I welcome the Minister of State but I am disappointed that we had to break for one and a half hours, which took away from the time we have to debate these important issues. When we adjourned I was speaking to the amendment and particularly the term "shall be in accordance with current medical practice". It specifically refers to "current" rather than existing medical practice, so when the amendment is read in 2020, it will refer to what is "current" at the time and practised in Ireland. My concern is not to import some of the barbaric practices that occur elsewhere which I have described. Those were not my descriptions, although some people seem to have put that slant on my contributions. These descriptions were set out by medical doctors, similar to Dr. Reilly.
Protection of Life During Pregnancy Bill 2013: Report Stage (Resumed)
They were not Irish medical doctors.
They were not Irish doctors but Irish doctors are no different-----
They were not English doctors either.
-----to doctors anywhere else. The problem is once the medical profession is corrupted by targeting innocent life and asking professionals to carry out such action, the ethos of medicine is changed.
There was a comment from Senator Burke to the effect that at 24 weeks, a baby has a good chance of survival. I do not know what the Senator would describe as "good" as the evidence given at the health committee was that a baby has a 50% chance of living at that stage. Of the 50% who would survive at that stage, 50% would suffer disability such as brain damage, cerebral palsy, etc. At that stage, only 25% will come through early viability to be able to perform and participate fully in society, which is regrettable.
In these Houses we all espouse causes of human rights but we have those rights because we are human. Those rights evolve from the fact that we are human. Peter Stringer and Robert George are professors at Princeton University, with one being pro-choice and the other pro-life. They agree that if a person is pro-abortion, there is no defence other than accepting that infanticide is the same as abortion. Stringer actually embraces infanticide.
On a point of order, the Senator is referring to Professor Singer.
Yes.
What does this have to do with amendment No. 1, which deals with medical procedures?
Does the Acting Chairman know what is the medical procedure?
I am asking you.
The medical procedure is the abortion procedure, which targets the life of the unborn baby. I am referring to two experts in the field, each one coming from a different perspective on the fundamental issue of either being pro-choice or pro-life. I am referring to their conclusion. It challenges all of us but particularly those who are pro-choice, as to where they stand on the spectrum. This is especially true when nobody is sick and there is a healthy mother and baby.
I heard the Minister say he is not accepting the amendment, which is part of a cavalier approach taken with the Bill since its publication or even before that. Health committee meetings were held to inform us but they were ignored and many Members put down amendments in the Dáil but not one was accepted for a Bill that deals with a fundamental function. Despite the legislation going to the root of life and death, not one amendment was accepted. If Senator Burke and others are happy with current medical practice, we should put it in our legislation. If we fail to put it in legislation, medical procedure - the abortion procedure - will have no prescribed meaning or definition, meaning everything happening in an international sense with abortion procedures will be legalised. If Senators want current medical practice to continue when they vote and they do not want alien practices, which everybody agrees are disgusting and barbaric, they should press the green button. If they press the red button, they should make no mistake but that they are legalising everything I described on Second and Committee Stages.
Senator Walsh accused the Government of acting in a cavalier manner.
I am asking Senators-----
On a point of order, we have spent more than an hour discussing this amendment. The Senator is merely trespassing on the usual-----
That is not a point of order.
It is a point of order as it relates to procedure. The Senator is being utterly repetitive and has strayed completely from the amendment. I addressed the amendment in my contribution.
I am laying down a personal challenge to the Senators opposite. While I know some of them do not have any difficulty with all these procedures being legalised, my guess is that many of them have serious qualms of conscience on this issue.
On a point of order-----
The Senator may not interrupt.
It is a point of order.
Has Senator Walsh concluded?
Yes, and I am pressing the amendment.
What is Senator Gilroy's point of order?
We cannot have Senator Walsh claiming to be clairvoyant as well as everything else. He cannot read my mind. The debate is becoming ridiculous and should be kept honest.
Tá
- Bradford, Paul.
- Daly, Mark.
- Healy Eames, Fidelma.
- Leyden, Terry.
- MacSharry, Marc.
- Mooney, Paschal.
- Mullen, Rónán.
- O'Brien, Mary Ann.
- Ó Domhnaill, Brian.
- Ó Murchú, Labhrás.
- Walsh, Jim.
Níl
- 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.
- Moloney, Marie.
- Moran, Mary.
- Mulcahy, Tony.
- Mullins, Michael.
- Naughton, Hildegarde.
- Noone, Catherine.
- Ó Clochartaigh, Trevor.
- O'Keeffe, Susan.
- O'Neill, Pat.
- Power, Averil.
- Reilly, Kathryn.
- Whelan, John.
- Zappone, Katherine.
I move amendment No. 3:
In page 7, lines 19 and 20, to delete all words from and including “or” in line 19 down to and including “2004” in line 20 and substitute “or any institution listed in the Schedule”.
On Committee Stage I proposed the deletion of the same part I propose for deletion in this amendment. The Minister of State, Deputy Kathleen Lynch, said that by deleting this part, I would prevent the three Dublin maternity hospitals from being registered and designated. The reason I have made this proposal is that I do not want to see clinics such as the Marie Stopes clinic being approved to carry out abortions. Even many of the people who have a different perspective on this issue from mine and who are pro-choice feel the Marie Stopes organisation is not an appropriate one to which we should refer any woman about whom we care. The amendment amends the proposal I made on Committee Stage. While I still seek the deletion of the same part, I wish to include the words "any institution listed in the Schedule". This part of the Bill would then read: "The Minister may by order, where he or she thinks it appropriate for the purpose of this Act, specify any institution managed by the executive or any institution listed in the Schedule". I hope the Minister will see his way to accepting the amendment. This morning we read an account in the newspapers of the unfortunate death of a woman in England who attended the Marie Stopes clinic. This is not the type of clinic we would like to see established here.
On this issue, there was a significant debate in the Northern Ireland Assembly about three months ago on a motion tabled by Mr. Paul Girvan, MLA, chairman of the justice committee, which asked for such procedures to be carried out only within NHS facilities. Unfortunately, the motion was defeated by Sinn Féin on the basis of the cross-community provisions. I urge the Minister to give careful consideration to the amendment which I hope he will accept.
I second the amendment. It is important that institutions or private practices such as those referred to by Senator Jim Walsh be categorically excluded from the legislation. It is important that in the future, for example, where a public facility is unable to carry out the procedures mentioned in the legislation, the HSE not enter into any form of service level agreement with any private operator, as happens in other services within the HSE budget. Such operators are part of a private industry and while the HSE does not propose to go down the road of opening this up to private industry, it is important to state this in the legislation. Organisations such as Planned Parenthood in the United States made a profit of almost $80 million and the Marie Stopes organisation is heading in the same way. These organisations are looking at what we are doing with our legislation. I, therefore, ask the Minister to look at Senator Jim Walsh's amendment and urge him to reflect on it or provide us with some reassurance in this regard.
Does the Minister envisage a situation where institutions other than those listed in the Schedule will offer terminations or abortions to women in this country? I am also particularly concerned about the Marie Stopes clinic and there is one such clinic in Northern Ireland. As Senator Brian Ó Domhnaill said, abortion services are now a huge industry worldwide. Today Senator Ivan Bacik mentioned the woman who died after an abortion in the United Kingdom. A termination may be offered in this country, under section 9 of the Bill, where there is "a real and substantial risk to the life of the woman". I remind the Minister that this procedure caused a real and substantial risk to the life of the woman who died in the United Kingdom. Carrying out an abortion is a high risk procedure.
On a point of order, with all due respect, we do not know the details of what happened to the woman in question.
That is not a point of order.
I do not know what it is called, but we do not know what happened.
The Senator should not, therefore, contradict the other speaker.
