries where late term abortions are legal be used here? Before voting on the Bill, Government Senators would like to know whether such procedures and drugs will be used here. What is the objective in training provided for staff to ensure no child is born disabled as a result of the termination process? Does the Minister propose to introduce regulations in this area?
I read an interesting article, the subject of which is a documentary on medical procedures on Channel 4. The documentary focuses on the work of Dr. John Spencer, the senior clinical director for the Marie Stokes clinic. He is one of only a handful of doctors in the United Kingdom who perform abortions up to the legal limit of 26 weeks. In his contribution he outlines that women are hardly ever asked for any more details because they are gruesome. Why should we ask for more details? With the vote we cast we are making a decision not for our partners, sisters or wives but for the general population. We have every right to ask what are the procedures. Dr. Spencer goes on to explain, in the "Dispatches" programme aired on Channel 4 in 2007, that he broke a huge medical taboo and spelled out exactly what happened during an abortion. I am quoting some of the comments relevant to the discussion on the procedures used:
Though we do not show the aborted foetus, what viewers [viewers being the mothers] will see and hear may very well shock them, but it is a vital contribution to the whole debate. In the first 12 weeks or so of pregnancy, doctors can use a simple suction procedure. After that, the surgery becomes more complicated [as outlined by Senator Jim Walsh]. Dr Spencer opens a fresh pack of shiny instruments. He's an extremely calm, softly spoken man, which somehow makes his words all the more devastating. "The foetus can't come out in one go. We haven't dilated sufficiently for that. The foetal parts are soft enough to break apart as they are being removed..." In other words, he has to dismember the foetus inside the uterus and pull it out, bit by bit. He uses an ultrasound scan to guide him. Even then, some body parts are too large to come out intact.
If we are voting for this-----
What does this have to do with the amendment we are debating? Let us do our job properly in this House.
On a point of order, there are young people in the Visitors Gallery.
All I can say is that what Senator Brian Ó Domhnaill is saying has been said already. We have spent an hour and a half on the amendment and I do not want to stymie the debate, but the Minister has indicated that he has given a comprehensive reply, which some do not accept. Senator Jim Walsh intends to press amendment No. 4. Senator Brian Ó Domhnaill should be mindful that there are children in the Visitors Gallery.
I am trying to add as much as I can to the debate in a rational and practical manner.
That has been said very clearly and graphically already.
I hear the argument that young people are in the Visitors Gallery and listening to the debate over the Internet, which is to be welcomed. However, Ronald Reagan once said that it was odd that all of the people in the world legislating to introduce abortion had already been born.
It is very difficult for the unborn to do so.
Who, therefore, is standing up for the unborn?
We are on the planet. Seriously, it would be very difficult to legislate if we were not on the planet.
The reason I have referred to these comments in the course of the debate, as raised by Senator Jim Walsh in the past few days, is that it is actually what happens, regardless of whether we like it. I have seen videos and educated myself. It would nearly make me sick to look at the procedure that takes place. I am not coming at this from a medical point of view. It is gruesome, barbaric and involves the ending of life.
On a point of order, I ask the Senator to keep the provocation and graphic detail out of his contribution.
That is not a point of order.
Some 100,000 people have had the misfortune of having experienced an abortion.
That is an unusual point of order.
We do not want to distress people any further in a most distressing situation. There is an onus on Members to be cognisant of this.
The Senator knows that is not a point of order and that he is taking leave of the Chair.
Uncomfortable as those words may be to people who find themselves forced to vote for the legislation, it is the truth.
Not for me; I am asking the Senator to be conscious that 100,000 women in the country have had abortions.
Unless the Senator is aware of some other way in which abortions are carried out, I do not think that is a point of order.
I do not believe the Minister is a bad person or anything like it, but he is in the grip of something bad if he cannot at least engage with us on the question of what might be done to alleviate foetal pain, where possible. I would feel much more reassured if the Minister even answered Senator Marie Louise O'Donnell's question.
On a point of order, I was trying to point out something rather than ask a question.
