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Dáil Éireann díospóireacht -
Friday, 7 Dec 2012

Vol. 785 No. 4

Report of the Expert Group on the Judgment in the A, B and C v. Ireland Case: Statements (Resumed)

No one yet knows for sure what happened to Savita Halappanavar. We know that she wanted to be pregnant, that she miscarried and that the care she received did not save her life. It is important to push for medical accountability in such cases and to demand full investigations into whether protocols existed and were followed and whether the patient was subjected to discriminatory harassment and remarks, as has been alleged.

We need not wait for the investigation to highlight what we know about abortion in Ireland. The Government has yet to regulate access to life-saving abortions despite the fact that such medical interventions have been legal in this country for two decades. The legality of an abortion where the pregnant woman's life is in danger was upheld by the Supreme Court in 1992 and supported by a referendum in the same year. While abortion generally is criminalised in Ireland, women whose lives are threatened by their pregnancies are constitutionally entitled to have abortions.

In 2010, the European Court of Human Rights berated the Government for not regulating access to life-saving abortions clearly, thereby creating insecurity for medical providers and patients alike. Many medical providers want clarity on when they can intervene and when they cannot. How does the Government propose to treat a woman who may or may not die as a result of her pregnancy? Should it tell her to return when she is sure she will die? How will she know and what if it is too late? Who would be responsible for such preventable deaths?

In recent weeks, we have heard time and again about the pain and fear that pregnant women face when something is clearly wrong with their pregnancies and they cannot receive care near home. Abortion is a medical intervention to which women need access, some to save their lives. This is not an opinion - it is a fact, as evidenced by the thousands of women who travel from Ireland to the UK or mainland Europe to terminate pregnancies every year. Knowing this, why do we keep postponing doing the right thing?

Twelve women travel from Ireland to the UK each day to access abortion services. They are from all walks of life and each has her own reasons for deciding to have an abortion. Women's experiences of abortion are diverse and complex and the decision to have one is not taken lightly. Women's reasons for choosing abortion, such as financial worries, concerns about the well-being of other children, diagnoses of serious foetal abnormalities, pre-existing health problems, including mental health problems, and relationship issues, can be stressful. The stress involved in making the decision is exacerbated by needing to travel to another country to access abortion services, by the expense involved, by feelings of fear, stigma and secrecy, by a sense of isolation and by a lack of support. For these women, the need to travel abroad involves unnecessary hardships and, in many cases, significant psychological, physical and financial burdens. The women and girls who experience the most difficulty are those who are marginalised and disadvantaged, namely, those with little or no incomes, those with care responsibilities, those with disabilities, those with mental illnesses, those experiencing violence, those who are young and those of uncertain residency status.

I have spoken on this issue twice in recent months, but I wish to make further points and to amplify points I have made previously.

Yet again, this issue is turning out to be emotive, divisive and contentious, and needlessly so, as there are central areas of agreement. For instance, I want healthy women to deliver healthy babies. This is everyone's ideal. However, the term "pro-life" is being used as if some of us favour death for children and mothers.

What is often forgotten is that protecting our young is possibly the strongest human biological urge. I do not like making generalisations, but I can say without fear of being contradicted that no woman ever lightly chooses a termination, even when her own life is at risk. We are often in awe of stories and reports of the lengths to which mothers will go to protect their children. In the most extreme circumstances in wars and so on, women make considerable sacrifices. For example, they will go without food and put themselves in danger of death to protect their children. This is not just the case in wars and other extreme circumstances. Every day, mothers are making the most amazing sacrifices for their children.

It is insulting to women generally to be of the attitude that there is a mindless desire among them for abortion on demand. People with that belief could not be more wrong. No one considers abortion a good or highly desirable measure. Let us at least agree on this much.

I welcome the Government's commitment to report on the option that will be chosen from the expert group report before Christmas. Legislation is the best option. Even the expert group, which was not asked to make a recommendation, but to give options, believed that, according to the logic of its deliberations, legislation would be necessary if legal certainty was to be given to doctors.

The outcome I want is that there should never be a hesitant, uncertain or procrastinating doctor attending pregnant women in this country, in particular in a crisis situation. The danger will continue to exist if we do not provide doctors with absolute legal certainty and legal protection for whatever medical interventions are required to save the life of the woman.

I am no longer willing to have such deaths laid at my door because we, as a Legislature, have failed to provide such protection. The time is long past for us to deal with the issue in a humane and determined way. Our task as legislators is clear; we must legislate for the constitutional provisions, as interpreted by the Supreme Court in the X case. We have been exhorted over many years and on many occasions by the Supreme Court to do so and now we are on our last chance from the European Court of Human Rights.

I regret that there have been efforts to extend the debate to either reduce or extend the provisions of the constitutional provisions. They are red herrings in the context of the current debate. We are not dealing with other situations. Suggestions have been made that this is the first step to euthanasia, to the introduction of abortion on demand or a regime similar to the one in Britain. One person suggested to me that we are taking a step towards terminating the lives of disabled persons. I have had many similar letters. They are all nonsense. They are complete red herrings. Such proposals are not on the table nor is there any suggestion that they should be.

I accept there are different points of view. I believe terminations should be considered in the case of rape, incest and where the foetus is unviable, but I completely accept that is not on the table. The only thing that is on the table is saving the life of the mother in circumstances where to continue the pregnancy would put her life at risk. Could that be so bad? Could people be so against that? Could there be a husband, father or brother who would want to risk the life of his wife, daughter or sister? The only justification that could be put forward for opposing such interventions is where it is denied that there are any such circumstances in which continuing the pregnancy would put the life of the woman at risk. Some have suggested that in the letters I have received, but we now know for certain that there are such circumstances.

We do not need to wait for the outcome of the tragic Savita Halappanavar inquiry to tell us that; doctor after doctor has told us such circumstances do exist, if we ever doubted it in the first place. They exist in circumstances similar to those described by Savita’s husband in a crisis where immediate choices have to be made, but they also exist in non-crisis situations and those are probably the most common. I refer to cases where women suffer from cancer, have severe heart conditions or dangerously high blood pressure. In many such cases, if the pregnancy is continued to full term, it is known that there is a real and substantial risk to the life of the mother. Currently, such women, after being briefed on their prospects for survival by their doctors, go to England for life-saving terminations. That sick women have to make that journey is not only unconscionable, it is not what is provided for in the Constitution. While the risk to life must be real and substantial, I do not believe it must be imminent. That must be addressed in the legislation or guidelines we provide in the new year. I see no justification for insisting that doctors wait until the risk is greater before intervening, as it will be in the more advanced stages of pregnancy.

The Constitution does not allow us to consider terminations merely due to a pregnancy’s impact on a woman’s health. Given that only the risk to life can be considered, the challenge is to determine when that risk begins. The truth is there is no one point when it suddenly becomes real and substantial. It occurs probably along a continuum and will be different in every case. To provide guidelines to doctors and for us to legislate will require the wisdom of Solomon. It will be extremely difficult. At the same time we must ensure we stay within the provisions of the Constitution, and allow discretion to doctors, because we could not possibly anticipate every situation with which they will have to deal.

In the past we have seen where a wording inserted into the Constitution turned out to mean precisely the opposite of what we all thought it meant. The Taoiseach was correct that we cannot rush matters. He was also correct not to try to introduce legislation before Christmas. I do not have either the legal or medical expertise to know what the precise wording should be, but I do know what outcome I want. Many of us do. I want what I believe most people want; that is to protect the lives of women when continuing with a pregnancy would endanger their lives. It is that simple. Since health cannot be considered, I want the bar determining where the risk begins set as low as possible. I do not want it set anywhere near when the risk becomes so great that it is irreversible. To achieve that and to stay within the provisions of the Constitution will be a considerable challenge but I hope that is what we will provide for in the new year. I look forward to participating in the debate.

I am pleased to have an opportunity to make a contribution on the recently published report of the expert group into the judgment in the A, B and C v. Ireland case which was taken to the European Court of Human Rights. In my almost 14 years as a public representative there is no other issue on which I have received more correspondence of varying forms than abortion and medical termination. Concerned constituents and people from all over the country have been in contact with Members of the Oireachtas repeatedly in the past few months in particular. Like the previous speaker, Deputy Mitchell, I am not a medical expert but I have taken the time in recent years to speak to women who had difficult pregnancies or who either travelled abroad for terminations or who had medical terminations in this country owing to the fact that their particular situation was dealt with by the existing guidelines of the Medical Council.

I am also conscious of the fact that, as a man, it is somewhat easier to make pronouncements than a woman who could find herself in grave, personal difficulty with choices to make. I will try my best to outline my position on these matters to the House while referring also to the report of the expert group. I do not believe any woman who has become pregnant has set out with the intention of having an abortion or termination. I have been struck by the unhappiness of the women to whom I have spoken who have travelled overseas. It was not a decision they took lightly. I did not detect any sense to the contrary from the people to whom I have spoken.

I have also spoken to a number of women who have had medical interventions in this country that have saved their lives but led indirectly to the death of the child they were carrying. That has certain resonances with the recent tragic events in Galway and the death of Savita Halappanavar in the most harrowing of circumstances. We await the outcome of the inquiries that are currently ongoing into her death which was a tragedy for her husband and family.

I am sure the findings of those reports will have an impact on the deliberations the Oireachtas will have on that matter in the coming months.

I hold a pro-life position but I believe fundamentally in the aim of the 1983 amendment to the Constitution, namely, the protection of the life of the mother also. In my conversations with women who had terminations in this country due to being gravely ill, I was struck by their overwhelming view that such a position should be protected into the future. I have been struck also by the number of women I have spoken to in recent months who hold strong pro-life views but who recognise the need for legal certainty for medical practitioners in dealing with cases where the life of the mother is under threat. I understand the Government is proposing to deal with those particular circumstances in the new year. That is something that arguably should have been done before now and the current Medical Council guidelines provide a basis under which legislation in this area can be formed. Most people who hold similar views to mine would be of the opinion that those guidelines should be included in legislation, regulation or a combination of both. That is not something with which people have any particular difficulty.