It is an interruption.
We do not know what happened, as Senator Brian Ó Domhnaill knows.
The Senator cannot contradict Senator Fidelma Healy Eames's contribution.
She does not know either.
Neither does the Senator.
I ask Senator Fidelma Healy Eames to refrain from dealing with a matter of which we do not know the full facts.
Okay. However, I understand she was an Irish woman who died in January 2012.
I again ask the Senator to refrain from referring to the case because there could be legal proceedings.
She did not die in Ireland.
There are sensitivities around the victim.
I agree completely. This woman had an abortion in the United Kingdom, in a Marie Stopes clinic. This is in The Irish Times today, as Senator Ivana Bacik pointed out this morning. She might have been affected by the abortion.
On a point of order, Acting Chairman, I think you have asked that this case not be mentioned. I would reiterate that as a matter of courtesy and respect.
Is that a point of order?
No; it is a statement, but I have asked the Senator to refrain from specifically dealing with a case that appeared in the news today. We do not know the specific details.
We had a situation in Galway where the tragic case of Ms Halappanavar was hijacked to put legislation on abortion through in Ireland.
On a point of order, that is not the case.
I would like to be given the floor.
To speak the truth, possibly.
In January 2012 the woman in question tragically died in the United Kingdom. There has not yet been an inquest into her death.
The Senator is going back to the case that I asked her not to mention.
I will go back to my initial question to the Minister of State. Does he envisage any other institution offering terminations or abortions in Ireland, other than those listed in the Schedule which I think number 26? If he does, can he please tell us?
As was explained on Committee Stage, the aim of the wording included in section 3(1) of the Bill is to ensure the three maternity hospitals and the large public multidisciplinary hospitals in Dublin which are not owned by the HSE will be included in the ambit of the operation of the Bill. Not to include these hospitals would have grave consequences for the safety of women in the Dublin region and beyond.
I understand the Senator has concerns about the possibility that the wording may leave open the possible future inclusion of private clinics. However, I assure him that this is not the intention of the Bill and the wording, as drafted, does not allow for this possibility. The names of all institutions which will be permitted to lawfully carry out the medical procedure referred to in the legislation have been listed in the Schedule to the Bill and any change to these provisions will be laid before the Houses of the Oireachtas. That is specifically provided for in the Bill. For these reasons, I do not propose to accept the amendment.
It is useful to look at the Health Act 2004. There is a reference in section 3(1) of the Bill to that Act which may needlessly be causing some concern. Section 3(1) states:
The Minister may by order, where he or she thinks it appropriate for the purposes of this Act, specify any institution managed by the Executive [manifestly, that is the kind of institution everybody has in mind and can give no cause for concern], or by another person pursuant to an arrangement entered into under section 38 of the Health Act 2004...
The Senator proposes to delete this latter part. I presume the Senator has looked at section 38 of the Health Act 2004 which states:
The Executive may, subject to its available resources and any directions issued by the Minister under section 10, enter, on such terms and conditions as it considers appropriate, into an arrangement with a person for the provision of a health or personal social service by that person on behalf of the Executive...
It is quite clear that any institution that might conceivably be involved will entirely be under the control of the executive, in the sense that it would be an arrangement entered into by it. There is literally no possibility, in view of the wording of the Bill, of the kind of circumstances and private institutions being provided for in the legislation. For that reason, there is no basis for the amendment. It is not required, based on what the Senator has advocated, and I do not propose to accept it.
I thank the Minister of State for his response and commitment that this will not happen. I would love to believe that was the case. Section 38 of the Health Act 2004 states the executive "may enter into". The Minister of State is relying on the fact that the executive will not enter into an agreement, but there is nothing in the legislation that prevents the executive from doing so. I have genuine concerns about this.
The current CEO of the HSE is somebody who worked for the IFPA which works closely with Marie Stopes. One of the concerns-----
On a point of order-----
These interruptions-----
-----we do not refer by name to any individual or otherwise identify them in the House. That is a Standing Order and Senator Jim Walsh is doing just that.
The matter is in the public domain.
Will the Sentator please refrain from referring to specific individuals?
I have concerns about people in the HSE and the Department who are in these positions. I am entitled to make my point on that issue. My concern is that it is quite possible that it could happen. I know the Minister of State says they will not do it, but in other areas the likes of Marie Stopes will fund these organisations and will receive referrals from some of them. There are counselling organisations in Ireland that are referring people to Marie Stopes. The Minister, the Department and other Senators are aware of this.
Who is funding the Senator?
That is current practice in Ireland. I am trying to avoid a situation where any of these private clinics will be allowed to do so. I hear what the Minister of State is saying, but I find it hard, from the language used in the Bill which includes the words "by another person pursuant to an arrangement entered into" - it could be a private clinic - not to have a concern about this section. I understand others do not have the same concern, but I know that they are concerned about Marie Stopes in Northern Ireland where there are many debates about it. The Minister of State is probably aware that the Minister for Health in Northern Ireland, Edwin Poots, MLA, was in touch with the Minister for Health about his concerns. He confirmed to me that he was opposed to any relaxation of the law in Northern Ireland on the termination of pregnancy. He stated in his letter that he would have concerns that legislation would open doors inadvertently for others to introduce much more flexibility in allowing abortion, although not intended by the Dáil. I have a copy of a letter sent to the Taoiseach, which states:
We, as individual members of the Northern Ireland Assembly and member of the pro-life group, are therefore concerned that a matter of such importance may be voted upon without the ability of legislators to freely exercise their conscientious objection to this important piece of legislation which, if enacted, will have profound consequences, not just in the Republic but also for Northern Ireland.
There are politicians in Northern Ireland who are seriously concerned about what we are doing. They have done everything possible to prevent Marie Stopes from establishing there. My concern is that under the legislation, as crafted, there is that possibility. I accept that it may not be the intention, but I cannot see how it could be prevented under the phraseology used in the Bill and the Act to which it refers.
I do not want to say too much more, other than to object to the Senator or anybody else seeking to impugn an exceptional public servant, the director general designate of the HSE, for whom the Minister for Health and I have the highest regard. He is a person of very high integrity and professionalism and I object to the manner in which the Senator has sought to traduce his name.
On a point of order, I did not impugn his name, nor would I do so. I said he had worked for the IFPA, which is true. I said the IFPA had associations with Marie Stopes, which is true. That is all I said. I did nothing else to impugn the man's name and I did not do so.
I move amendment No. 4:
In page 7, between lines 27 and 28, to insert the following:
"(iv) facilities for the intensive care of newborns,".
This amendment concerns in-patient services provided under the direction of medical practitioners. I want to ensure that the services would include facilities for the intensive care of newborns. Senator Burke raised the viability of the foetus after abortions or inducements, accepting that every effort will be made to save the life of the baby. When we come to section 9 we will explore that a little further. Let us accept that for the purpose of this amendment, some of those babies will be seriously damaged because of the abortion process. Many will be dead. The least we will need as some precautionary measure to mitigate the numbers that will be brain-damaged or affected in the future, is a proper intensive care unit specifically staffed with experts in the field of dealing with newborn emergencies. That is a reasonable amendment and it should have been included in the Bill.
I second the amendment. How many of the institutions or hospitals listed in Schedule 1 have facilities for the intensive care of newborn babies? One would expect that all those hospitals would have such facilities if the Bill seriously intends to protect both lives, even though we know it does not protect the unborn child. It is my understanding that is not the case and a large proportion of the facilities listed do not have those dedicated facilities. I yield to the Minister of State. I believe it is important to find out how many of the facilities being included under this legislation have those types of facilities for the intensive care of newborn babies. We need to know that.