None of us is a medical person.
The Senator is not-----
The Senator has been answered four times.
Senator Rónán Mullen should not try to interpret Senators' comments.
I am sorry, if I mistinterpreted-----
The Minister has responded in detail and it is unlikely that he will change his mind, no matter how long we argue the point. Perhaps the matter should be put to a vote. I will allow Senator Rónán Mullen to conclude as I am anxious not to stymie the debate. I will then ask Senator Jim Walsh whether he wants to put the amendment to a vote.
If Senator Marie Louise O'Donnell sought to clarify a point, it would be reassuring if the Minister for Health, assisted by his officials, conferred some kind of legitimacy on the clarification. I do not think that has happened. I am not sure whether what the Senator said, the desirability of which Senator David Norris concurred with, stands up. I am sure the Senator made the point in good faith, but we have heard testimony from experts on the pro-choice and pro-life side and abortion practitioners that there is an issue of foetal pain. We cannot accept Senator Marie Louise O'Donnell's words, with due respect to her, as providing some kind of reassurance that there is no problem. The Minister has not given us any kind of reply. For all he said, we do not know whether he has ever thought about the issue of foetal pain.
The Minister has told us nothing. When an issue such as this arises in any other legislature, its Members are given some information for the assistance of their understanding and deliberation. The Minister has done nothing of the kind. That, in itself, is absolutely shocking.
The Minister stated he can tell doctors what treatments are legal but he seems to be saying we cannot tell doctors what treatment to use. What is it that prevents him from being prescriptive of medical practices, where necessary, in order to attend to and honour the dignity of the unborn child, even in circumstances where his or her life is to be lost, and requiring, none the less, that the doctor not be prevented from what the legislation requires him or her to do? This mantra that the Minister cannot be prescriptive of clinical practice is untrue; he can because he is the Minister responsible for health.
The only case in which he should not be prescriptive of medical practitioners would be if his being prescriptive were to have an overreaching effect and prevent practitioners from doing what they would need to do to protect a person's life or health. Nobody is talking about that here. If we are, or if there is a circumstance in which the administration of pain relief to an unborn child might cut across a doctor's ability to carry out the medical treatment that the law permits, he should tell us. He should show us some evidence that he consulted on this. He should not give us mantras, however. I ask again for some information, at the very least. It is simply not acceptable to say he will not engage with us on this because he will not be prescriptive, the result being that he gives us no information. That shows nothing but contempt for the legislative process. Even if he regarded Senators as mere advisers, he ought to engage with us. In theory, at least, we are supposed to be the people who, in conjunction with the Members of the Dáil, decide whether one can do as proposed. Obviously, that is a very theoretical idea. I ask the Minister one last time, if only to ease our concerns, to share with us his understanding of the pain issues.
I have not spoken to my amendment No. 37, as other amendments in other groups actually deal with the same topic. I will not hold up the House at this point; suffice it to say my amendment concerns what happens to a child who is viable. I did not find the Minister's reassurance in this regard very reassuring at all. He said that if a viable baby is born, everything will be done to sustain its life. He told us about infanticide, etc. We know there will be no destructive procedures permitted after delivery, but many of the amendments ahead of us today, and ahead of the Minister if he stays with us, pertain to what happens prior to and in the course of delivery. The amendments seek to address what I hope are unintended lacunae in the Bill and not something more sinister.
Has the Minister anything else to add?
We are at an impasse.
I heard that. The Minister's silence speaks volumes. It has been more instructive than anything he has actually said to the House today. It clearly indicates the various forms of abortion practised in other countries will now be practised in Ireland.
That is ridiculous. We have to keep the debate honest.
I hope the Minister will reflect on what he heard and that it might make him re-examine the evil outcome of this Bill. It would be wonderful if he did so and told the Labour Party where to go in regard to the Bill. However, the Minister is not accepting amendment No. 4, which goes to the core of the Bill. It would have a significant effect on the application of section 9, which is totally unnecessary, as we heard during the health committee hearings. The intention was that babies would not be aborted in any shape or form where it is not necessary to save the life of the woman. What I describe is clearly the case.