The issue that causes the most concern, certainly for me, is suicide and psychological well-being. In other jurisdictions, most notably the nearest one to this country, the inclusion of loose terminology on the matter of the psychological well-being of the mother when abortion legislation was introduced in the United Kingdom in 1967 has led to a situation in the UK where abortion is freely available. From talking to people on all sides of the argument, and particularly those most affected, who are young women of the age to have children, I do not believe anybody who wants to have abortion freely available as is the case in the United Kingdom.

We are charged with providing a solution that recognises the 1983 constitutional amendment and the subsequent decision of the Supreme Court in the X case judgment, and provides a legal framework both for women and medical practitioners in ensuring that amendment is reflected in the law of the land. A number of interesting analyses were carried out recently. Many of us were briefed recently by Professor Casey from the Mater Hospital who has analysed births in the Dublin maternity hospitals since 1980. Approximately 700,000 births occurred in those hospitals in that 32 year period and Professor Casey's figures and analysis suggest that in that time just two women who had been in contact with the maternity hospitals in Dublin committed suicide. I believe it was the head of Holles Street maternity hospital who commented recently that suicide is very rare but it does occur. We have to develop a system in this country that acknowledges that while suicide might be very rare, it can occur and that the necessary legal protections are in place for practitioners, mothers and suicidal mothers to ensure their medical and health interests are protected.

This debate has been ongoing for the duration of my life having been born at the end of the 1970s. The abortion issue arose periodically at intervals in the past 35 years. It tends to bring out the worst in proponents on both side sides of the argument, namely, those with strong pro-life and pro-choice views. An irrational debate occurs in which most of the population tend to hold more middle ground views that are much more understanding of the circumstances in which people find themselves and tend to be of the view that the right to life of the unborn should be protected also.

In the United Kingdom, approximately one out of every five pregnancies results in a termination, which is an incredibly high statistic. I do not believe that the majority of our people want a regime which would lead to a similar development in this country. I believe, from extensive discussions I have had, that the majority of people want a clear legislative framework underlining the existing Medical Council guidelines. That should happen, and the Government has outlined a course of action over the coming months which will lead to that being put in place.

Regarding the options outlined in the expert group report, it appears there is very little disagreement on the matter of physical threats to the life of the mother. The only issue arises in the area of psychological threats to the life of the mother. My opening position, and it is the position I have garnered from medical practitioners here in terms of their view of the operation of any new legal framework, is that everything is done in practice in our maternity hospitals to protect both lives. If it becomes apparent at a particular juncture that the life of the mother can only be saved by a medical termination, that is what happens at present. That view is the one most reflected in my interaction with constituents and with people who have concerns about this area, particularly in recent months. It is probably the most emotive issue this country has faced in the past 30 years and it is one on which people hold very strong views. My views are not rooted in a religious perspective.

I believe in a society that is based on rights and the most fundamental right is the right to life. That right should be upheld and vindicated and all other rights are subsidiary. That goes for everyone and it underlines my position in being a vocal critic, over many years, of the death penalty and other issues. We must arrive at a situation where protection is given to women who find themselves in medical difficulty during pregnancy. We must provide protection for professionals working with women who find themselves in medical difficulty during pregnancy.

I agree with previous speakers from the Government side who have raised the potential for further constitutional amendment with regard to the matter of psychological issues. It should still be considered by the Government but I agree with the need for the legislation and regulation to be introduced in this area in the near future. It has dragged on since the X case in 1992 and action needs to be taken. Consultation with the public on this matter is not something that should be ruled out at this juncture by the Government.

I propose to share time with Deputy Michael McNamara. I welcome the opportunity to address the House on this important matter. Some people believe the debate should be confined to women. The debate is happening in the House, I was sent here by the women and men of Dublin North and I can do nothing about my gender. In my adult life, I know of no debate that is so divisive, bitter and harsh as the debate on abortion. It has been dominated by loud and vociferous voice from both ends of the spectrum from those in favour of a liberal abortion regime to those who want to see no move towards an abortion regime in Ireland, including legislating for the X case. The Labour Party position on this has been clear for over a decade. Our unambiguous and clear position is that we support legislating for the X case. It will remain our position until we have satisfactory legislation in place. The expert group report states that the X case decision is the law of the State as declared by its highest court. It is binding on all lower courts and generally. The report states, "Although it could have done so and has been criticised in the Supreme Court for failing in that regard, the legislature has not put in place a formal system to provide the exercise of this constitutional right." It is our job to put a formal system in place. Due to the fact the Labour Party is part of the Government, we are closer than ever to achieving it. Recent opinion polls suggest overwhelming support for legislation on the X case. The tragic death of Savita Halappanavar, six weeks ago, has brought the need for clarity in the form of legislation to the front pages again. We await the findings of the report into her death and further comment on individual circumstances is inappropriate at this stage.

The tragic death of Savita has acted as the further catalyst for public opinion. In the past few days, the budget and related matters have dominated the airwaves, newspaper columns and social media sites. The coverage of the abortion debate has moved back somewhat. I welcome the space we are now in to push the process through the House over the coming weeks. We need to learn from the past and conduct the debate in a forthright, honest and, ultimately, respectful manner. It is the bare minimum the women of Ireland deserve. For too long, there has been a lack of respect running through those most vociferous in the debate. Blame can be shared on both sides, pro-life and pro-choice. I have seen it in the past few weeks as citizen turns on citizen. This week has seen the bitter debate in the form of argument on social media about the number of people at opposing demonstrations. This debate should not operate on that level. The vast majority of people in this country are not on the extremes but want a civilised and informed debate. The majority of people in the Labour Party are not on the extreme and reflect a wide variety of views on the issue. The Labour Party reflects the beliefs of most people in Ireland on this matter. What we share is a desire to legislate for the X case as soon as possible. This is what Labour Party wants and we have brought it to Government. Now is the time for it to be delivered.

I thank the Ceann Comhairle for the opportunity to speak on this important issue which, as previous speakers stated, is the most divisive in Irish politics. That is perhaps why successive Governments have done so little for 20 years. The fact that something is difficult is no reason to do nothing. If that were the case, this august Chamber would still be a lecture theatre of the Royal Dublin Society. Instead it is the Parliament of a sovereign state. I welcome the commitment of the Minister for Health and the Minister for Justice and Equality to legislate in the area. I was nine years of age when the eighth amendment to the Constitution was made. I was 18 years old, and about to become a law student, when the Supreme Court decided on the X case. It involved a 14 year old girl who had become pregnant as a result of rape and, as a result, was suicidal. I will reiterate what the Chief Justice stated in that case because there has been a great deal of obfuscation: "I, therefore, conclude that the proper test to be applied is that if it is established as a matter of probability that there is a real and substantial risk to the life, as distinct from the health, of the mother, which can only be avoided by the termination of her pregnancy, such termination is permissible, having regard to the true interpretation of Article 40.3.3 of the Constitution." Considering that a suicide risk had to be taken into account in reconciling the right to life of the mother and the unborn, the Chief Justice continued: "I am, therefore, satisfied that on the evidence [it has been] established, as a matter of probability, that there is a real and substantial risk to the life of the mother by self-destruction which can only be avoided by termination of her pregnancy." Similar judgments were delivered by three of the other four judges, with Mr. Justice McCarthy noting pertinently "The right of the girl here is a right to a life in being; the right of the unborn is to a life contingent; contingent on survival in the womb until successful delivery." He concluded: "On the facts of the case, which are not in contest, I am wholly satisfied that a real and substantial risk that the girl might take her own life was established; it follows that she should not be prevented from having a medical termination of pregnancy."

In that same year, 1992, a proposed 12th amendment, which would have excluded the threat of suicide from justifying an abortion, was defeated by the Irish people. Some ten years elapsed and nothing was done by the House. In 2002, the 25th amendment to the Constitution Bill also proposed to remove the threat of suicide as a grounds for legal abortion. That was rejected by the Irish people. A further ten years elapsed and this august Chamber did nothing. Less than a week before the second anniversary of the judgment of the European Court of Human Rights into the A, B and C v. Ireland, we are discussing the report of the expert group set up to examine the judgment.

That is the legal context or, rather, the absence of a legal context in which the A, B and C v. Ireland case was decided. As a result, girls born in the same year as me and women who went to college in the same year as me spent their entire lives subject to what is described in the European Court of Human Rights judgment as the chilling effect of the criminal law provisions in the 1861 Act, which have an impact on women and doctors during a medical consultation because of the risk to both parties of criminal conviction and imprisonment. The UN Special Rapporteur on health and the UN Committee Against Torture have also commented on the effect of criminal laws that have an impact on the health of women. When discussing the Bill tabled by Deputy Clare Daly, which he acknowledged was well-intentioned but substantially defective, the Minister for Justice and Equality, Deputy Shatter, commented that her Bill failed to deal adequately with sections 58 and 59 of the Offences Against the Person Act. In recent weeks, the Act has placed doctors in an impossible position, as alluded to in the European Court of Human Rights judgment.

I have heard such claims from medical doctors who work in obstetrics. The master of the National Maternity Hospital at Holles Street called for more guidance to deal with the grey area that arises in cases where there has been a risk to the mother's life, and a consultant in emergency medicine, Dr. Patrick Plunkett, called for legislation to clarify when doctors can intervene and terminate a pregnancy in a bid to protect the mother's life. Therefore, I welcome the Government's commitment to bring forward legislation to bring clarity in that area.

That, however, is not the end of successive Governments' failures to legislate in this complex area. Some Deputies have said marriage is primarily about children, its main purpose being to propagate. While I disagree with that, an increasing number of couples find it difficult to propagate. They find it difficult to conceive a child and, as a result, resort to IVF and assisted reproductive methods. One of the undeniable consequences of that is an increase in the number of frozen embryos, again a matter for which the House has failed to legislate. In Roche v. Roche and others, it fell to the Supreme Court to decide whether a frozen embryo was human life within the meaning of Article 40.3.3°. The Chief Justice, Mr. Justice Murray, said:

I do not consider that it is for a Court of law, faced with the most divergent if most learned views in the discourses available to it from the disciplines referred to, to pronounce on the truth of when human life begins.