It is a very reasonable amendment that my colleagues Senators Walsh and Wilson have put forward to ensure that such facilities would be compulsory in any hospital setting within the public system that is going to be used under this Bill in what is defined as medical practice. We know that the medical practice is an abortion. It is a glossary term for the medical practice. Reference was made to Senator Walsh's naming the person who is head of the HSE. We are parliamentarians and we have every right to name someone who is responsible for a budget within the HSE, over 50% of which is tax revenue generated by the State. Let us reflect on that truth.
I would like to follow up on the question about the number of institutions that can care for babies born on the cusp of viability. In my own family there were twins born at 23.5 or 24 weeks. At 22 weeks, when it looked like that was going to happen, one of the hospitals listed in this Schedule could not handle that. This was five years ago. The mother had to be moved to the Rotunda. This is a critical point because the Minister for Health, Deputy Reilly, has made a very strong claim here that once a baby is viable, or on the cusp of viability, despite the fact that the mother is seeking a termination, the State will do everything to ensure that the baby is delivered alive. Can the 26 hospitals listed here manage that crisis? Can they save the life of the baby after it is born?
In fairness to people in the medical profession, if they feel that a difficulty will arise in their unit and they are not able to deal with it they will do everything possible to transfer the patient to an appropriate unit. There are many units around the country which will transfer to the Rotunda, Holles Street or the Coombe, depending where and why the specialty is required. In the southern area the patient will be transferred from Waterford or Kerry to Cork, in the northern area to Galway. For instance, a patient in Letterkenny or Sligo will be transferred to Galway where the specialty is required. The medical profession will do everything possible to save the life of the mother and of the unborn.
This is the first time I have ever heard the treatment of neonates or babies in this country being criticised or questioned. I have never once come across any parent or individual who criticised neonatal treatment in this country. To ask where would newborn babies be treated or kept and to suggest that they would not be treated is a terrible criticism of our health system and culture. Babies will be born in the next few hours in this country, and young couples who will have the beauty of a new child will possibly listen to this debate and wonder whether the hospital they are attending has the facilities to treat their newborn baby.
Last week, a baby was born in Letterkenny hospital whose mother was brought in by helicopter from Arranmore. I did not hear one person saying that Letterkenny hospital did not have the facilities to treat that baby which was born in unusual circumstances in the corridor of the hospital. It is insulting. My four children were born in Letterkenny hospital. Not once did anyone say that Letterkenny hospital might not be the best place for our babies to be born. The same is true of Sligo hospital or Beaumont or wherever. For anyone to suggest that about the HSE or the medical profession is outrageous. If that is the level of debate that we are having tonight on the protection of life it is a good case for the abolition of the Seanad. If we have come so low as to criticise the neonatal services in this country to ask how could they cope with the most extreme circumstances where a child is born-----
The child is aborted. It is not born.
We are talking about the neonatal care. When Senator Ó Domhnaill has had that experience he can come back and tell me about it.
You are voting for abortion at Letterkenny General Hospital.
It is totally outrageous. As the father of four children, including two daughters, I find the type of debate going on in this House this evening offensive. It is disgraceful. It is neither theological, physiological or on any level-----
I ask Senator Harte not to get into a debate with his colleagues.
I am not getting into a debate. I am making my comments as a father and husband and brother because the debate has gone to the level of picking the rawest situation to scare the public, and saying all of a sudden we want the Constitution for ourselves but not for the women of Ireland, that they are different. The Constitution stands for every person in this country, man, woman or child. The Constitution and the X case are the law. It needs to be tidied up but for people to suggest that people who-----
I do not wish to cut across the Senator but this is more like a Second Stage speech.
It is an emotional speech because I find it very difficult to comprehend the thought processes of certain people.
Does anyone else wish to speak on amendment No. 4?
Senator Harte has completely misunderstood what this amendment is about. Of course there are situations in emergencies where most doctors do their best.
Senator Mullen cannot make implications about doctors by saying "most doctors". Senator Mullen should withdraw that remark. He cannot say "most doctors do their best".
The Senator should withdraw that remark. He cannot say that most doctors do their best. I want my family to be safe when treated by any doctor, not just some doctors. Maybe the Senator is aware of doctors who do not do their job-----
Please resume your seat, Senator Harte.
Sadly, I am aware. Senator Harte needs to extend his compassion beyond his own family to those who will be affected by this legislation. The point is that there will be foreseeable situations where, at best, this legislation will involve bringing children into the world in circumstances in which they are premature, very sick and in danger of severe disability. We all know that any hospital will do its best when emergency situations arise. This is not what we are talking about; we are talking about circumstances in which foreseeable procedures will be dangerous from the point of view of the unborn child if it survives. These should only be done at facilities where everything can be done to preserve the life of the child. It is a very simple point. Senator Harte should understand it. It is no use for Senator Burke to say, "Trust me; I am a doctor's spouse. Everything is fine with doctors." That is not what this debate is about.
Is the Senator saying that doctors cannot be trusted?
The amendment concerns the provision of facilities for the intensive care of newborns in appropriate institutions under the terms of the Bill. As was discussed on Committee Stage, it is not proposed to accept this amendment for the reason that it is not necessary. I am confident that if a newborn infant requires intensive care facilities anywhere in the State, nothing in the provisions of this Bill would prevent the child from accessing those facilities.
Of the 25 hospitals listed on the Schedule to the Bill, 19 provide neonatal care services across the country. In addition, neonatal transport is now universally accepted as an essential component of newborn care. The national neonatal transport programme has been in operation for 11 years. Currently the service operates seven days a week and accepts calls from 9 a.m. to 5 p.m. The extension of this service to a 24-seven service is one of the objectives of the HSE service plan for 2013 and is on target to be achieved in September.
I thank the Minister of State for putting the facts on the record of the House.
I thank the Minister of State for his response. My question is not so much about neonatal services, because that service is the minimum to be expected in hospitals where abortions are being performed. I am alarmed to think that five of the 24 hospitals do not have at least that minimum facility. I am looking for facilities for the intensive care of newborns. I will comment briefly on Senator Harte's rambling musings on the issue. Along with many other Members, I am familiar with the expertise of doctors in delivering babies which are at full gestation. However, that is not the issue. Senator Harte seems to have missed the point completely. This Bill is about removing babies at 23 weeks - and indeed before that, when they have no chance of survival. At 23 weeks, 24, weeks, 25 weeks, 26 weeks, 27 weeks or 28 weeks, such babies will require intensive medical care. All I am looking for is that they be given that care. My concern is that if these facilities are not on-site it is logical that there will be a period of delay. If these young babies have only a 25% chance of survival without being seriously injured, the 25% who will be injured should be given the best possible service. That is saying nothing about the good maternity care system in the country, which I have acknowledged at all stages of this debate. If we cut out the obfuscation and the interruptions from the far side, and listen to the intent of what is being sought in some of these amendments, maybe some grounds for agreement will be found-----
I appeal to the Chair.
I did not interrupt anyone and I hate to see-----
You are doing it now.
I am doing so because Senator Walsh is implying that everyone is interrupting him.
Amendments Nos. 6, 11,16, 17 and 32 are related and may be discussed together.
I move amendment No. 6:
In page 8, line 34, and in page 9, line 1, to delete all words from and including “(being” in line 34 down to and including “practicable)” in line 1 of page 9 and substitute the following:
“(being an opinion which respects the equal right to life of the unborn, and which has regard to the duty to deliver the viable unborn alive where practicable)”.
