Dáil Éireann Debate, Wednesday - 29 March 2023
200. Deputy Carol Nolan asked the Minister for Health the actions that termination of pregnancy providers, including GPs and community providers, must take in instances where they suspect coercion in a request for a termination of pregnancy; the steps being taken to ensure that termination of pregnancy providers can identify possible instances of coercion; and if he will make a statement on the matter. [15674/23]
View answerMedical practitioners are obliged to comply with the Medical Council’s Guide to Professional Conduct and Ethics. The Guide includes information on the principles underpinning consent and the importance in ensuring that patients have given full and informed consent prior to a procedure or examination. The HSE’s National Consent Policy, revised in December 2022 also contains extensive guidelines for health practitioners and includes information on decisions made under duress. These apply to all medical procedures.
In relation to termination of pregnancy services in the community, on April 6th 2020 the Model of Care for Termination of Pregnancy was revised temporarily for the duration of the COVID-19 public health emergency to facilitate remote consultation in early pregnancy. No formal research or analysis on remote consultation has been conducted in Ireland however, there has been positive feedback from providers and patients and there is strong evidence from published literature in the UK and Europe that remote provision of abortion care is safe and effective. In light of the easing of Covid-19 restrictions in Q4 of 2021, the Department requested the HSE to revisit the Model of Care to review its operation and consider whether it should be retained going forward.
This review has shown that including remote consultation as part of the termination of pregnancy service is safe, effective and acceptable to both service users and providers. It improves access for many women and addresses geographical and logistical barriers. It also alleviates some of the difficulty associated with the mandatory 3-day waiting period. Availability of remote consultation places the woman at the centre of the process and supports her reproductive autonomy. There is a growing body of evidence that telemedicine use in termination of pregnancy care has outcomes that are consistent with in-person care and it is now becoming normalised in many other countries. The majority of providers feel that a blend of remote and in-person care is optimal. Timely access to care, as close to home or the community as possible is a key principle of the vision of Sláintecare. The review of the changes to the Termination of Pregnancy model of care adopted during the pandemic is an appropriate and timely initiative. The Department is continuing its engagements with the HSE regarding the final considerations, vis-a-vie adopting the blended model as the enduring model of care for termination of pregnancy services. The outcome of the review will be made available once this deliberative process concludes. In the meantime, it is important to reflect that the temporary model of care, along with the relevant public health advice remain in place.