It is important to recall that the European Court of Human Rights came to the same conclusion in the A, B and C case, that is, that there is no consensus in Europe as to when human life begins and that protection for that human life and the decision as to the moment it begins falls to member states to adjudicate. This State has singularly failed to decide when human life begins and when the protection of human life begins in accordance with Article 40.3.3°. The Supreme Court, in the case of Roche v. Roche and others, decided that frozen embryos did not attract the protection of Article 40.3.3°. Mr. Justice Hardiman stated:

But the fact that difficulties are raised does not absolve the legislature from the obligation to consider the degree of respect due to fertilised embryos and to act upon such consideration “by its laws”. There has been a marked reluctance on the part of the legislature actually to legislate on these issues: the Court simply draws attention to this. That is all it can do. That is what McCarthy J. did, apparently in vain, in the X case eighteen years ago. But the Court does so as seriously and as urgently as it can.

Another anomaly in Irish law concerns the 2007 case of Ms D, a minor, which was also considered by the European Court in the A, B and C case. Ms D was a minor in HSE care who had been prevented from going abroad for an abortion. Her foetus had been diagnosed with anencephaly, a condition where a major part of the brain is missing. The diagnosis was accepted as being incompatible with life outside the womb. The High Court clarified that the case was not about abortion or termination of pregnancy but about the right to travel, admittedly for the purpose of a pregnancy termination. I happened to be in court on other business the morning Ms D applied to the court. I recall her standing towards the back of a crowded court room full of bewigged and begowned barristers and solicitors as her medical details were read out to the crowded courtroom. Women with a medical condition such as hers should not be dragged into court to outline the most intimate medical details to a crowded courtroom.

In the A, B and C case, the European Court of Human Rights considered it evident that travelling abroad for an abortion constituted a significant psychological burden on each applicant but concluded there had been no violation of the convention as regards the first and second applicants. In general terms, the court affirmed that it does not consider that the prohibition in Ireland of abortion for health and well-being reasons exceeds the margin of appreciation accorded in that respect to the Irish State.

Nevertheless, it is high time the Legislature decided what exactly constitutes the unborn who attract the protection of Article 40.3.3°, aside from the A, B and C and X cases. Does it include frozen embryos? If not, when will this Legislature legislate for that? Does it include a foetus that is diagnosed with a condition that is incompatible with life outside the womb? For the avoidance of doubt, because I am clear this issue is emotive and that every word every politician says on it is likely to be skewed, I am not talking about diagnoses of an illness or disability. I am talking about a diagnosis where it is found that the foetus is incompatible with life. Does that foetus enjoy the protection of the right to life?

I welcome the opportunity to speak on the Government commissioned report of the expert group on the judgment in the A, B and C case, which has led to a broader discussion on the provisions in our Constitution and the interpretation of the Constitution, particularly with regard to the X case.

I thank the members of the expert group for a report that is very legible, even for a lay person, but which raises very complex issues. I thank them for that.

It is well nigh impossible to debate this issue without reference to the tragic death of Savita Halappanavar in Galway. I extend my sympathy to her husband and family on her very tragic death. What made the story newsworthy was the fact that deaths of that nature are, thankfully, rare occurrences. It has evolved into a greater story with many facets. It was always going to be difficult to have a rational debate on the expert group report on A, B, and C, without the emotive charge of the death of Savita Halappanavar. Until we know all the facts, it is important not to confuse the two issues.

For that reason, I welcome the HSE inquiry and the decision by HIQA to hold its own inquiry. I hope those reports can be expedited and can inform this debate. I also hope the inquest can be expedited so that we have a full picture of what happened.

The issue is one of great public interest and sadness because it is unusual, but not unprecedented. We remember the tragic death of Ms Tania McCabe which was followed by a similar statutory inquiry. For those who care to read the report of the inquiry, the circumstances are somewhat similar and the outcome also tragic. It is important to acknowledge the content of that report and that it assists us in coming to a decision.

This is a complex issue. It is one for the Irish people and their representatives to decide. For that reason, I was irked by the offensive reference to the issue by the visiting United States Secretary of State, Mrs. Hillary Clinton.

We have an extremely good record in terms of safety in our maternity hospitals for women and this is newsworthy because it is so rare. That is a fact that holds up to international scrutiny. I accept there is a debate about how those figures are constituted but they hold up to comparison with any country in the developed world, including the United States.

It is also apparent, with a few exceptions, that we have moved on significantly in this debate in terms of the capacity to have a civilised discourse on the issue and to be tolerant of different views, and there are many different views. The death of Savita Halappanavar has generated an enormous number of communications with constituents and citizens that fall into one or other side of the debate on how we should move forward. What has struck me most are not the generic e-mails I received but the people who took the time out to construct their own emails and to cogently express their concerns. Middle Ireland has a view that might be simply interpreted as not wanting, in any circumstances, to compromise the lives of mothers during pregnancy and we all share that outlook in this debate. It is important as we try to chart a roadmap on this difficult issue to accept that we start from fundamental values we hold. The lazy labels go back to the 1980s when this issue was first raised during the scramble for a constitutional referendum and the context in which it was conceded. Those lazy labels do a disservice to all sides and it is important to remember we all share a certain fundamental approach on this issue.

Conservative or liberal are other labels that go with this. I would be on the conservative side of this debate but on other related issues, such as human assisted reproduction, I am on the record as saying that it is disgraceful we have not legislated for this or provided legal certainty for children born through surrogacy and who have second class status in the State akin to the former status of illegitimacy that we legislated to abolish. Those labels are lazy.

The political context of the debate is simple. We campaigned on the basis of not legislating for the X case but establishing an expert group. The Labour Party position was quite clear that it was its policy to legislate for the X case. As in any arrangement for government between two parties, a compromise was established in the programme for Government, which established the expert group. The issue of concern to me is if the outcome of the debate was a foregone conclusion given the circumstances and terms of reference for the expert group. Annex 2 of the report stated that the terms of reference were to recommend a series of options on how to implement the judgment, taking into account the constitutional, legal, medical and ethical considerations involved in the formulation of public policy in this area and the overriding need for a speedy action. It appears to me that in many respects the group was channelled into pursuing a certain course of action.

None of us wants a situation where doctors in the labour wards must refer to the small print of the law to deal with an individual case of pregnancy. I have never been lobbied officially by the Institute of Obstetricians and Gynaecologists, but if their voices now emerge in the context of the Savita Halappanavar case, and the existing Medical Council guidelines must be given statutory impact, I have no difficulty with that. No one wants a situation that compromises any mother's life in the slightest.

The issue in the context of the X case is how to deal with suicide as the threat to life of the mother. Regrettably in society today, suicide has far too high a currency and happens all too frequently. I have sought the statistics for threats to the life of the mother due to suicide and I heard one of the heads of one of the Dublin maternity hospitals say it could arise once every 25 years. Be that as it may, none us would want in any circumstances to deny a mother the appropriate treatment. People fear the principle of the Trojan horse, whereby we make provision but find subsequently that it was not sufficiently legally watertight and would in future lead to unintended consequences.

The dilemma is the divergence between the legislative intent of the public when they passed Article 40.3.3° in 1982 and its interpretation by the Supreme Count. It would be one thing, and this is not a criticism of the Supreme Court as it vindicated the right to life of the mother, for the interpretation of the Constitution to have diverged from the legislative intent of the citizens but for that to happen a second time as this House grapples with the necessary legislation to underpin that ruling would be an unforgivable error. We must remain true to the democratic imprimatur given for our efforts to protect the life of the unborn while bearing in mind the equal right to life of the mother while giving the legal certainty that is required.

Much has been said about 20 years of inactivity but that is not entirely true. There have been four referenda in the intervening period, two of which were passed and two of which were rejected. While I have reservations about the suicide issue, I am cognisant of the other side of the argument that states that on two occasions the public rejected referenda to exclude suicide as a grounds on which to secure a termination because of the threat to the life of the mother. I know that is open to argument and dispute because of the circumstances of the debate but I am also cognisant that given the high incidence of suicide, there is a distinct possibility that if a single issue referendum was held on suicide, the public would reject it and then we would have to reflect on the consequences of that and how it might be interpreted by others as a vote for a more liberal approach to the issue. It is complex.

I would prefer a situation where the Oireachtas through its joint committee held hearings before the Government makes a decision so that we can assimilate all the information from the various experts who have different and conflicting views of the reality. That would be a preferable route. As we grapple with this very difficult issue we must be cognisant of the legislative intent of the people in Article 40.3.3° of the Constitution. At the same time we must never in any circumstances put any mother at risk by our failure to act or by our actions.

I welcome the opportunity to participate in this very important debate on the report of the expert group on the judgment in the A, B and C v. Ireland case. This is a major part of the abortion debate and I am glad to be able to put my views on the record of the House and not to be totally misrepresented as has happened in recent weeks. Of course I offer my full sympathy and support to all the family and friends of Savita Halappanavar. The loss of human life is a total tragedy and our compassion and support must go out to all of them. We need to look at the facts surrounding her death and then make a decision based on the evidence and facts. I do not do hearsay evidence, but I emphasise that the Halappanavar family members must be given the maximum support in their requests.

Let us be open and honest in this debate and drop the slogans. I have always considered myself pro-life in all aspects of my beliefs and political philosophy. I do not know anyone who is anti-life and we all want to do our best to save lives. We all need to do our best to save mothers and we all want do our best to save babies and young children. That is my view and I feel it is the view of most Members of the Dáil and Seanad. However, life is not fair and can be very difficult at times. There are times for extremely difficult choices and they have to be made. Many of us have had those difficult times in our lives through miscarriages and threatened miscarriages or having a baby with a disability. They have all touched our families, but at all times life is at the top of our agenda. That is why I disagree with many of my colleagues that the issue of abortion is complex. The bottom line for me is as follows. I have two daughters and now, thankfully, a granddaughter. I would do anything to protect, safeguard and save their lives in any difficult pregnancy situation, as would most parents and family members. There are no talks about talks when it comes to one's own family members. Most medical people would do that and if a termination is necessary to save the life of a young woman, I would agree to doing that.

My clear position is that in cases of women's health, rape and incest, termination should be allowed after the best medical advice involving the people directly affected by it. I know many people who have different views on abortion, but none of them is anti-life.