I will speak briefly on all these amendments. We are discussing the test for reasonable opinion with regard to sections 7, 8 and 9 of the Bill, and more particularly in the context of section 9, which is where the mischief exists. The test for reasonable opinion is very subjective. The opinion has to be noted of those who are certifying the abortion, not those who would be carrying it out. The reasonable opinion as defined does not require any court test of reasonability at all; it merely has to be an opinion formed in good faith. As the Minister of State, with his legal background, will well know, it is very difficult to prove bad faith. The other requirement is that the certifying person must have regard to the need to preserve unborn human life as far as practicable. That appears to invoke the test of the Eighth Amendment, but that contains an undertaking to defend and vindicate the right to life as far as practicable. The need to respect the equal right to life of the unborn is not qualified in any way in the Eighth Amendment. Therefore, these amendments would strengthen the requirement for the certifying medical personnel to form an opinion which respects the equal right to life of the unborn. That is the constitutional mandate. They would have to have regard, where practicable, to the duty to deliver the viable unborn alive. That is the effect of amendment No. 6 on section 7, amendment No. 11 on section 8 and amendment No. 17 on section 9.
We have been given many sorts of reassurance that where a child is at the cusp of viability or is viable, not only will his or her life be preserved if born alive, but he or she will be protected through the procedure so that he or she can be born alive. This reassurance has been given informally and is certainly not in the legislation. I would like the Minister of State to restate that assurance. However, even if he does, it is quite clear that it is not required in the legislation. It is the certifying physician who is supposed to have regard to the duty to preserve the life of the child where practicable but there is absolutely nothing in the legislation about the lawfulness of the procedures themselves that imposes the requirement to preserve the child's life.
I second amendment No. 6.
I am speaking on amendment No. 16, which concerns the risk of loss of life from suicide. At the risk of being interrupted, I will do my best to formulate thoughts which have been put to me by people in the medical profession. In the case of suicide, according to this legislation, where there is a real and substantive risk to the life of the mother, it is deemed that to save the life of the mother the baby's life must be taken. This includes the threat of suicide. What is the legal status of the unborn in this case? The expectant mother is not looking for a live baby at the end of this procedure. The State is making a commitment that it will deliver a live baby where possible. We have a terrible record of State care. It is a surreal scenario. I ask the Minister of State if there is anywhere else in the world where it happens that a mother believes her pregnancy is the reason her life is at risk from suicide, and therefore she is seeking a termination of that life, but the State decides to deliver the baby alive.
Where else in the world does this happen? What is the status of any such baby and to whom does he or she belong? What surname will the baby be given? I accept completely that we are talking about women in a distressed condition, women who are perhaps mentally unwell and might even be in a psychosis. My concern, however, is that a month later, the mother will recover and her first question will be about her baby and where he or she is. Dr. Jacqueline Montwell made that point very clearly during the committee hearings. A woman in those circumstances might want the baby, or she might say she never wanted a live baby. In the latter case the baby will be placed in State care, which could have a further negative impact on the mother's mental health. I hope the Minister of State will answer the important points I have raised.
The legislation proposes that an abortion shall be lawful to save the life of a woman where doctors, in their reasonable opinion, believe that the risk can only be averted by that procedure. The word "only" is the one I am emphasising here. We are all agreed that section 8 relates to those awful situations which sometimes occur where a termination is necessary. There are certain syndromes or conditions whereby an otherwise healthy baby will threaten the life of an otherwise healthy mother. Senator Jim Walsh says that such cases do not exist, but they do. They consist mainly of syndromes which present the risk of pulmonary hypertension in the woman. I will not mention other syndromes because I do not want to distress people who might suffer from them. It is important that we contain ourselves in this discussion. I could give Senator Walsh a graphic description of what happens in such cases, but it would serve absolutely no purpose other than offending people who might have experienced it.
If we agree that there are circumstances where the deliberate taking of the life of the child, because of a medical emergency, is legitimate, then we accept the legitimacy of section 8. I presume Senators Walsh and Brian Ó Domhnaill and even Senator Rónán Mullen accept that position. It follows then that the only thing separating my position from theirs is a question of degree.
It is a question of intent.
What about a situation where pulmonary hypertension is present and the mother's life is threatened with immediate effect? Senators might wish to consult the website of the Mayo Clinic for information on what I am referring to here. In such cases, even when rapid and immediate medical treatment is given, the outcomes are not always life-saving. In the case of pulmonary hypertension and aortic dissection, the direct cause of the threat to life of the woman is her pregnancy. We all agree that such conditions, which are extremely rare, would qualify under section 8. Their reported instance is so low that it is not even possible to formulate an opinion on their statistical prevalence. We are all surely agreed that termination of pregnancy is justified in those circumstances. However, Members on the other side of the House have seen fit to accuse me of being pro-abortion. I am not any more pro-abortion than is Senator Walsh, yet he has made that charge on numerous occasions in the House.
I never accused the Senator of anything.
In fact, he and I have common ground on this particular point.
Let us now take that argument and apply it to section 9, which refers to the risk of suicide. We have heard a great deal of talk about the threat of suicide, but what we are actually dealing with here is risk of suicide.
We are not discussing section 9.
Amendment No. 16 relates to it. If we accept that suicidal risk is a legitimate grounds for termination then we accept the legitimacy of section 9; otherwise, we do not. I would contend that the difference between me and those who do not share my view relates essentially to our respective attitudes to mental health. Efforts to separate out the risk of suicide grounds are a clear pointer to the holder's views on mental health. Senator Walsh said earlier in this debate that we are pretending when it comes to suicide. I do not agree. I worked in the area for a long time and I do not believe anybody is pretending. Senator Fidelma Healy Eames asks about the woman who gets better in a month's time and asks for her baby. That question demonstrates a fundamental attitude towards mental health that I as a professional had hoped was gone from this country 40 years ago. It is paternalistic, treating people like they are-----
On a point of order, that point was made by a psychiatrist during the committee hearings.
It is even worse if a psychiatrist said it because it indicates a paternalistic approach to psychiatric and mental health care which should have gone out with the straitjacket and walled asylums. One's position on this provision is very insightful in that it gives a good idea of where one stands vis-à-vis mental health and whether one believes mental illness is a real illness. I have worked in the area for 28 years and I contend that the provisions in section 9 are absolutely legitimate on medical grounds.
We are not dealing with section 9.
I am referring to amendment No. 16.
The amendment is specific.
Even if I did not believe that, it is the position set out in our Constitution. Those who hold a contrary position have little choice but to seek out a referendum to appeal the section. They should bear in mind, of course, that the people of Ireland have already spoken twice on this issue. There can be no doubt about the constitutional position. The bottom line is that those who would seek to exclude section 9 are doing so based on something other than sound legal and medical grounds.
On the point raised by Senator Fidelma Healy Eames, it should be noted that the Health Service Executive has strict guidelines on how to deal with a situation where a pregnant woman is in need of psychiatric care or where a baby is born to a woman in those circumstances. There are standard procedures in respect of court applications and so on. The legislation is not introducing anything new in that regard.
Senator John Gilroy said that anybody opposed to section 9 is ignoring what he termed the legal and medical grounds for its inclusion. In fact, we have very much taken into account all the scientific evidence that was presented to us. I support this group of amendments and particularly the comments by Senator Rónán Mullen. Regardless of who brings the challenge or commences the case, this legislation will almost certainly be tested from the point of view of its constitutionality. The final case for the defence of the Bill, when all the hard questions have remained unanswered, particularly in regard to section 9, will come from the Minister and his colleagues who will point to the current protection for the unborn as per the Constitution. That particular protection is very specific in its language. The Minister of State, Deputy Alex White, is much better than I at legal language, but I urge him not to ignore this series of amendments. He said previously that he is not interested in any amendments other than minor technical amendments. He has undertaken to reject any and all substantial amendments; at least he was reported by our friends in the media as having said so.