That is Article 40.3.3°.
Article 40.3.3°, which we are not meeting.
We are on amendment No. 4.
I know exactly the amendment I am on. I have been reminded of Article 40.3.3°. Section 9 is repugnant to the Constitution.
We are not on the section but on three grouped amendments.
Is the Minister prepared to take us into his confidence and tell us precisely what advice he received from the Attorney General? That has been kept a closely guarded secret. It is impossible to visualise how any Attorney General could say what the Minister is doing is constitutional. Could he tell us what the constitutional advice was?
People have spoken twice on this issue, in two referendums.
This is my first time speaking on it.
Is the amendment being pressed?
Is the Minister prepared to answer the question?
Is the amendment being pressed?
It is not relevant to the amendment.
- Bradford, Paul.
- Healy Eames, Fidelma.
- Mullen, Rónán.
- Ó Domhnaill, Brian.
- Ó Murchú, Labhrás.
- O'Brien, Mary Ann.
- Walsh, Jim.
- Wilson, Diarmuid.
- Bacik, Ivana.
- Brennan, Terry.
- Burke, Colm.
- Clune, Deirdre.
- Coghlan, Eamonn.
- Coghlan, Paul.
- Comiskey, Michael.
- Conway, Martin.
- Cullinane, David.
- Cummins, Maurice.
- D'Arcy, Jim.
- D'Arcy, Michael.
- Gilroy, John.
- Harte, Jimmy.
- Hayden, Aideen.
- Heffernan, James.
- Henry, Imelda.
- Higgins, Lorraine.
- Keane, Cáit.
- Kelly, John.
- Landy, Denis.
- Mac Conghail, Fiach.
- Moloney, Marie.
- Moran, Mary.
- Mulcahy, Tony.
- Mullins, Michael.
- Noone, Catherine.
- Norris, David.
- Ó Clochartaigh, Trevor.
- O'Brien, Darragh.
- O'Donnell, Marie-Louise.
- O'Keeffe, Susan.
- O'Neill, Pat.
- Reilly, Kathryn.
- Sheahan, Tom.
- van Turnhout, Jillian.
- Whelan, John.
- White, Mary M.
- Zappone, Katherine.
Amendment No. 5 is in the name of Senator Colm Burke. Does the Senator wish to move the amendment?
May I raise a point, a Chathaoirligh?
Is it a point of order?
I do not mind what it is called, but it is an important point.
There are young people in the Visitors Gallery and there are young people at home listening to this debate on their computers. The phraseology being used in the debate is disgraceful. I carried a dead baby who was removed while I was under anaesthetic. The carry-on here is disgraceful. I urge the Cathaoirleach to use his good office and stop this kind of talk here. There is no need for it. Everybody in the Chamber knows what we are talking about. We do not need to have it vocalised in front of children and young adolescents who may be listening in at home. I do not care what kind of point the Chair calls this, but that is the way I feel about it.
Amendments Nos. 6 to 8, inclusive, are related and will be discussed together. Is that agreed? Agreed.
I move amendment No. 6:
In page 7, to delete lines 7 to 9 and substitute the following:
“ “unborn”, means a foetus which has reached that stage of development at which, if born, it would be capable of life outside the womb;”.
As if my life is not complicated enough, I find the grouping of these amendments complicated.
This issue has to do with the discussion we had yesterday on fatal foetal abnormalities and the definition of "unborn". What I am seeking in this amendment is confirmation and reassurance regarding the definition of "unborn" as stated in this Bill. As I am not a legal person, perhaps Senator Bacik might answer this question for me, but will the definition of the "unborn" that is now, for the first time ever, being written into a Bill end up as a precedent for further or additional legislation or interpretation, or is the definition confined to this Bill? It is for this reason that Senator O'Donnell and I seek to include a definition of "unborn" which deals with the challenge of whether a foetus is compatible with life. This relates to our debate yesterday on fatal foetal abnormalities.