There is also the issue of personal conscience and personal choice, something that the political parties should respect. People with different moral and ethical views in very difficult situations should be allowed to have a free vote on this issue. People should not be whipped into making a decision with which in their conscience they disagree. I know the Minister of State, Deputy Brian Hayes, has said this in the past and I strongly support that position. This is a very personal, private, moral and ethical issue and they should be allowed to have a free vote. Despite that free vote, I believe most people will move towards the consensus in the middle ground.

As things stand the 1992 X case judgment remains the basis of abortion law. Hospitals can and do carry out terminations where there is a risk to the life of the mother. Suicide is currently accepted as a risk. In the past 20 years the sky has not fallen in with women claiming suicide as grounds for abortion and therefore it proves that women are more responsible than many have portrayed them. It is argued that the Government should formalise this situation and that would be my personal position. I will deal with this later in my contribution.

In recent weeks the media have made repeated mention of the abortion lobby. Those who want the Government to legislate for the judgments in the X case and the A, B and C v. Ireland case are not the abortion lobby. They are the majority of people in this country and have been so since 1992.

The suicide issue is at the heart of the problem. If suicide is excluded other medical emergencies become easier to legislate for and control to some extent. However, any mental health advocate knows that suicide can and does form a very real risk during pregnancies. To disallow suicide could make for stronger legislation, but it could also lead to tragic instances where women who are victims of particularly traumatic experiences are left without the support they need and have a life-saving option taken away.

I acknowledge that my colleagues across all parties in the Dáil have engaged in a common sense and non-emotional debate with no hysteria. We have had a decent debate and an open discussion with all our views on the record.

Internationally, laws on abortion are diverse with differences arising according to influences of religious, moral and cultural norms. A survey of abortion law in 197 countries and territories published in 2009 found a range of legal regimes with highly restrictive law on one end of the spectrum and abortion on demand at the other end. In the 32 countries with the most stringent legislation, including Malta, Andorra and San Marino, abortion is not legally permitted on any grounds. In the next category, 36 countries permit abortion when the woman’s life is threatened. Ireland is the only country in this category in a developed region with all the others from the developing world. A few countries in the category, for example, Panama and Mali, make exceptions in cases of rape, incest or foetal abnormalities.

Foetal abnormality has been mentioned in the debate. I base what I say on life's experience. As many Deputies will know, I have a daughter with an intellectual disability. We would not swap her for the world and I have many friends in the same position. That was our choice and family consideration. When people have a child with any kind of disability, despite the trauma, sadness and often the deep loneliness, there are many positive sides to it. My other daughter and the rest of the extended family would not swap her for the world. It is important to say that because there are many other people in the same situation.

Some 36 countries allow abortion to save a woman’s life and to preserve her physical health, and 23 allow abortion to save a woman’s life and to preserve her physical health and protect her mental health. The latter categories include countries such as Israel, New Zealand, Spain and South Korea. Less restricted again are the 14 countries, including India, Britain, Finland, Iceland and Zambia, which permit abortion on the three previously mentioned grounds and also for socioeconomic reasons, with exceptions made variously in cases of foetal impairment, rape or incest. When it comes to rape or incest, or if the health of the mother is at risk, termination should be allowed.

The remaining 56 countries and territories allow abortion without restriction as to reason, although in many countries certain conditions must be met for abortion to be carried out. For example, many impose gestational limits, most commonly that abortion must be carried out during the first 12 weeks of gestation. Other limitations placed on access to abortion include parental consent where a minor is concerned. Again these are all issues.

Countries like Nicaragua and El Salvador have amended their already restrictive laws to prohibit abortion entirely. This is what is going in the world.

I am still going through the report but my initial gut reaction is for the option on page 49, section 7.4.3, which is legislation plus regulations. It is important to look at the advantages of this. According to the report, the Oireachtas would have the opportunity to discuss and vote on all relevant details of the proposed legislation and access to lawful termination of pregnancy would be put on a statutory and thus more secure footing. The report argues that such legislation would update the 1861 Act and arguably provide better protection for the unborn than is currently provided by the Act and that the chilling effect of the Act would be removed and legal protection from prosecution would be attained by compliance with the proposed legislation. It argues that the role of the Minister would come under less scrutiny in respect of procedural matters as these would be in the legislation and that the regulations could be amended relatively easily in order to address changes in clinical practice, scientific advances and challenges arising from their implementation. It argues that legislation plus regulations would be likely to satisfy the requirements of the implementation process of the European Court of Human Rights judgment in the A, B, and C v. Ireland case. This is the position regarding option four in the report. It is very important that we look seriously at this option as one of the possible solutions.

I thank and commend the expert group for the magnificent work it has done in respect of this issue. It went away and did a considerable amount of work on it and I note that of the 14 people in the expert group under the chairmanship of Justice Sean Ryan, nine were women. This is something that has not been heard over the past number of weeks in the broader debate. There has been considerable misinformation about the expert group. It has done an excellent job and come back to us with different options. It is now up to us as legislators to get on and make the decisions.

Another issue that has arisen in this debate and has been touched on in respect of the Savita Halappanavar case is that of the Coroners Act. I raised this issue recently in the Dáil with the Minister for Justice, Equality and Defence to see if the legislation needs updating. The Minister told me the Coroners Bill 2007 is before the Seanad, having been restored to the Order Paper on his initiative. He told me the Bill is being reviewed by his Department with a view, among other matters, to making it as cost-effective as possible. The Bill, as published, provides for the comprehensive reform of the existing legislation and structures relating to coroners and provides for the establishment of a new coroners service. I raise this issue because it is also connected with the tragedy we saw in Galway.

To conclude, I commend my colleagues for the reasonable and balanced debate that has been held. I urge the Government and the major political parties to give people the option of a vote of conscience in respect of any further debates, particularly when legislation comes before the House. The world will not end if we respect difference and diversity. I want to live in a republic that is inclusive and pluralist and that respects all religions, faiths and ethical and moral values. What a boring place this country would be if we all had the same values and beliefs, particularly in respect of this issue. While I am talking about religion, I must say that the attacks on Alliance Party public representatives and sectarian attacks in recent days in Northern Ireland have been appalling. It is important that we also speak out on that issue.

When we discuss this issue, it is important that we look at the different options. We have heard from the expert group which has provided us with excellent information for which I commended it earlier. The expert group gave us different options and following this debate during which everyone was given a fair amount of time and where every view was respected and listened to, it is time for legislators to deal with it. I am leaning towards option four in the expert group's report. We need legislation and strong regulations to provide clarity for the citizens of this State and the medical profession and in order to do our best to save the lives of mothers, children and citizens of this State.

Deputy Farrell proposes to share time with Deputy Pat Breen. Is that agreed? Agreed.

I echo the sentiments of many of my colleagues who have spoken on this issue over the past number of days or hours and indeed in the debate over the previous two Private Members' Bills. Although these Bills were insufficient to deal with this issue, nonetheless we are discussing it in a broad sense. I would like to state initially that I am unapologetically pro-life but I also respect the law and the sentiments of the Irish people in the 1983 amendment to the Constitution and the X case judgment in 1992. What the Irish people want and what the Supreme Court ruled upon 20 years ago are clear and unambiguous. I do not think the opinions of people have changed that much although if one was to believe the recent polls, 85% of people want clarity on legislation relating to the X case and the C case that went to the European Court of Human Rights, upon whose judgment this debate is based.

The report of the expert group was predicated on the programme for Government and the decision of the European Court of Human Rights and not the tragic loss of life in Galway. Some have suggested that the timing is a bit peculiar in that the report happened to coincide with the release of information about the tragic death in Galway but nonetheless, here we are. It is timely for us to be having this debate some 20 months into the term of office of this Government. I have no doubt that both society and the medical profession require confidence, clarity and certainty as to what qualifies for a medical termination when the life, as opposed to health, of a woman is at risk. In providing that certainty, clarity and confidence to young women right across this State and particularly in Galway, it is very important that if legislation is chosen, we get it right.

I echo the sentiments of Deputy Creed in respect of the chronology the Government proposes to use in respect of this issue. It is better for us to have a wide-ranging debate in this House and the Oireachtas Committee on Health and Children followed by a decision by the Cabinet. We should get all interested parties to take part in that debate. It is not something on which I have stayed quiet. I articulated this point on a number of occasions. Although I changed my view on that a week ago, I have since reverted to the view echoed by a number of my colleagues on both sides of this House that we should have a very thorough and open debate with society in general on this issue. That can only occur if we invite interested groups to take part in a debate before the Oireachtas Committee on Health and Children.

No doubt both sides of this issue have very firm views, so much so that we have all received hundreds of telephone calls, postcards and e-mails. Indeed some of us have even been subjected to some pretty horrific photographs like the one I received this morning which was disguised as a Christmas card. My secretary opened it and I was also subjected to it.

I plead with those on both sides of the debate to desist from doing this. It is disgusting. As a legislator I understand people want to express their views, but neither my staff nor the staff of other Deputies and Senators should be subjected to horrific photographs.

The need for legal certainty and clarity for the medical profession is one of the two main issues in this debate. We do not want a scenario where doctors and consultants must consult the law prior to making a decision or providing medical treatment to a woman. This is why we must strike the right balance between the need for legislation and-or guidelines. We do not need another referendum on this issue, specifically on the X case. I would welcome a debate on whether we should legislate for cases of rape and incest, but like Deputy Creed I am not convinced the people would make a clear decision due to the very real difficulties and problems the country has with regard to the number of people committing suicide. This is an issue the House must deal with and attempt to assist those who find themselves under such severe constraints and personal difficulties that they would consider such a course of action.

If we are to believe the polls, 85% of people want action on the X case which would most likely include legislation. As a personal request, I would like the Cabinet to seriously consider repealing the 1861 Act which perhaps was correct when it was written because medical science was not as advanced as it is today, but we are a modern society in a modern world and we can and should ensure sufficient clarity for the medical profession and women throughout the State to know when they are legally entitled to a termination and when a termination is required for medical reasons.