If this legislation is to stand up to constitutional scrutiny, then it must tie in with the 1983 amendment to the Constitution. The question of delivering a viable unborn life, where practical, is a matter upon which the Minister of State, as a legal scholar, must reflect. He must also have regard to the duty that must be imposed on medical personnel. As drafted, the Bill does not provide the security which, in the context of their intentions, was to the fore in people's thinking when they voted in the 1983 referendum.
Notwithstanding the fact that amendments are not being accepted, I ask the Minister of State to provide us with his legal opinion on why the measures being put forward are not in accord with Government policy. This has been a lengthy process and the last thing anyone wants is for the legislation, when it is finally passed by the House, to be deemed unconstitutional. I am aware that we cannot be presented with the advice provided by the Attorney General. One of the bizarre aspects of parliamentary procedure is that when the Attorney General advises the Government, we are not allowed to see that advice in order to assess its strength or discover whether the various pros and cons have been examined. In the context of amendment No. 6, will the Minister of State indicate how he and his colleagues in government are so comfortable and content that what is being proposed is fully constitutional and that what is contained in the amendments is not constitutional?
I am struggling to understand the intent behind these amendments. Perhaps the Minister of State will provide some clarification in respect of them. The amendments relate to the judgments which medical professionals and practitioners will make in respect of situations where women's lives will be in danger. Amendment No. 6 suggests that the phrase "being an opinion which respects the equal right to life of the unborn" be inserted into the legislation. The inference is that medical professionals will not respect the equal right to life of the unborn. One could infer something even more sinister from the wording used. It is the latter which gives rise to my concerns. What would be the result if the amendment were to be accepted? The amendments under discussions all relate to sections 7 to 9, inclusive. Those sections are all very clear and address the Supreme Court judgment which refers to a substantial and real risk of loss of life to the mother. Essentially, it is that matter which is under discussion. The medical practitioners who will be obliged to make decisions in this regard - in good faith - will have to do so on the basis of assessing the level of risk to the life of the mother.
I cannot understand why anyone would want to include the phrase "being an opinion which respects the equal right to life of the unborn". As already indicated, the inference here is that medical professionals would not be making their decisions on the basis of the risk to the life of the mother but rather for other reasons. I cannot accept that and I do not believe it is what medical practitioners making decisions in good faith would do.
There are two parts to amendment No. 16. The first of these relates to the reasonable opinion of medical practitioners. I refer here to opinions formed not just in good faith but also on reasonable grounds. I understand, from discussing the matter with legal people, that reasonable opinion on reasonable grounds could be interpreted separately and that including the term "on reasonable grounds" actually strengthens the degree to which judges might interpret the defence of the unborn. It is for this reason that the term is included. I tabled a similar amendment on Committee Stage. Both it and amendment No. 16, which is currently under discussion, suggest removing the reference to the need to preserve unborn life as far as practicable and replacing it with the phrase "which has regard to the right to life of the unborn". The latter is taken directly from the Constitution. I may be wrong but I believe that on Committee Stage the Minister, Deputy Reilly, - although it could have been the Minister of State - emphasised the fact that the phrase "as far as practicable" would be removed from the legislation if the amendment I had tabled at that point were accepted. In this context, the Constitution says, "The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right." I do not believe, therefore, that attaching the phrase "as far as practicable" to that of "to preserve unborn human life" interprets the intention of the constitutional amendment accurately. I am of the view that the phrase "as far as practicable" applies to the obligation of the State, in its laws, to defend and vindicate the right to which I refer. I see a certain distinction in that.
The Irish version of the Constitution is probably even clearer in respect of this matter. It states, "Admhaíonn an Stát ceart na mbeo gan breith chun a mbeatha." The term "ceart na mbeo gan breith" is much clearer than the English version. What is meant by the word "unborn" needs to be defined and some people would dispute that meaning. The rights of the living who have not been born is the literal interpretation of the Irish version of the Constitution. I am of the view that this is a more accurate description and it strongly underpins the equal right to life. The Irish version also states "an ceart sin a chosaint is a shuíomh lena dhlíthe sa mhéid gur féidir é." We have to defend the latter, which is also an aspect of the English version. However, we must also defend the ceart na mbeo gan breith. I suggest that what is contained in the Irish version of the Constitution provides a reason for giving further consideration to this matter. Many of the procedures that will be legalised and the instances in which their use will be allowed will specifically depend on the interpretation of judges of that section.
The second part of amendment No. 16 comprises the phrase "the pregnant woman has undergone an ultrasound". If the amendment were accepted, there would be a requirement under section 9 to have an ultrasound carried out. I wish to explain why I have worded the amendment in this way. Senator Mooney tabled a similar amendment on Committee Stage which was debated and subsequently withdrawn. I listened carefully to what the Senator stated and I considered the matter and discussed it with people in the psychiatric field in the interim. I included this provision in amendment No. 16 as a result of my concerns on this matter. In the United States one in every four pregnancies is aborted. In New York the figure is one in two, which is appalling. Regardless of one's perspective, I do not believe one could provide any justification for one in four or one in two babies being aborted. I am concerned about the effect of abortion on women who have undergone the procedure. When one meets such women and listens to their stories, one cannot but be moved.
I wish to quote the president of Feminists for Life in respect of this matter.
This is a genuine feminist, not the pseudo-feminist from whom we often hear on this topic. She said that feminists are opposed to force, abortion is a denial of feminism and that exploitation of women, including abortion, is interfering with nature. That is the reason I raise this and the reason I tabled an amendment on the ultrasound. This person went on to say that some women who fought against slavery fought for rights of women and also fought against abortion in the early stage of feminism in the US, and that is their history. She made a point, to which I referred on Second Stage, that whereas financially independent, educated women generally will not need abortion, we pass on this to disadvantaged women. She reckoned abortion is the ultimate exploitation of women and that it affects so many others including men, siblings and grandparents. I remember members of Women Hurt saying in the audio visual room that an average of 45 people are affected by every abortion.
The second part of that amendment is fairly specific in regard to-----
The amendment is very specific about the ultrasound. I am giving the reason I tabled it and the reason it is specific. This person also mentioned that abortion is a reflection that we have not met the needs of women but many states, particularly in the United States, have brought in a requirement that once a woman has made this irrevocable decision, she must be made aware that she can never reverse it. When she is suffering the anguish and the pain of the decision subsequently, having made it in a time of severe trauma, she is not able to reverse it and therefore it is imperative that if women are informed and are to be informed, they need to see the results of the ultrasound. My understanding is that in certain states in the United States, up to 90% of those who seek an abortion have decided against having the abortion. That is good because it informs the woman.
I will conclude by quoting a woman who was in the Women Hurt delegation. She is a woman who had an abortion. She said she made the choice of abortion and had a safe, legal abortion. She has worked in abortion recovery helping other women who have struggled with their abortion experience. She said that their voices are rarely heard in this debate. She said that those who would advocate and fight for her right switch sides and attack her, and other women, who dare to say that their choice was the complete unchoice in the end. She told me that I did the right thing. Women need to know the truth about what they are choosing. Otherwise, and this is the point about the ultrasound, doctors must ask themselves if their patients, as women, have fully informed consent when they make that decision. The truth has nothing to fear from disclosure. If the Minister is wont to accept this amendment it will ensure that we do not rapidly head in the direction they have gone in the neighbouring island where in almost one in four pregnancies, the baby is aborted and killed. I do not want that. I do not believe anybody in the House wants that.
I wish to speak to the general amendments and I assume I am allowed some flexibility.
There are six amendments.
Yes. Section 9 states:
It shall be lawful to carry out a medical procedure in respect of a pregnant woman in accordance with this section in the course of which, or as a result of which, an unborn human life is ended....
That is not equality. That is abortion. We should be clear about that.