The National Women's Council of Ireland and the Irish Family Planning Association have the view that the new definition gives equal protection to a non-viable foetus and a woman and limits the Government's ability to introduce measures in the future to allow terminations in cases of fatal foetal abnormalities where the foetus is incompatible with life. They refer to the D case. I know the Minister has received advice from the Attorney General. However, I find it worrying that the definition, which is included in legislation for the first time in this Bill, limits the possibility of future change or might rule out future legislation, particularly legislation dealing with fatal foetal abnormalities.
The definition of "unborn" in the Bill relates to human life following implantation until such time as "complete emergence of the life from the body of the woman". The explanatory note states that this definition has been inserted to protect the life of a baby who is in the process of being delivered. As was identified by the expert group, a baby being delivered is not protected under the offence of either murder or abortion. While applicable within the narrow and defined parameters of the Bill, if this definition is applied in a broader sense, it amends the position the Irish Government adopted in the D v. Ireland case before the European Court of Human Rights. I will not go into detail on this, as my esteemed colleague Senator O'Donnell argued this case yesterday. I know the Attorney General's advice is a closely guarded secret, even more so than the secret of Fatima. However, on this issue it would be helpful if that advice was put on the record. Senator O'Donnell and I do not intend to press this amendment, but it is important for future legislation and law-making that we get clarification on the definition in regard to the advice from the Attorney General, the senior law adviser to the Government.
The Council for Civil Liberties points to the case of Roche v. Roche, in which Mrs. Justice Denham, who is now the Chief Justice, gave insights into the definition of "unborn" as in Article 40.3.3°. She stated that the concept of the unborn envisages the state of being born, the potential to be born and the capacity to be born, which occurs only after the embryo has been implanted in the uterus of the mother. The Irish courts can be expected to draw on Supreme Court jurisprudence in Roche v. Roche in any future determination of the definition of the "unborn". The interpretation section of this Bill does not state that the definitions contained in it apply only to this Bill. I heard the Minister say yesterday that was the case. However, I would like to hear the legal response on whether, with regard to any future cases, we have cornered ourselves as law-makers.
I know there is a political will to deal with this issue in the future and Senators Hayden and Bacik were very eloquent and supportive of the need for legislation dealing with fatal foetal abnormality, but they felt it could not be delivered in this Bill. Will the definition in this Bill stymie any attempts to introduce legislation to deal with fatal foetal abnormality under a separate Bill? We need clarification on that. There may also be circumstances in which a case falling outside of the scope of this Bill requires further interpretation of the meaning of "unborn". For example, the dictum of Mrs. Justice Denham in the Roche case would suggest that a non-viable foetus, being incapable of birth, does not come within the constitutional concept of "unborn". Therefore, it might be unwise to seek to apply the definition in this Bill to such a case, as to do so might not be in keeping with the constitutional interpretation. In addition, we might not want to fall foul of Article 3 of the European Convention on Human Rights, particularly with regard to protecting women, their treatment during pregnancy, and the issue of fatal foetal abnormality. I would like legal clarification of the definition of "unborn" and ask the Government to publish the Attorney General's advice on the definition and the reason it was felt it should be included in the Bill.
I am sorry if Senator Moloney was upset. That was not my intention.
Oh my God, how could the Senator not know that what he said would be upsetting? It was disgraceful talk.
Senator Jim Walsh to continue, without interruption.
On a point of order, it was insulting to all of the women here.
And the men.
We are not reopening that debate.
However, I am not sorry if Senators on the other side cannot stomach the graphic nature of the unfortunate reality.
The Senator should address the amendments. We are on amendments Nos. 6 to 8, inclusive. We will not reopen the debate.
If this arises in the future - I do not think it will - I will give advance notice of what I am going to say.
On a point of order, Senator Walsh's voyeurism does not offend me, but it is very offensive to a great number of people.
That is not a point of order. We are not opening that debate.
This is offensive to anybody who is pushing this Bill.
That is the Senator's opinion. We must all respect each other's opinions.