Like the previous speaker I compliment the expert group, particularly Mr. Justice Seán Ryan, for the work done on behalf of the Houses of the Oireachtas and the Government. It provided everyone with a huge amount of information in a very clear and frank fashion. I also compliment the group on the manner in which the information was framed because not all of us have the benefit of a medical or legal education and the work the group did on our behalf is greatly appreciated.

If legislation and guidelines are the selected options, as I believe they most likely will be, I do not envy the Attorney General in striking the balance required to frame the legislation correctly to ensure the 85% of people who, if one believes the polls, want action on the X case will be happy while preventing what the overwhelming majority of people including me do not want to see, which is unfettered access to abortion on demand. I do not wish to ever legislate for this. I thank the Minister and the Government for the opportunity to discuss this matter.

I welcome this opportunity to contribute to today's debate. I acknowledge the commitment of the Minister for Health and the Government to listen to the debate and give careful consideration to the views expressed in the House before any decision is made on the recommendation of the expert report. The issue of abortion is one of the most painful and controversial issues which will ever come before the House. Many of us in the House in all parties have very strong and deeply held views on the matter. The lack of consensus is also reflected in the Irish people who are equally divided. Every day I receive calls from constituents who hold strong and diverging views on how we should move forward. Five referenda have been put before the people and on each occasion the campaigns were bitterly fought. Ireland has seen many economic and social changes in the past 30 years since Article 40.3.3° was first inserted in the Constitution but there has been little change in people's attitude to abortion. It remains a very emotive issue and the country is as deeply divided now as it was 30 years ago.

The latest situation arose as a result of a judgment of the European Court on Human Rights in the case of A, B and C v. Ireland. The Government established an expert group in January and I congratulate this group on the work it has done. It has made a number of recommendations which must be considered. The debate has been further complicated by the recent tragic events in Galway and I express my sympathy to Praveen Halappanavar on the death of his wife, Savita. The entire country has been deeply affected by what happened. It is important that the facts of the case be established as quickly as possible. Two inquiries are under way, namely, a HSE inquiry headed by an eminent professor and a HIQA inquiry. The first priority is to have a prompt conclusion to these inquiries and ensure pregnant women in the country have the confidence they will receive the best possible care when they enter our hospitals.

It is not right to apportion blame to the medical profession or anybody else without establishing the facts. We also need these inquiries to conclude as promptly as possible, because some people have sought to exploit this tragedy to force the House to rush through legislation. I do not want go into the specifics of the case. The eyes of the world may be upon us but we should not be rushed. The full facts should be available to us before any decision is made because it is important we get it right. We all know how rushed legislation can lead to bad law. It is important to point out to those observing the debate outside the country that our maternal death rate is one of the lowest in Europe and we have the highest birth rate per capita in Europe.

Legislating for abortion is fraught with confusion. In 2002 the then Government put a referendum before the people which sought to exclude suicide as grounds for abortion, which was rejected by the people. Last week a RedC poll carried out by the Sunday Business Post reported that 85% of people now support legislating for the X case, which means allowing abortion where the mother's life is threatened including by suicide. However, as in 2002 there appears to be much confusion because the same poll shows 63% of people believe suicide should be excluded as grounds for abortion. Based on analysis of the calls I have received it is clear a substantial number of people have doubts about making abortion available on the grounds of suicide.

However, there is universal agreement on one matter, which is that everyone wants to ensure where a clear danger to the life of the mother exists every medical intervention is performed to save her life. This right is already enshrined in Article 40.3.3° of the Constitution. If further clarity is needed for the medical profession in this regard it should be provided and clear guidelines issued. However, legislating for abortion on the grounds of suicide is a very different matter. This is a very complex area with many differing views among the medical experts as to whether it is necessary. The suicide rate among women is low and a previous speaker referred to this. It is approximately 4.5 per 100,000 and it is extremely rare for it to occur during pregnancy. According to statistics, between 1980 and 2011 two suicides among women occurred in the three Dublin maternity hospitals, both of which occurred post delivery. One of the women had a long history of depression and the other a long history of substance abuse. It would be virtually impossible to legislate for every eventuality and several questions arise, such as who will determine a woman is suicidal and that her life can be saved by an abortion. Will the view of one psychiatrist be sufficient? Will general practitioners be involved?

Will it require the involvement of a second psychiatrist? Will a panel of experts be involved? There are many questions that need to be asked here. At this stage, I am not convinced that abortion on the grounds of suicide should be part of any legislative solution and I will take a great deal of convincing that legislating in these cases would be watertight so that it would not lead to abortion on demand.

Like other Deputies, I have reservations. We all have our own personal experience. I will not discuss it but given my own personal experience, I value life very much indeed. I value every minute of life.

I am pro-life and anti-abortion and I do not want to see abortion available on demand in this country. All I hope is that our views and concerns can be taken on board and that a solution can be found to the European court judgment which should try to satisfy all of us.

I welcome the opportunity to speak in this debate today. It is very sensitive for many. Like Deputy Creed, I would have liked the hearings to have been held before the Cabinet makes any decision. I hope the Minister might take those views on board.

The next slot is a Fianna Fáil slot of 15 minutes. There is no Fianna Fáil presence. The two next speakers presenting are Deputies Ó Ríordáin and Eric Byrne, who have the option of either sharing this slot or taking the two slots consecutively.

We will take the two slots separately.

Deputy Ó Ríordáin has 15 minutes.

I had a chance to speak briefly on this issue on the night of the legislation put forward by Deputy Clare Daly.

This issue, as has been stated, is the single most divisive one in Irish politics. Every politician who talks about abortion always says it is a very sensitive issue, and then nothing happens. Effectively, this issue has seen the greatest amount of political cowardice and hypocrisy of any in Irish debate.

I was not politically active in any way - I was only a child - in 1983 when the pro-life amendment was made to the Constitution. It was introduced by the same people who were against contraception, divorce and all other supposed social ills that would bring Ireland to its knees. In my view, and that of others, the 1983 amendment effectively reduced the status of a woman to that of a vessel, effectively, to that of a womb.

Inevitably, regardless of those who warned against the actions of the group which was intent on pursuing that course of action, the X case arose in 1992. I need not go over the details of the case but it is sometimes convenient when we call a teenage rape victim X rather than give that person a name. It is sometimes easier for us to merely call a person by an initial rather than discuss a human being. The Supreme Court determined that a constitutional right to abortion existed when there was a real and substantive risk to the life of the mother and the constitutional right was vindicated in a referendum by the votes of the people that year. As it stands, that is the position. There is no legislation.

The 2002 referendum - let us not recast what happened - was a cynical attempt to remove the threat of suicide by a Fianna Fáil Party in pre-election mode, and it also was rejected by the people. Where are we? There is a constitutional right which is left without any legislation. The 2002 referendum was not an attempt to legislate. It was an attempt to pander to pro-life voters and to subvert the X case judgment, and they failed.

We are all told to be calm and respectful and Ministers make reference to a free vote so that Members can wrestle with their consciences. I was surprised at the speech made earlier by an Independent Member. I remember canvassing during the general election an hour after that gentleman and being confronted with the issue of the Labour Party and abortion at every door. It is amazing how the wind changes and people's positions change.

I looked through the pre-election manifestos before I came into the Chamber. There was no reference to legislating for the X case judgment in the manifestos of the Fine Gael, Sinn Féin or Fianna Fáil parties, or in the manifestos of any of the members of the United Left Alliance. Only one manifesto mentioned the X case. It was my party, the Labour Party. We have had a consistent approach to this matter because we understand law and we understand the responsibilities of legislators.

I am bewildered by some of the contributions made in this House today and last night. Reference was made to a "herd mentality" and a "rush to judgment". A Member, only a short time ago, spoke about people "exploiting the death of Ms Halappanavar" - I find that quite offensive. How can one have a herd mentality and a rush to judgment after 20 years?

The expert group makes it clear that legislation and regulation is needed. The pro-life stance states Ireland is the safest place in the world to have a baby - if I have heard that one time in the past couple of weeks, I have heard it a thousand times. If that is the case, if there is never a case when a woman's life may be at risk, then what is the problem with legislation? Of what are they afraid?

The reality is when there is a problem, women simply travel to England. I have asked those who have experience of this to contact me in the past couple of days and some of them have. I will not name these women. I have an e-mail before me. In it, the lady writes that she found out she was pregnant on 11 November, the day of her partner's birthday. She gave the pregnancy test to him as a surprise birthday present, and he was doubly delighted as they had only been trying for three months. She then discovered that her baby's condition was incompatible with life. She writes that they travelled to Liverpool to the women's hostel where they talked her through the procedure, gave her the tablet to stop her body supporting her baby, and told her to go and rest in a hotel for two days. She writes that this was the hardest part. She did not want to leave the room, she felt as if she was going to die, and all they did was watch the clock for the next 48 hours until they returned to the hospital. Fortunately, the reserves arrived in the form of her aunt and mother who helped distract her from her partner. She writes that the hospital was great in accommodating all four of them with beds and food. That same morning they induced her and she went into labour by lunchtime, which went on until 10 p.m. that night when they finally had to give her painkillers.

Junior, as the lady calls her baby, was born asleep after 10 o'clock. She writes that they asked those taking care of them to hand him to her partner first so he could check that he looked okay and he sadly stated he was perfect. They then got to hold him and look at his hands and feet which were all perfect, and then they were able to have him blessed by a priest, and that during the blessing even the midwife cried with them. She writes that the midwife then gave them an imprint of his hands and feet and although she initially refused photographs in her dazed state, the midwife kindly took them anyway and informed her they would be put on file and she could collect them at any time, for which the lady is now very grateful.

In addition to the emotional cost, the lady writes that financially, she and her partner were set back €3,500 as well as her extended time off work, that though the necessity of terminating a child would be no less traumatic in any situation, the fact that they had to slink off under a cloak of lies and guilt is unacceptable, and that she personally felt an overwhelming desire to explain to everyone she came across, even a taxi man, that she wanted her baby, she did not want to be doing this but she had to so that her baby would not suffer. Such a case will not be dealt with under X case legislation.