Honour before honours. Concede to no one one's hard-won principles. I attended an event in Frenchpark yesterday honouring a priest, Fr. Padraig Devine of the SMA, who was 25 years ordained. It was attended by the Cardinal who is Archbishop of Nairobi, Kenya, as an example of the contribution of the church to the people of the Third World, including Africa. I picked up The Angelus-----
We are on the amendments.
Yes, and that is the point I am making. An effort has been made in the past two years to denigrate the work of the church, building up to this situation where we are bringing in abortion. The first step was the closure of the embassy to the Holy See.
Come on now.
What does this have to do with the amendments?
Senator Leyden, you are not speaking to the amendments.
I am sorry. I am getting to the point.
He is giving a Second Stage speech.
The Senator is making a Second Stage speech.
On the amendments, Senator.
I am dealing with the amendments. I am trying to make the point that there has been a softening up in relation to this issue for some time.
For 21 years-----
Senator Leyden without interruption.
Do the Senators not think it appropriate that the hierarchy would make a statement in this regard?
Senator, I do not think you are speaking to the amendments.
Which amendment-----
The right to life is the most fundamental of all rights. It is the foundation of all other rights. No individual has a right to destroy life and no state has the right to undermine the right to life.
We are saving the lives of women.
Senator Leyden, to which amendment are you speaking?
I am speaking to all the amendments.
Senator, I cannot see where you-----
I am here longer in this Oireachtas that any of the Senators.
Yes, Senator. We appreciate that.
I have been around a while.
Is Senator Leyden saying the Cathaoirleach is wrong?
We have the shortest serving Senator and the longest serving Member of the Oireachtas in the Chamber, and I welcome the Senator again.
Senator Leyden, on the amendments.
When I stand up to speak there is a general tendency to shout me down.
You are making a Second Stage speech, Senator. That is what you are on.
Pardon?
Does it not cause you to reflect?
Senator Leyden without interruption please. Senator, you are on a Second Stage speech.
This is the kernel of the issue. My two colleagues have expressed many views in this House, which is what they were elected here to do. I am trying to put the other side of the coin. The fundamental issue in this debate is that the State, through the Minister and through members of the Fine Gael and Labour parties, is prepared to bring about a particular situation under section 9 and the amendments go in some way to alleviate that. Is that right? The principal idea behind my colleagues putting down amendments was to try to reduce this-----
-----and give the Minister a last chance in that respect. He should let his conscience rise to the occasion-----
And do the right thing by the women of Ireland.
That is exactly what you are doing.
I will tell you-----
Senator, you are not speaking to the amendment.
You might find in years to come-----
Senator Ó Domhnaill.
Are you the Senator who knows about Jean McConville?
On the amendments-----
What did I do?
Can we have silence in the Chamber and no crossfire?
-----where is the right to life of that unborn child? Where does that unborn child go? Who will bear responsibility when that child is born and the mother, who had intended to commit suicide, decides not to commit suicide? The child is now born and the State must take responsibility.
Senator, you are not speaking to the amendments before us.
Of course I am. That is the basis for the entire Bill, and this is the key point. Every time I stand up the Senators opposite do not like what I say. It upsets them, and in years to come-----
Senator, the Senators who have spoken have spoken to these amendments.
I want to tell the Cathaoirleach something.
Senator, unless it is to do with the amendments-----
In years to come the Senators in this House will regret the day they voted for this Bill.
Why?
They will rue the day-----
Senator, we are not disposing of the Bill at the moment. I call Senator Ó Domhnaill.
-----because they will have been responsible for opening the floodgates and creating a situation-----
Senator, resume your seat.
-----where the State will co-operate and collaborate on the abortion of children, and that is a fact.
Senator, resume your seat please.
I could go on.
I know you could.
I am entitled to go on, and I am entitled to come back to it if I want to.
You are a disgrace. Do not mind him, a Chathaoirligh.
Senator Ó Domhnaill without interruption.
Senator Leyden's contribution was made from the heart and no one should shout across the floor at him when he is trying to give his heartfelt opinion. Everyone should be allowed speak on this particular issue, irrespective of their religion. We live in a democracy, and there is freedom of speech in a democracy. Both in this Chamber and outside it, everyone should be-----
Senator, everybody is getting a chance to speak. Amendments are specific and the Senator had moved away from the amendments. On the amendments please.
On this particular amendment, I have listened to some of the debate. It is not true, as the Government would claim, that it is legislating for abortion on the grounds of threatened suicide but simply clarifying pre-existing constitutional law. Successive Governments have deliberately refrained from legislating for the X case because it was medically baseless and fundamentally unjust. No constitutional crisis ensued in the 21 years that have been spoken about. This legislation gives explicit support for the judgment and provides a mechanism whereby the right to life of an innocent child can be extinguished.
Thus far, the X case has not resulted in abortions taking place in Ireland but this legislation will.
A Second Stage speech.
This is the reason these amendments are so important, because if accepted, they provide the constitutional protection to the unborn that is not contained in this Bill. There is no other area of law in which a threat of suicide to one person is sufficient to deprive another person of his or her fundamental rights. It is baseless and disgraceful that one would treat suicide by removing the most basic rights of an unborn human being. It is not right to extinguish them but this is what is being done by this legislation. Are Members to abandon the principle of equality, about which so many on the Government side speak on a daily basis on the Order of Business or when defending the rights of persons with disabilities-----
What does that have to do with it?
----- and agree that some human lives are less equal than others? A man for whom I have great respect-----
Senator Ó Domhnaill was on about the Special Olympics last week.
Senator Ó Domhnaill, without interruption.
I refer to the former Taoiseach and leader of Fine Gael, John Bruton, who has pointed out - to use his words and not mine - this legislation flies in the face of the Constitution's words.
The present leader of Fianna Fáil disagrees with him.
Let us cut to the chase in this regard, because this legislation is being introduced to hold onto power.
Senator.
It is to keep the Labour Party happy and Fine Gael will pay any price to do that-----
Senator, you have moved away from the amendment. I call Senator Ó Murchú.
----- including murdering children, which is a disgrace.
To which amendment is the Senator speaking?
That is a despicable comment.
Senator Ó Murchú.
Senator Cullinane would know a lot about murder now.
Yes, despicable.
Please. Senator Ó Murchú.
What would I know about it? The Senator is a disgrace.
Senator Cullinane, please. Can we have Senator Ó Murchú without interruption?
On a point of order, can Senator Cullinane tell Members where is the body of Jean McConville?
Senators, resume your seats please. Can we eliminate crossfire from the Chamber please? I call Senator Ó Murchú.
If only one person speaks on behalf of the unborn or acts as an advocate, it at least goes onto the record of the House. What is important is that Members do not prevent someone from putting both sides, because that is the way the Constitution is at present.
Hear, hear.
There is a serious possibility that Members are ignoring the Constitution. I acknowledge that all the legal advice will have been given and am certain the Attorney General has examined the matter but Members should consider for a moment that if it is in conflict with what is in the Constitution, there then could be a challenge.
As legislators, it is important that Members put both sides of the story in the debate. I get very disillusioned by some of the responses when Members wish to speak. One is not obliged to agree with what the other person is saying. However, if an amendment is before the House, it is important that Members examine it. Moreover, if two views emerge, there ultimately is a procedure for deciding the outcome and this has been evident in the amendments already debated.
I can find common cause with the arguments of Senators Leyden, Walsh and Ó Domhnaill with regard to this amendment and I believe there is a grave danger that Members are not considering at all the life of the unborn child. If this is the case, Members are then in conflict with the Constitution. There is no need to get too animated or excited about the debate and I note that on foot of all the debate held thus far and amendments tabled, Members are coming near the end of their consideration of the legislation at this Stage.