Senator Jim Walsh to continue on the amendments.
Amendment No. 7 is a very short amendment which proposes, in page 7, line 7, after "life," to insert "for the purposes of this Act." As somebody who believes as a principle that human life is inviolate from conception to natural death, I want to clarify that the definition in this Bill only applies to this Bill and does not have any wider connotations.
This part would then read "“unborn”, in relation to a human life, is a reference to such a life, for the purposes of this Act, during the period of time commencing after implantation..." If one likes, it is making the distinction between conception and implantation, and not interfering with the Bill. For clarity, I would not like this definition to influence other areas that might come up in the future.
We have spent six and half hours on the Title and section 2 of the Bill. I agreed to give ample time in the House for everybody to have an opportunity to speak but I am being approached by Members from both sides of the House in regard to the filibustering that is going on and the lack of decorum in the House. I am being forced-----
That is shameful.
On a point of order-----
I have been asked to bring this to-----
Name the people.
What is the point of order?
I take exception to calling the debate in this House filibustering. Views are sincerely held and very well meant.
The Senator should resume her seat.
It should not be called filibustering.
We see the support for the filibustering - eight votes on the last vote.
Against the barbaric approach taken in the proposal.
I ask Members to be brief and not to be repetitive. The Cathaoirleach and all of the chairpersons have asked for this but it is not being adhered to. We are finishing Committee Stage tonight, that is all I am saying.
Senator Rónán Mullen to continue on the amendments.
I take this issue very seriously, as do many other people on both sides of the argument. However, it really does demean our efforts, it demeans the Seanad and it demeans the sincere and constructive way we are trying to earn our living from the people by doing our duty to them to use the word "filibustering".
Senator Rónán Mullen to continue on the amendments.
I am deeply disappointed. Anybody who could characterise a debate like this on a life and death issue as filibustering really does not deserve a mandate from the people ever again. If there is one issue-----
Not one bit was untrue.
Senator Rónán Mullen to continue, without interruption.
On a point of order, those remarks about the Leader cannot be allowed to stand on the record of the House.
I treat them with the contempt they deserve.
I did not hear what the Senator said.
He is a disgrace.
I gave the courtesy to the Leader of not even mentioning him. I was simply trying to urge people to avoid disparaging language about our efforts by suggesting filibustering was going on, which was shameful. We spent about two and a half hours talking about foetal pain. If the Leader does not think that is important, I am sorry for him.
It is six and a half hours.
Silence in the Chamber.
I wonder what the people of Waterford make of that attitude.
Is Senator Rónán Mullen going to stick to the amendments?
I am, but I have to say I am disturbed.
If foetal pain is not important, what is important?
We have dealt with those amendments. We are on amendments Nos. 6 to 8, inclusive.
Let us not demean them, please.
On a point of order, I do not know where this is going. I ask that the Leader or the Cathaoirleach adjourn the Seanad for five minutes for Members to take stock.
Will the Senator, please, resume her seat?
This debate is sinking lower and lower and doing nothing for the House.
The only one who can propose amending the business is the Leader or somebody on his behalf.
I respect what Senator Moran has said and would support-----
I ask the Senator to stick to the amendments before us.
Yes. Amendment No. 6 is that of Senators Mac Conghail and O'Donnell. I understand it would remove protection from any unborn child prior to viability. If I am right in that, obviously, I would oppose it. I do not think I need say any more about it.
My own amendment No. 8 relates to the issue of viability. I am not trying to remove any protection for unborn children prior to viability but, in fact, to ensure that, where a child is viable, his or her life would be fully protected. That involves inserting a definition that the word "“viable”, in relation to a pregnancy, means an unborn who, as a matter of medical probability, would, by reason only of his or her gestational age, be capable of surviving outside the womb with the appropriate medical support”. Clearly, the purpose of that amendment is to help incorporate the idea of time limits into the legislation.