Another lady wrote to me about her sister. She writes that after further scanning, her sister and her husband were told that the baby had severe abnormalities. The brain of this baby was never fully developed and it had other abnormalities, and they were sent home to be brought back the next day to have further scanning. She writes that she will never forget this day as long as she lives, seeing the devastation on her sister's face as she curled up on the sofa with her lip shaking while she tried to fight back the tears as she felt like her world was falling apart. She writes it was so hard to watch. The following day, after detailed scanning, doctors came to the conclusion that the baby was, in fact, incompatible with life and would not survive outside the womb if the pregnancy even managed to reach full term. She writes that both her sister and her husband booked flights to London, that when her sister went in for the procedure, she was devastated and kept explaining to the nurses that she really wanted this baby, that it would not survive once it was born, and that she was trying to justify herself. She felt like she was doing something wrong because her own country had made her feel this way by not providing this service.

The person who wrote the e-mail continued that it is absolutely disgusting that in this day and age, women are forced to leave their own country to have terminations in cases where their much-wanted baby would never survive.

A lady named Siobhán wrote about a condition called anencephaly, in which the brain and skull do not develop fully. She wrote that on the day of the scan, she found that her baby would not live. While that was devastating enough, she and her husband were then told she could continue on with the pregnancy for a further 20 weeks to her due date and, if she did not wish to do so, she would be obliged to travel to the United Kingdom to terminate the pregnancy as the law in Ireland would not allow anything to be done here. She writes that, consequently, she travelled with her husband to Liverpool and spent a few surreal days carrying on as if all was well with their world while it actually was turning upside down. They met the team in Liverpool's Women's Hospital, who were kind, gentle and compassionate and were sorry Siobhán and her husband had to be there with them. The hospital team gave her a tablet to take and then she and her husband were obliged to leave the hospital for 48 hours before returning. She writes these were 48 hours of trying not to think about what was happening and trying to act normally in a city they did not know while separated from their families and friends, including their two children, aged four and two.

On returning to the hospital, she was given further doses of a tablet every few hours to induce labour and eventually, after 12 hours, her baby was delivered. Siobhán writes that she and her husband held him, named him and cried together for the death of their son. The hospital chaplain came in and blessed him for them. She writes he and all the staff were so sympathetic, caring and understanding at the horrible predicament in which she and her husband had found themselves. She concluded by stating this was her story, which she was sharing in the hope it would bring about change in our country, as the women of Ireland deserve better.

A woman called Ruth, whose child unfortunately had the same condition, wrote she could never have been prepared for what she and her husband were told that morning, as the experts scanned her. Their baby had anencephaly, a neural tube defect that results in the absence of a major part of the brain and skull. The consultant explained that Ruth and her husband had two choices, that is, she could continue with the pregnancy and their baby would die as soon as she was born, or shortly thereafter if the pregnancy got that far, or they could terminate. Ruth wrote that ringing her dear mum and being obliged to break this news to her was utterly heartbreaking. She recalls her mother being so shocked, not by her awful news but by the fact that she and her husband would be obliged to travel to the United Kingdom for termination. Ruth wrote she does not really remember the days that followed, other than the amazing support from her husband, family and close friends. She wrote that she cried and cried and was so angry. The anger was not about their baby's diagnosis, as she had nursed for long enough to realise that bad things happen to people every day, but she just felt so angry that she and her husband were obliged to travel. She wrote she had thought that surely under these circumstances, termination was allowed in Ireland. She wanted to have the chance to stand up in front of a judge and plead her case to allow her to be looked after in her own country, but instead she and her husband were obliged to travel to the United Kingdom with all their grief, feeling like criminals. She then goes on to outline precisely what happened to them but she concludes with the damning statement that although they felt no shame about the decision they had made, this journey made them feel like criminals.

The cases of none of the aforementioned women will be dealt with under X case legislation and Members are only discussing the risk to the life of a mother. Much now has been made of the issue of suicide but it is dealt with under the X case judgment of the Supreme Court. Moreover, it has been reinforced in the referendum results of 1992 and 2002. One cannot come into this Chamber and talk about mental health and suicide ideation or complain about budgetary measures in respect of mental health if one does not, in one's gut, trust a woman when she is suicidal as a result of a situation that brought about her pregnancy for whatever reason. One cannot do this if one simply does not trust her and simply thinks she is telling lies. Despite all the wind expended in this House about mental health and suicide, obviously Members do not trust women because, clearly, they will not be telling the truth. All of the e-mails I received came from devastated women, because they know that abortion is always a tragedy. It is as though women wilfully wished to discard their babies and pregnancies because they are so callous. Members must be clear about this suicide issue. It is part of the determination of the Supreme Court of this land in 1992. It was reinforced by the votes of the people in 1992 and 2002 and it must be part of this legislation. Members cannot walk away from this issue. Perhaps, in the fullness of time, when people stop being so cowardly and hypocritical, Members might return to the amendment that was introduced in 1983 and listen to what I consider to be the wise words of the Minister for Justice and Equality, Deputy Shatter, in this regard.

The time has passed for talking any further on this issue. I do not want legislation to be introduced to this House via a Private Members' Bill as it must come from the Government and must come from the Office of the Attorney General. Moreover, the idea of a free vote is an absolute nonsense in a modern parliamentary democracy that must deal with issues of conscience every single day. Members deal with issues of conscience each day. Each day they pass laws and budgets that potentially will hurt people but Members know in their guts that sometimes it is for the greater good. Consequently, this idea of a free vote, mentioned earlier by an Independent Deputy and previously by a Minister of State, is a nonsense and cannot be allowed to happen in this situation because the women of Ireland need to know the Government of the day is on their side.

This is the first time I have spoken on this issue but it is a matter of such importance, nationally and internationally, that it would be remiss of me not to spend some time dealing with the situation that obtains in Ireland today. I am slightly older than the previous speaker, who covered most of the points in great depth. However, in the Ireland of the 1980s, women often did not trust and were so terrified of having their babies in maternity hospitals with a so-called Catholic ethos that many preferred to travel to the Rotunda Hospital in Dublin because of its so-called Protestant ethos. Women felt more reassured that they would get better life-saving response and treatment there in a crisis situation. That was a widely held view in the 1980s among those of us who knew there was a distinct difference in ethos between the Catholic maternity hospitals and the Rotunda Hospital, Dublin.

Imagine that in those days, worried women were obliged to travel to Belfast to have amniocentesis tests because of their lack of availability in the Republic. That was 30 years ago and one would have imagined that our maternity hospitals would have progressed to a point where the life of Savita Halappanavar would have been saved and no one could have cited as an excuse that this is a Catholic country. That was the Ireland into which my children, aged 32 and 30, were born, yet here Members are, having this inconclusive and ongoing debate again, for which they need finality.

I believe the hypocrisy and indignity of forcing women from this country to travel to England for a termination, including a 14 year old suicidal rape victim, is an obscenity and a blot on the image of Ireland both nationally and internationally. Ireland is indeed an overwhelmingly Catholic nation, and the recently completed census shows that 84% of the people in the Republic proclaim themselves to be Catholic. However, Members also must note that now more than ever before, Ireland is a highly diverse society. As legislators, they must legislate for the nation as a whole and not just for the religious moral teachings of one faith. Ireland now is a multi-faith society and Members must legislate for such.

It might be useful to put on record what constitutes the Ireland of 2012. Members might note that the group nearest in number to Catholics are those who declare themselves as having no religion.

They now number 269,000, an increase of 44.8% over the 2006 census figure. A further 73,000 people do not state their religion, which would be indicative of an open-minded collective. Among those who did declare their religion last year, the next largest grouping to those with no religion are members of the Church of Ireland at 130,000, members of the Presbyterian Church, which have increased 4.5% to 24,600, and Jehovah's Witnesses, which stand at more than 6,000 people.

The most significant non-Christian religion in Ireland is Islam, with members of the Irish Muslim community now representing approximately 50,000 people. That is a big increase of 52% over the figure from 2006. Hindus are important in this debate, as it has as a backdrop to the case of Ms Savita Halappanavar, who was Hindu. Their numbers have grown by almost 76% to approximately 11,000. Ireland also has a Buddhist and Jewish population, among other groups.

I respect absolutely the right of the five bishops and their congregations to picket the Dáil but we should not, as legislators, attempt to legislate for one faith or the morals of one religious grouping. We must legislate for an open, diverse and multicultural society, and I remind those who practice Roman Catholicism that no Catholic with a moral belief need avail of such services that may be available to those who do not believe that life commences at the moment of fertilisation, which is the Roman Catholic Church position. I believe very strongly that, in a modern liberal democracy, we as legislators must not impose in laws the singular view of one faith group.

I will not spend too much time going over the details of what has happened in the past in Ireland. Deputy Ó Ríordáin mentioned some and I have quickly perused the report of the expert group, so it strikes me that one group does not appear to matter in this country, aside from the women whose lives are threatened. I am talking about the families of such women, including mothers, fathers, sisters, brothers, partners and extended family. They are mainly excluded from these debates. There is the case of Ms D, who brought Ireland to court. She discovered after 14 weeks of pregnancy that one of the twins she carried had died in the womb and the other had a lethal foetal abnormality, Edwards syndrome. In all humility I ask how the religious and pro-life groups are arguing that women like this should be compelled to continue the pregnancy when she, her husband, her family, her mother or father, her aunts, uncles and grandparents may have decided, with her agreement, to abort.

Another woman brought a case against the Health Service Executive. She was four months pregnant at the time of the hearing and had learned that the foetus had a neural tube defect resulting in the absence of a major portion of the brain, with the condition usually fatal within three days of birth. I wonder how insensitive this society has been to mothers, husbands, children and families that we have not, over 20 years, improved the circumstances where a woman can go into a maternity hospital and feel absolutely secure that if she and her family make a decision that a foetus is dead in the womb, she will not have to continue the pregnancy. It is an obscenity and we as legislators should pull out our fingers and begin legislating for women and their partners as a collective.

The five bishops had an amazingly excited audience of pro-life group members so hysterical in their extreme views that they were the mirror image of the groups demonstrating two days earlier which sought abortion on demand. These extreme groups were screeching, hysterical and mind-boggling. One group was led by five Roman Catholic bishops and the other was led by ultra-leftists, Trotskyists, Éirigi and radical feminists. These groups constitute the extremes, but we have a mandate as democrats in a liberal democracy to ensure we do not interpret their views but accept that we have a maturity in Parliament to implement legislation for the betterment of any mother using our maternity services.