However, for such a fundamental issue in all the debate and if this is the only focus that remains, it is important that Members consider the life of the unborn child. I have been a little worried by much of the debate in this Chamber, in that while Members rightly must consider the life of the mother, this should not be to the exclusion of the life of the unborn child. I cannot imagine anyone in this House or anyone outside of it who would disagree with a comment based on that premise. Who would not wish to consider the life of a mother or the life of the child? Is that not what the amendment is about?
I do not wish to go into the issue of suicidal ideation, which has been dealt with. It also was dealt with in the hearings and I am unsure whether there has been any great follow-up from that. It has happened and may be history at this point but no matter how tired Members are, how weary they are or how exasperated they are because they must listen to different views, were they to avoid the fundamental protection in the Constitution for both the mother and the unborn child, as legislators I do not believe they would be doing the right thing.
I am sure the Minister of State will tell Members this matter has been examined legally. However, Members also are aware of what happened in the past when they were so sure something was copper-fastened legally but this proved not to be the case. Members still may find themselves in the courts. Would it not be far better here in this Chamber, as legislators, quietly, calmly and with reflection, to tease out this issue and put Members' own minds at ease? This is what the people expect from us. I do not like the idea of name-calling. I do not like the idea of heckling or interruption. It does not bring Members anything at the end of the day but I hope this amendment and any other amendment to be tabled right up to 8 p.m. tomorrow evening can be dealt with in the spirit that all Members would like to protect human life. I believe this to be what this is about.
On Senator Ó Murchú's last point, there could be no objection at all to there being careful consideration of the legislation, what it is intended to do or objections raised by Senators to its wording and terms. There is no issue about that and is what Members are here to do. Moreover, it is no less legitimate for a Senator to table amendments that have the effect of altering completely the Bill. Senators of course are entitled to do that but I would draw a distinction between efforts along the lines about which the Senator has, very reasonably, just been talking, which is to tighten up or improve the wording or to ensure the wording passes muster under the Constitution and all such issues and the Government is very much open to that. However, some amendments - I do not suggest people are not entitled to table them - in truth have the effect and the intent of wholly altering the intention in a particular session. Some Senators are in agreement with that and that is what they are here to do. However, that will not be accepted.
Not here.
Perhaps not here, although to some extent, perhaps in one case here. However, in this group of amendments that is largely not the case. However, I believe I am entitled to draw a distinction between the two approaches.
As for these amendments, I will respond to amendment No. 16 first, which refers to the wording in the Bill on reasonable opinion and proposes to delete the phrase "as far as practicable" from the Bill. I cannot accept the amendment. As was pointed out on Committee Stage, the words "as far as practicable" used in the wording of the Bill are taken directly from Article 40.3.3° of the Constitution. I understand a distinction has been made by Senator Walsh and earlier by Senator Mullen to which I will return, but as colleagues are aware, these words appear in plain terms in Article 40.3.3°, which states "The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right". It is entirely proper that, when one seeks to set out the appropriate wording in the Bill in respect of the need to preserve unborn life, the qualification that is placed on that need should be a qualification that comes from the Constitution.
When Senator Walsh quoted the Irish version Article of 40.3.3°, he did not emphasise in the way I suggested the very last words, which read "agus ráthaíonn fós na cearta sin a chosaint is a shuíomh lena dhlíthe sa mhéid gur féidir é." We understand "sa mhéid gur féidir é" to mean "as best one can". It is a qualification that is actually necessary because in neither our formation or that proposed by the Senators is there an absolute requirement. Senator Mullen, in his amendment, uses the wording, "being an opinion which respects the equal right to life of the unborn, and which has regard to the duty to deliver the viable unborn alive where practicable". Senators Mullen and Walsh, therefore, concede that there is a necessity to qualify their words. The words are not absolute but qualified with the term "where practicable", which implies "sa mhéid gur féidir é" or "as best one can". Nobody is saying the requirement is absolute; everybody is saying it must be qualified. Therefore, there is no great distance between us in the use of the terminology. It is perhaps clearer in Irish than English.
In reference to the requirement in the amendment regarding an ultrasound scan, the Minister stated on Committee Stage he does not propose to dictate in primary legislation the practice of obstetrics in the way advocated.
With regard to changing the wording on reasonable opinion proposed in the other amendments in the group, the relevant sections provide that a termination can be carried out only when the medical practitioners have formed a reasonable opinion that the risk "can only be averted by carrying out that medical procedure". We are very familiar with this and have gone over it time and again.
Although I understood Senator Mullen to be saying he is concerned the requirements do not seem to extend to the doctor carrying out the procedure and to inhere only in the certifying personnel, I must point out, with respect, that his amendments and those of Senator Bradford refer to the certifying personnel and not the doctor carrying out the procedure.
I have another that complements it.
Later?
Yes.
I am only required to address the amendments in the group. Senator Mullen's and Senator Bradford's amendments refer to the certifying personal and not the doctor carrying out the procedure. Therefore, there is no difference.
I cannot see the necessity for the amendment stating "being an opinion which respects the equal right to life of the unborn, and which has regard to the duty to deliver the viable unborn alive where practicable" given the overarching constitutional and statutory imperative inhering in all the people involved in certifying and carrying out procedures to preserve unborn life as far as practicable and with due regard to the equal right to life the mother. We are struggling with this all the time in the debate.
At an earlier stage of the debate, perhaps Second Stage, Senator Brian Ó Domhnaill, whom I hope I am not misrepresenting, stated as part of his main line of attack that there was plenty of protection for the life of the mother and precious little, if any, for the unborn. That is a fair expression of what he said. I reject that characterisation of the Bill. What the legislation seeks to do, in what is admittedly a very difficult area for any legislator, is put into statute law the provision set out in the Constitution that the mother and unborn have an equal right to life and that the protections must have regard to this. The difficulty concerns what happens when there is a conflict and when it is not possible to be immediately absolute about a particular outcome. The difficulty is when, in practice, there is a need for regard to be had to both rights. It is a question of how this must be navigated and that is why we are putting into legislation what is rightly a very onerous requirement on doctors to ensure that when they are certifying under sections 7, 8, 9 or 13 that there be a real and substantial risk to the life of the woman according to their reasonable opinion, "being an opinion formed in good faith which has regard to the need to preserve unborn human life as far as practicable". These words are not meaningless in the way implied.
The wording "has regard to the need to preserve unborn human life as far as practicable" is a quite legitimate and correct requirement on doctors but it is quite profound and is not to be easily dismissed. Second, the medical procedure is to be carried out by an obstetrician at an appropriate location. It must be the case that the risk can be averted only by carrying out the medical procedure. When one considers the strength of this language, one concludes it is unnecessary to include the wording, "being an opinion which respects the equal right to life of the unborn, and which has regard to the duty to deliver the viable unborn alive where practicable". What is intended to be conveyed by the amendments put forward by Senators Mullen and Bradford is suggestive of a scenario absolutely contemplated by the Bill, as drafted. There is a constitutional imperative, and a requirement to have regard to the need to preserve unborn human life is given force in statute.
Irrespective of one's view of the Bill, it is not accurate, fair or reasonable to criticise it in a way that suggests it does not have regard to the right to life of the unborn. I have some sympathy with the tone of the remarks of Senator Labhrás Ó Murchú, who said we may need to go further and that the balancing is not quite right. We could have that discussion and have had it for months actually. We have, quite rightly, arrived at this set of very various onerous requirements on the medical personnel involved. I understand the objective of the amendments but they are not required. The statutory scheme being put in place does have regard to the equal right to life of both entities.