The amendment works in conjunction with the suggested amendments to sections 7 to 9, inclusive, and 13, which we will go on to consider. It also works with amendment No. 37, on which I did not speak earlier and which adds the requirement that "the medical procedure is not intended to end the life of the unborn where such life is viable.” This is in conjunction with the definition of viability. The rationale for all of this has to do with the discussions about whether time limits could be introduced into the Bill.
The line from the Government on this issue has been that one cannot time limit a constitutional right. If one looks at the Government's utterances on this issue, however, there is considerable confusion. I quote the Minister of State, Deputy Alex White, on this point. At one point, he said:
... the plain meaning of a gestational limit must mean that the test of a real and substantial risk goes out the window after it is reached. ... It is manifestly against the intention of the legislation to introduce such limits. They would undermine the legislation and change the meaning, giving a right with one hand and taking it back with the other.
However, the Minister of State's objections expressed missed the mark. Time limits refer not to the general rights of a woman but to the procedures which end the life of a viable child. The Government is at pains to suggest to us that what the eighth amendment provides for is not the termination of a life but the termination of a pregnancy, even if, in many cases, that termination of pregnancy will result inevitably in the termination of the life of the child. That is why it is so controversial. However, time limits do not refer to the general rights of the woman. The idea of time limits refers to the procedures which are used which end the life of a viable child. The Government is at pains to point out that the woman, under section 9, does not have the right to end a life of a viable child - that is in the context of suicide. They themselves limit the woman's right in this regard. What this amendment seeks to do is to express and make explicit that sentiment.
The Minister of State cannot have his cake and eat it. He cannot claim, on the one hand, that there is no right to kill a viable child under section 9 and then, on the other, claim that making this explicit in the Bill would actually revoke a woman's rights under the Bill. One cannot make both of those statements.
I propose to deal first with amendments Nos. 6 and 8. The definition of "unborn" in the Bill provides protection to the unborn from the moment of implantation and ends on the complete emergence of the life from the body of the woman, in line with the Constitution. That is exactly the legal advice we got from the Attorney General, namely, this Bill has to be in compliance with the Constitution. In addition, the Bill imposes a clear duty on medical practitioners to make every effort to preserve the life of the foetus. Not to do so would mean a medical practitioner would be in breach of the proposed legislation and subject to penalties.
With regard to amendment No. 7, I see Senator Mac Conghail had to leave but Senator van Turnhout is present. As a matter of course, the definition or interpretation provisions contained in a specific Act define words or phrases for the purposes of that Act alone. Therefore, the amendment is not necessary and I cannot accept it. The definition clearly relates just to this Bill. If, as legislators, we were in future to introduce additional legislation, it would supersede this.
The amendment will be withdrawn, but we reserve the right to resubmit it on Report Stage.
In reference to the amendments tabled on the issue of life, particularly amendments Nos. 6 to 8, inclusive, the one thing that is very apparent in the legislation - in its Title, the Protection of Life During Pregnancy Bill - is that it contains no legal definition of "life". What exactly are we protecting if we are not protecting life? Perhaps that is something the Minister of State might clarify. The people have a right to know what is being protected within the Bill.
The legal definition of life, which holds the same meaning as it does under natural law, is life "from conception until natural death". That is as contained in natural law. I have sought legal clarification from the Attorney General's office on this issue. I wrote to that office on 4 July, forwarding an opinion of senior counsel on the issue, and asked questions. I requested in writing that before the Bill came to the Seanad legal clarification should be provided for me, such as I am entitled to receive as a Member of the Oireachtas. I have a copy of the letter I sent to the Attorney General's office. All I received on 9 July was an acknowledgment-----
The Senator can raise that point on the section. We are discussing amendments Nos. 6 to 8, inclusive.
I would be happy to do so. For the avoidance of doubt, I refer again to the definition of life. Where is there contained in the Bill such a definition? I have not observed it. Perhaps the Minister of State might outline it. The Bill is entitled the Protection of Life During Pregnancy Bill - where is the legal definition that relates to the protection of "life" contained within it? That may be one for the Minister for Health.