As a man, speaking in a male-dominated Parliament and a room in which not a single woman is present, I find commenting on and adjudicating the most sensitive and difficult decision that any woman could make to be a difficult experience. Any difficulty I may experience would be meagre in comparison with the emotions any woman who has attempted to reconcile her desire for life and that of her unborn child would feel as she looks at this debate. Such a woman would be looking at mostly men talking about a terrible choice that only women face. As legislators and public representatives, we often use empathy to bridge the gap between the decisions we make and the people who live with these decisions. However, even the most developed sense of empathy will flounder in the face of the sadness and grief that women face when the joy of carrying life is accompanied by the risk of their own death. That this only happens to a small number of women should not allow a diminishment of the horror of this predicament.

A philosopher once observed in a very different setting that when one cannot speak of a matter, one must be silent. Despite the massive difficulty I face in imagining this choice as a man, as a legislator and a public representative I am required to speak, make known my views and act. Amid this turmoil I have looked to retrace the main decisions made by our people and our institutions of State on the issue. I do so conscious that in my nine years as a public representative, this is the first time as a Member of the Oireachtas I have dealt with an issue that has riven our nation.

What are the key public events that have defined this debate? In 1983 the people voted to introduce Article 40.3.3° into Bunreacht na hÉireann, including the key phrase "with due regard to the equal right of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right". In 1992 our Supreme Court interpreted our Constitution to allow for lawful termination if there is a real and substantial risk to the life, as opposed to health, of the mother.

In 1992 and again in 2002, people voted against measures that were designed to exclude suicide as a ground for lawful termination. Everything that has occurred since is defined by the contours of these decisions.

Two other points must also be made regarding the role of European institutions in this deeply sensitive matter. First, in July 2006, the European Court of Human Rights rejected an application from a woman referred to as "D" on the grounds that Irish courts offered sufficient remedy and procedure for deciding on her application. The court recognised that Irish institutions provide the first and proper public space within which decisions are to be made. Second, it should be noted that the decision made in December 2010, again by the European Court of Human Rights, was in respect of compliance with decisions made by Irish people and institutions.

The expert group report states that "the European Convention for the Protection of Human Rights and Fundamental Freedoms is an international agreement which Ireland has signed and ratified and which is consequently legally binding upon Ireland". However, in accepting this we must acknowledge that what is required of us is coherence between our laws and courts. No one is seeking to foist a decision upon us. What we are required to do is be consistent with decisions we took in the past. What we cannot do is second guess those decisions. The right to decide the interpretation of law is not open to everyone. If that were the case, it would instigate the gradual but inevitable erosion of the foundations of legitimacy and authority upon which the State and institutions, including the Oireachtas, depend. This competence is, therefore, exclusively reserved for our courts and if we disagree with an interpretation of the courts, it is open to us to change the constitutional framework within which they make such interpretations. This has not occurred.

Having made forays into the world of the abstract, the world of our laws and institutions and a world in which women are referred to as initials, let me address the handful of tragedies to which we are seeking to respond. In a case where the life of a mother is threatened, the State has two responsibilities, namely, to do everything possible to keep mother and child safe and alive and to ensure that those medically involved in any such dilemma are protected by the law when they stay within the law. By omission, I cannot accept that when the life of a mother is threatened the State should make a decision for her or reduce the choices open to her. It should be recalled that in such circumstances, the life of a woman, who could be a neighbour, friend or someone we have not met, is at risk. In the solitude conferred by the horror of such a choice the State should not be present beyond meeting the two responsibilities I have outlined.

I am against the introduction of abortion for social or economic reasons. What we must do is clarify our law as it stands. Having had the honour of seeing my own children brought into this world, I will not yield to anyone in my recognition of the rights and lives of the unborn and born. Perhaps because of this experience I am also deeply aware that the law is not always successful in governing by absolutes. We all live our lives in the space between absolutes. Sometimes we are aware of the right thing but on other occasions we fumble forwards and hopefully do the right thing. Our fragility and vulnerability to chance and events beyond our control defines our humanity.

For these reasons, I believe the option of advancing legislation or regulation to deal with the consequences of the X case should be pursued by the Government in a careful and deliberative manner. We must be particularly careful on the issue of mental health and risk of suicide. We must also remember that threats to mental health already cause deaths at substantial cost to society. This issue is not about changing the law but about making it clearer for those who depend upon the law for their lives or exercise duties upon which the most vulnerable depend.

This will be a difficult debate. I have already been the victim of comment and behaviour that gives me a taste of what is to come. Francis Bacon once made the following observation: "It is as hard and severe a thing to be a true politician as to be truly moral." I have certainly felt this when considering this issue.

The separation of powers is sacred to our Republic. While the courts cannot make Parliament act, the Oireachtas is obliged to consider the views expressed by the courts. In giving such consideration, we must recognise our obligation to support a woman in circumstances where her life is threatened but we must not make a decision for her.

I thank the members of the expert group which drafted the report on the judgment in the A, B, and C v. Ireland case. The report has been eagerly awaited by members of the public and I am pleased the Government will decide before Christmas which of the options it will pursue. This issue has been ongoing for too long and it is important that the Legislature makes a decision on it.

It is important to note that this debate is solely on the report of the expert group. Bearing this in mind, we must be cognisant of the provisions of the Constitution pertaining to the rights of mothers and their babies, the findings of the Supreme Court in the X Case in 1992 and the judgment by the European Court of Human Rights in 2010.

I do not agree with the labels of "pro-life" and "pro-choice" and they do not have any place in the House. In recent weeks, Ireland has been gripped again by an abortion debate, which was reignited following the tragic death of Savita Halappanavar. The loss of this mother and her child in such circumstances has touched the hearts of everyone in the country. As with every Member of this House, I have been inundated with correspondence from members of the public outlining their views on this matter. What I have found is that many of the issues being raised fall outside the remit of the report and that any action taken by the Government will not impact on the scenarios raised.

After more than 20 years of inaction, the Government needs to legislate on the Supreme Court ruling. Such legislation will not only protect our medical professionals in their decision making, but also give mothers and, indeed, fathers certainty about their rights. This is an emotive issue, but it is vital that it be debated in a calm and measured manner. I do not believe that any Deputy present wants to see abortion on demand in Ireland. It is not what the Irish people voted on in three referendums.

We must be aware that, by legislating for the X case, we are merely maintaining the status quo in terms of the availability of terminations for medical reasons. It is necessary because it will provide legal footing for the medical profession. Regulations must be introduced along the current medical guidelines to assist the profession further.

From a personal perspective, I would also like to see the terms of the Supreme Court ruling extended to the health of the mother, not just the risk to her life. The European Court of Human Rights ruled in favour of C. It found that while there was not necessarily a real and substantial risk to the life of the woman due to the pregnancy, her health could have been affected by the pregnancy due to the cancer treatment she was undergoing. This matter is worth considering.

Having listened to my constituents, members of the public and other Deputies who have spoken in the House on this matter, the element of suicide appears to be one of serious concern. I understand how these concerns can arise but I remind the House of what my colleague, Deputy Neville, stated, namely, that the risk of suicide decreases during pregnancy and, therefore, this risk, although real in the sense that it can occur in very rare cases, is not likely to increase the number of terminations undertaken.

Furthermore, I must agree with Deputy Neville, in that we must put our faith and trust in our mental health psychiatric services and their ability to diagnose correctly a genuine suicidal case over someone who dishonestly claims to be suicidal in order to obtain a termination. The expert group report sets out a number of options in this regard and I tend to agree with the suggestions regarding two psychiatrists and one obstetrician assessing the woman before a decision on termination is made.

The issue of suicide was put to the people in 1992 and 2002 and we must listen to their voices. As Deputies, we need to put our personal and moral beliefs aside and act as legislators by correcting this anomaly, which has existed for the past 20 years.

The next slot is Fianna Fáil's. There being no Fianna Fáil presence in the Chamber, I will call on the next presenting speakers, Deputies John Lyons, Seán Kenny and Eamonn Maloney. They can exercise their speaking options.

Deputy Maloney has asked me to go first. He will return in a few minutes.

I wish to express my deep sadness at the death of Savita Halappanavar and to send my condolences to her husband, family and friends. I say this as a parent and a grandparent.

I welcome the opportunity to speak in the House on this issue. It is only right that every Member is able to express his or her views on the report and to have his or her constituents hear the voice of those they elected to represent them. Like other Deputies, I have been contacted by hundreds of my constituents expressing their views on the matter. I thank them for doing so. I have never received so many representations from constituents on a single issue, which speaks volumes about how seriously the people view the matter of the X case.

As someone who remembers the 1983 referendum, I welcome the calm and rational debate that is taking place. Those of us who disagreed with the wording in 1983 were subjected to a great deal of aggravation at the time, some of it in the workplace. Thankfully, we can debate this question today with greater maturity and tolerance.

As Mr. Justice Seán Ryan stated in the report, the European Court of Human Rights concluded that an existing constitutional right had been identified by the Supreme Court in the X case and that it was logical and rational that this right would be available and enforceable in law. Article 47 of the European Convention on Human Rights requires the Oireachtas to implement the European court's judgment. As this State ratified that convention, we cannot make excuses for ignoring the report.

Many of the representations I have received have been incredulous, asking why the Oireachtas has failed to take action on the issue of the X case for two decades. The simple fact is that the Oireachtas failed to address the case. I am glad that those who are now Members of the Oireachtas will finally ensure that the X case will be addressed.

Having carefully read and considered the expert report, I believe that what the Oireachtas must do is obvious, that being, to enact legislation to address the X case correctly. The best method of doing so is to enact new legislation, not amend existing legislation. The new legislation should be accompanied by regulations that govern the technical and procedural aspects of how to provide for a lawful abortion.

There are groups and individuals who believe that regulations will be enough to address the requirements that the European court has laid down. Others believe that there should be another referendum to remove any right to an abortion, especially in the case of suicide. I do not support the former view and the latter option was attempted a decade ago, when it failed. Therefore, we must act within the Constitution's current provisions.