I have covered most of the points. With regard to the point on the wording "as far as practicable" having a slightly different context in the eighth amendment than in the legislation, it is true. The kind of provision in the eighth amendment, in Article 40.3.3°, is directed towards the State and its laws. That is what it is about. Nobody would suggest that the Constitution could prescribe specifics along the lines we are talking about. It is always going to be directed towards the State and what it should do in its laws, as far as practicable, to vindicate the right to life of the unborn with due regard to the equal right to life of the mother. It is quite proper that we should draw on that language when seeking language to describe the need to preserve unborn life and to determine how we should qualify it. It is not absolute, as the Senators agree. In trying to find language, it is absolutely prudent and correct to draw on language in our Constitution rather than any found elsewhere.
I do not wish to interrupt the Minister of State, but can I have a reply to the terms "reasonable grounds" and "in good faith"? In other words, does it qualify "reasonable opinion"? Can the Minister of State deal with that point?
Senator Walsh cannot come back in.
As currently drafted, the Bill places a clear obligation on medical practitioners to ascertain - by the very wording of the section, and Senator Gilroy made this point - whether it is possible to deliver the unborn or, indeed, take other measures that would enable the foetus to be brought to the point of viability before the pregnancy was ended in order to save the mother's life. I remind the House that is what we are doing here. We are putting in place legislation which relates to circumstances where the mother's life is in danger - where there is a risk to her life. By the way, there is a lot of repetition of words here. There is no harm in spelling out what we mean by a risk to the mother's life. It is a risk that she will die, that she will be dead.
No. Section 9 is not that risk
How many times does that have to be repeated in order for people to understand what we are actually talking about? That is why we are bringing in this legislation. That is the basis upon which it is being introduced to the House.
Senator Bradford asked about the question of constitutionality, but ultimately that is not for me to decide. We touched on this the last day. I thank the Senator for his kind words about me being a lawyer, but I am not a legal adviser to the Government. I am, however, proud to be a Minister of State. The Attorney General advises the Government on the law. She has given assiduous and careful advice throughout this process. I have no reason to doubt any of the advice she has given on this Bill concerning its constitutionality or the constitutional questions. Ultimately, the Attorney General does not determine constitutionality either. As we know, other people do that. That is the system we have.
For the reasons I have outlined in this section, I do not propose to accept the amendments. As regards Amendment No. 16, I note that it is not to be required in the case of section 7 or section 8 terminations. That has not been explained, but I suppose it relates back to the overarching objection to section 9. There will therefore only be an ultrasound in a section 9 situation, but not in a section 7 or section 8 situation.
It would not be practicable.
The Senator referred to an opinion formed on reasonable grounds and in good faith, which has regard to the right to life of the unborn. I would respectfully say, however, that he is probably wrong in thinking that is stronger than a provision that requires the doctor to have regard to the need to preserve unborn life as far as practicable. I actually think that is stronger than the Senator's formulation in this instance.
I call Senator Mullen.
I would like my questions-----
There is no provision for Senator Healy Eames to get back in.
I would appreciate it if my questions were answered by the Minister of State. That is all I am asking.
The more I listen to the Minister of State the more I am bemused about what type of amendments the Government would be interested in considering. It also seems to me that the job of the Legislature is to scrutinise legislation in detail and to propose substantive amendments, not just tinkering with technical points.
The more I listened to the Minister of State, the more I felt that it is dubious from a constitutional point of view. The Minister of State himself spoke about the need to shape this Bill within the wording of the Constitution. He even referenced the equal right to life, as set out in the Constitution, but it is not in the Bill. In fact, my amendment would invoke directly a more objective requirement on those certifying the procedure that they would not just form a reasonable opinion. There is a real dishonesty, not in the Minister of State's words but in the words of the Bill, to suggest a reasonable opinion. It certainly avoids frightening the horses but when one goes on to define that opinion and what is required in subjective terms - namely, the requirement of good faith - then the wool is being pulled over people's eyes.
The alternative proposal would make that more objective and would say that the person has to form an opinion which respects the equal right to life of the unborn. One finds the words of the Constitution there, but not in the Bill. As the Minister of State rightly said, we should fully respect that the duty to deliver the viable unborn alive should be carried out as far as practicable. That is the State's obligation, by its laws, to defend and vindicate the life of the unborn.
There is no difficulty with section 7 and section 8 procedures because, in the end, one has a coincidence or coalition of interests - a mother who is very sick and her unborn child whom she would want to save, and a doctor who wants to save both the mother's life and that of the unborn child. Efforts will be made to do everything right. However, the problem with section 9 is that the procedure involved is happening because of a threat of suicide-----
A risk.
-----which has been deemed to constitute - please listen - a real and substantial risk to life. I do not know if Senator GIlroy is aware, but the problem is that section 9 does not confine its operation to situations where suicidal ideation derives from mental illness.
Correct.
If it did so, medics would be on very safe ground because it could be easily demonstrated that abortion would be no treatment and could be highly counterproductive. In more general terms, we know in regard to those situations where a person has autonomy and is threatening their life, that one must always believe a threat of suicide. Senator Gilroy himself and the eminent experts in suicide prevention who attended the hearings at the Sub-Committee on Health and Children pointed that out. Therefore, by definition, a threat of suicide must be taken seriously and must be deemed to constitute a risk to life. Therein lies the danger and injustice of section 9.
This amendment would require that where that threat becoming a risk arises in situations where it would be possible to bring the baby out alive, and ensure that it is born as safely as possible, as distinct from doing a destructive abortion, notwithstanding the aspirations of the person who has presented to the psychiatrist, that there would be such a duty. It seems that it is the antithesis of respect for the equal right to life of the unborn to exclude that duty, both at the level of certification by the medical professionals involved, but also - this was my point to the Minister of State, as I have provided elsewhere - that those carrying out the procedure would be subject to the requirement that they do not intend to end the life of the unborn where such life is viable.
On that basis, I would submit that the overarching constitutional and statutory imperative to which the Minister of State referred, to defend and vindicate the right to life of the unborn, appears to be ignored. I do not know where the Minister of State finds the overarching statutory imperative to defend and vindicate the life of the viable unborn, given that the legislation does not provide for it in terms of what is a permissible lawful procedure.
I call an tAire Stáit.
I have nothing to add to that.
Is amendment No. 6 being pressed?
Yes.
Question, "That the words proposed to be deleted stand", put and declared carried.
I move amendment No. 8:
In page 9, to delete lines 4 and 5 and substitute the following:
“(b) that medical procedure is carried out at an appropriate institution by—
(i) an obstetrician, or
(ii) a medical practitioner of a medical speciality in respect of which he or she is registered in the Specialist Division of the register, and which is relevant to the care or treatment in respect of which the risk of such loss arises, not being a psychiatrist or a general practitioner.”.
This amendment is designed to protect medical personnel other than obstetricians who legitimately give medical treatment under section 7 where such medical treatment might have the effect of ending the life of the unborn. As I said on Committee Stage, I had occasion to discuss this problem, which I believe is a lacuna in the legislation, in part with my friend and colleague Senator John Crown. My amendment would provide that in section 7 the requirement that the medical procedure be carried out by an obstetrician would be extended to include "a medical practitioner of a medical speciality in respect of which he or she is registered in the specialist division of the register, and which is relevant to the care or treatment in respect of which the risk of such loss arises, not being a psychiatrist or a general practitioner."
I am not an expert in this area but I am sure the Government has done its homework, or is in a position to do it between now and tomorrow. For example, an issue might arise with giving treatment for cancer that might put the pregnancy at risk of being still-born.
It seems this legislation changes the situation because it provides for the criminalising of the intentional destruction of the unborn, but it then defines what procedures shall be lawful. It is not talking about abortion but procedures to end a pregnancy.
Is there a seconder for the amendment?
I second the amendment.
When is it proposed to sit again?
Ar 10.30 maidin amárach.