Senator Walsh made a point about the need to seek the advice of the Attorney General. Such advice should be made available to all Members of the House, irrespective of our political colours, especially in the case of such defining legislation in the history of the nation.
I support Senators Mac Conghail and O'Donnell on amendment No. 6.
That amendment was not moved.
I regard that as rather a pity. Perhaps I will say a word on the section.
We are discussing amendments Nos 6 to 8, inclusive.
I refer to a definition of "unborn", which is a rather ungainly and unpleasant word. I do not know what it means. Anything could be unborn. For example, the attempts to attribute grotesquely sophisticated capacities to a fertilised egg are unseemly - I have listened to them. That is the very beginning of life and it is not that I disrespect it. However, to describe such entities as "citizens" is utterly unreal. Fertilised eggs are shed by the million on this planet every day. Nature is very profligate. I do not understand why we cannot have acceptance that life is a spectrum and it develops. It does not automatically and intrinsically have these qualities. Again, I point to the fact that the Roman Catholic Church only changed its mind in this respect less than 200 years ago. For 18 centuries it took the view that abortion during anything up to 166 days was reasonable, even under Catholic law.
The definition of "unborn" is an important one for that reason and I do not terribly like the one in the legislation, which states:
“unborn”, in relation to a human life, is a reference to such a life during the period of time commencing after implantation in the womb of a woman and ending on the complete emergence of the life from the body of the woman;
“woman” means a female person of any age.
I will be happy to propose or second the definition contained in the amendment if its proposers or seconders are not able to do so and would be happy to put it back in if we have another opportunity on Report Stage. There is a cleanness, clarity and focus about it: “ “unborn”, means a foetus which has reached that stage of development at which, if born, it would be capable of life outside the womb;”." I agree with that definition and much prefer it to the Government's one. It is realistic. I am sorry it was not moved and I am very grateful to the Cathaoirleach-----
It was moved, but the Senator has indicated it is more than likely that it will be withdrawn.
She has not withdrawn it. In that case, I will wait and see what happens. If it is withdrawn, presumably it can be put back. I believe it is a good idea and I support it for the reasons I gave.
May I clarify this? We have withdrawn amendment No. 6 with a view to perhaps bringing it back on Report Stage.
The House has not agreed to that yet. We are discussing amendments Nos.-----
Just to clarify this for Senator Norris, we will listen to the reply of the Minister of State and reserve the right to bring the amendment back on Report Stage. Obviously the House must agree to this.
As I understand it, the term "implantation" applies only to this Bill. Any other legislation would supersede that, and therefore my amendment-----
That is if we were to introduce any other legislation.
Yes. It would not apply to subsequent legislation.
Yes, but not following from this.
The term applies only to this legislation.
Obviously this Bill could be amended in the future and therefore "implantation" would be the term applicable.
And the summer may last forever. Anything is possible.
Have we finished discussing amendments Nos. 6 to 8, inclusive? Is amendment No. 6 being pressed?
Amendment No. 7 was discussed with amendment No. 6.
I move amendment No. 7:
In page 7, line 7, after “life,” to insert “for the purposes of this Act”.
Amendment No. 8 was discussed with amendment No. 6.
I move amendment No. 8:
In page 7, between lines 9 and 10, to insert the following:
“ “viable”, in relation to a pregnancy, means an unborn who, as a matter of medical probability, would, by reason only of his or her gestational age, be capable of surviving outside the womb with the appropriate medical support;”.
I wish to refer briefly to this section because it is important to have clarification.
Much incorrect information was given this morning in regard to the procedures for termination. The majority - 99.99% - of terminations involve the application of medication, not the procedure outlined by Senator Walsh, who is about 25 years behind the times in the description he gave yesterday, today and other days. It is wrong that this kind of false, misleading and untrue information is given out. It is important that I clarify that issue.
The issue I wish to raise in respect of section 2 is a concern I have had. In fairness, I have had a detailed discussion with the Minister on the matter, which is the definition of "obstetrician", and know the matter is being dealt with. It was raised at the public hearings. I refer to what Professor Fionnuala McAuliffe said in those hearings. This comes from the report on the heads of the Bill. She is a member of the Institute of Obstetricians and Gynaecologists, which proposed that the definition be expanded to cover cases in which an obstetrician who is registered only on the General Medical Register is acting in the role of a consultant, who would be on the specialist register. These situations occur commonly, such as over weekends, and requiring a full registered consultant to intervene in such a case could cause harmful delays. This was endorsed by Dr. Rhona Mahony. The term "obstetrician-gynaecologist" could be used to cover cases in which a specialist has simply chosen not to register, or where a specialist registrar is covering for a registered consultant.
I raise this issue because the Institute of Obstetricians and Gynaecologists contacted me last Friday and raised its concern that it had not made progress with the Department on the matter. There are three parties to this issue: the Department, the institute and the Medical Council. It is important to deal with the issue. I was talking not just to one person; I spoke to Professor Robert Harrison, Professor Fionnuala McAuliffe and Dr. Cathy Allen. There is no legal requirement for obstetricians to be on the specialist register. The definition in the Bill provides that people who are on that register are defined as "obstetricians". Professor Robert Harrison has indicated to me that up to 30% of those involved may not be on the specialist register.
He has agreed to write to every practising obstetrician to make an application to go on the specialist register. The process must be expedited to get people on. The issue arose as when the legislation was being passed a number of years ago, people who had been practising for a number of years were already recognised as being on a specialist register and everybody else coming through after that had come through a training process on the specialist register. A number of people were offered positions but had not taken them up at the time the legislation went through and were not on the specialist register in real terms. The issue must be resolved, as I am speaking particularly about smaller units with three obstetricians, for example. The problem with smaller units is there is a one-in-three call, meaning one consultant is on call from 5 p.m. on Friday right through to 9 a.m. on Monday. If the person on call is not on a specialist register, there may be a problem with a delay in dealing with a medical procedure.
I raise the matter in this context as it is a genuine concern of mine and the institute. The matter should be resolved. It is not just the Department that is involved, and although I know it does not oversee the issue, we must nonetheless progress the matter. There 12 small units with only three consultants among the 19 units. There is another matter relating to locums, which are difficult to recruit for smaller units. I know a major effort is made by the Department and the HSE to ensure all locums are suitably qualified but there may be instances where some locums are not on the specialist register. We must resolve the issue in the shortest possible time.
Senator Colm Burke is inaccurate in rebutting my comments. The only way I know of carrying out an abortion - perhaps the Senator knows a different way - is the medical and surgical process.
The Senator is incorrect. He should speak to a consultant.
I have done so.
Speak to another.
Senator Jim Walsh to continue, without interruption.
I have spoken with people active within the gynaecological and obstetrics area, as well as elsewhere. The fundamental issue is the life of the baby is not protected, which is a major concern.
I have nothing more to contribute.
I did not refer to amendment No. 6 but I will refer generally to the Bill. I thought when it was not moved that I could not refer specifically to it.
That amendment has been dealt with and we are on section 2.
I mostly agree with the Government wording, as it gives a fairer reflection. There is the idea that we move from reclassifying "unborn" to a "foetus" but I have never heard a couple say they are expecting a foetus. They expect a child.
They expect a child when it comes.
Maybe some couples would refer to it otherwise but I have never heard of it.
The Senator should confine himself to section 2.
I mostly agree with the Government's terminology. I have a question regarding section 2, with the definition of unborn and the idea of "complete emergence". There is no reference throughout the section to "complete emergence" and what that means. In reference to human life, the reference is to life during the period of time commencing after implantation in the womb and ending on the complete emergence of the life from the body of the woman. Will the Minister of State give some clarification in that regard?
Section 2 deals predominantly with definitions. This morning I received a note from a gentleman living in this city who is a member not of my party but of a Government party. He e-mailed to say that as a result of an unplanned and unwanted pregnancy in 1968-----
I ask the Senator to report progress as it is 2.15 p.m.