Some individuals have contacted me to express their wishes to see legislation introduced that widens the provision of abortion in order to deal with cases where termination of a pregnancy is permitted for medical reasons beyond the scope of the X case. These cases occur where the pregnancy has a fatal foetal abnormality, where there is no chance at all of life outside the womb. I am sympathetic to this point of view and I have indicated to the Minister for Health that situations such as this need to be considered.

Such cases are generally thought to be outside the scope of the X case and may well be outside the scope of the Constitution. Will the Minister for Health consider this particular area of abortion legislation to verify whether that is the case? Women in these situations must endure a difficult physical and emotional crisis. If they choose not to endure that crisis, which is entirely understandable, they must travel outside the State. That is wrong.

Suicide is a real factor that must be considered when legislating for the X case. The X case hearings accepted testimony from mental health professionals regarding the state of mind of X. Beyond that dreadful case, however, suicide is not something that women will lie about in order to obtain abortions. On the matter of abortion legislation and suicide, every Deputy must ask himself or herself whether he or she trusts women. When it comes down to it, all Deputies do trust women. Therefore, the House must accept that suicide is a real factor that must be covered by the legislation.

Following on from the matter of suicide, there is a concern about legislation leading to what is termed "abortion on demand", as indicated to me by some of my constituents. I wish to address this concern. Abortion on demand cannot or will not happen under any legislation that will be enacted as part of the expert group process. It would not be unconstitutional and, therefore, would not be legal. What must be considered also is the question of trust in medical professionals, who are required by society to behave ethically. All Deputies believe that medical professionals, including mental health professionals, act ethically.

I am certain about one aspect of the issue relating to the Offences against the Person Act 1861, namely, that no reasonable person wishes to see a woman who obtained an abortion go to prison for any length of time. It would be inhumane. Women who seek abortions seek them because they are in crisis. That crisis should not be something that results in a prison sentence.

Time is required to develop legislation but I would stress that a reasonable amount of time is needed as opposed to an undue amount of time. The Oireachtas must act without delay. I am certain that whatever action is taken by this House on foot of the expert group report will be challenged in the Supreme Court by those who do not wish to see any action and who will try to undermine the outcome of the work done by the expert group. Therefore, the legislation must be legally robust. This would be in the best interests of the State, Irish women and all of the Irish people.

In the same way as Deputy Donohoe, I will never understand the issue to the extent of a woman, but I wish to contribute to the debate nonetheless. We have waited a very long time in this country to have this debate, but now that it has come it is very welcome. Like everyone else in the House, I have been inundated with telephone calls, letters and e-mails from constituents - from home and abroad - in recent weeks about the death of Savita Halappanavar. Many of those who contacted me were also people who stood on Kildare Street on the day the story broke, and marched on O'Connell Street the following Saturday, to show their support and compassion for Savita's family. I have never seen such a public reaction, and how it has informed the debate in this House.

Until then, for many the X case was an abstract, legal discussion, but now it is also a personal story of loss. People with previously entrenched positions in this debate have realised the status quo cannot continue. The recent polls tell us the public wants this issue resolved, and it will be. We have an opportunity to show the women of this country that we will act to vindicate their rights, show leadership and provide clarity of purpose on the issue. Many of those who contacted me in recent weeks said that for too long politicians had dodged the issue and that they would not stand for it. This Chamber and its Members cannot be the rock on which the tide of public opinion breaks and recedes. Not this time.

In the same way as other Labour Party candidates, I stood in the previous general election on a manifesto that included a commitment to legislate for the X case. I want the commitment to be honoured not just because it was often a difficult and lonely policy to support, but because it is the right thing to do. We have seen the expert group report. We know the options it gives us and we must now draw up a plan to proceed. Whatever course of action is chosen - be it legislation, regulations or a combination of both - I will support it. The report does caution that to get the right balance between appropriate drafting and democratic scrutiny will take time.

I know the impatience of people and the desire for an immediate reaction but we should not spend a minute more or less than we need on the issue. This is the opportunity many people never thought they would see, and I am prepared to wait just a little bit longer for a response that will satisfy the people of this country. Regardless of whether we like it, this debate and the subsequent legislative response will not be the end of the abortion debate in Ireland. That will be the case as long as thousands of Irish women continue to travel to other countries to access medical services each year. Whatever people's opinions on abortion beyond the X case, it is a debate in which we must all engage at some point.

I welcome the report and recommend its reading by as many citizens of the State as possible. I hope the report is available in all public libraries, schools and colleges. I encourage everyone to go online to read it. The Government must ensure that hard copies of the report are available because of its importance.

I acknowledge the great work of the expert group and its composition of medical, legal and administrative expertise. It is regrettable the abortion debate in this country has been dominated by extremists on both sides for many years. There is now a middle ground of public opinion that urges us, as legislators, to get on with the job. We have, on the publication of this report, an historic opportunity for all-party consensus on a way forward. The report and its options offer a reasonable solution to a highly charged and emotive issue. Abortion is a difficult, sensitive and divisive issue not only in this country, but around the world. People hold strong personal views. The debate must be kept calm and within certain perspectives of civility. The Government sought the report to provide expert guidance and advice on the State's obligation to the judgment of the European Court of Human Rights. A range of options was sought and it was delivered. Delay and the status quo are not among them. It is 30 years since the highly-charged referendum and 20 years since the X case judgment. The issue must be addressed within the framework of the Constitution and its interpretation by the Supreme Court in the X case.

The constitutional review group of 1996 recommended legislation as the "only practical possibility" to clarify the state of the law. The all-party group stated that the legislation should cover matters including definitions, protection for appropriate medical intervention, certification of real and substantial risk to the life of the mother and a time limit on lawful termination. Three years later, the Green Paper on abortion in 1999 considered seven options and, of those, two fall within the terms of reference of the current expert group's work. The two options involved primary legislation and regulating abortion in line with the X case criteria.

It seems to me, therefore, that the only means by which certain legal clarity is required to the issue of lawful termination in Ireland is by means of primary legislation. People require clarity. Failure to act may cost lives. Courts in this country and in Europe have made it clear that this legislative vacuum is unacceptable. Mothers must know the law; doctors must know the law; people must know the law. We are told there are grey areas. Grey areas may cost lives. The report acknowledges that no criteria or procedures have been laid down in law since the X case by which to measure or determine the risk to a woman's life. Hence, there is uncertainty as to the application of the law.

We have a duty as public representatives to help provide clarity on issues, but I acknowledge that whatever legal clarity is assured, such clarity must be within the confines of the current constitutional framework. Four options were outlined in chapter 7 of the report. None of the four options will lead to abortion on demand. One or more of the options will be considered by the Government and acted upon.

There is also the issue of the Offences against the Person Act 1861 and in particular sections 58 and 59 thereof. If the favoured course of action is that this House opts for legislation to give effect to the provisions of the X case – I believe it will - then sections 58 and 59 must be replaced. The "chilling effect", as it applies to women and medical practitioners, must be removed in its entirety. The expert report reminds us that the European court indicated that the criminal provisions still in force would have a chilling effect on both women and doctors during the medical consultation process because of the risk for both parties of criminal conviction and imprisonment. The need for legislative compliance which would offer a defence from criminal prosecution seems a necessary protection for medical practitioners.

Current Medical Council guidelines may be seen at times as ambiguous and can on occasion be interpreted differently. Obstetricians say they require legal protection and they deserve protection where there are legal and practical grey areas. In situations where the mother’s life is not at risk, where the health of the mother is not life threatening, then the law is clear, "A termination cannot be performed". The 1861 Act will apply and a criminal offence will be committed. However, medical emergencies can throw up difficulties and it is sometimes problematic to distinguish between threats to the life of the mother and threats to the health of the mother. The X case decision is the law. The European court requires the State to establish procedures in law to determine the risk to the mother's life and to set out criteria which a doctor may employ to measure that risk. The X case judgment states that the correct test is that a termination is permissible if it was established as a matter of probability that there is a real and substantial risk to the life of the mother and the risk can only be averted by the termination of the pregnancy.

It should be noted that under current law the doctor need not be of the view that the risk to the life of the woman is inevitable or immediate. That is a decision for doctors and doctors only.

The setting out of the four options, one or more of which will ultimately form the basis of the Government's response, is clear and detailed. The report leaves it to Government to choose an option, and I understand that will be done next week. I welcome that. Under the terms of reference of the expert group it was not the function of the group to specify the way the judgment was to be implemented but to provide this House with options, and it has done that. However, it appears from reading the report that a combination of primary legislation and statutory regulation offers a likely way forward.

The focus must always be primarily on the health and well-being of the mother. As legislators and regulators we must accept that burden of responsibility. I do not believe a referendum is the best option but in any event it is not considered by the expert body. I strongly disagree with colleagues who call for this issue to be put to the people again by way of referendum. Government must govern, and the Dáil must act in accordance with the principles of a representative democracy. The Dáil must ensure, on the best advice available, that no woman's life is ever put in danger. We need safeguards for medical procedures to protect the life of the mother by setting out criteria and conditions which are required to be met to be lawful. Those criteria must be framed in primary legislation and regulation.

The precise detailed nature of the legislation must be carefully considered and it must respect the current constitutional position. Legislation is by definition specific, sometimes very specific. That is where the complication arises.

I wish to state categorically that I am very much against abortion as a form of lifestyle choice or for so-called socioeconomic reasons. However, where there is a clear and undeniable medical necessity or emergency I will be guided by doctors.

I have heard many men make statements on this issue but I advise my single male colleagues in this House and beyond to discuss it with women before they make a final judgment on their position. This is primarily a matter for wives, daughters and partners and it is essential that we get this process right in a calm and logical sequence.

The fact that senior medical specialists remind us as legislators that there are situations where a termination is necessary but that there are grey areas where they need legal protection must be addressed. Doctors deserve protection and, more importantly, women deserve protection.

The expert report, like the Supreme Court in the X case judgment, uses the phrase "real and substantial threat" to cover all forms of threat to the life of pregnant women. Within that general definition of the threat two different medical scenarios can be identified, the first being physical health threats and the second being mental health threats, particularly the threat of suicide.

There is an emerging political consensus on the way to deal with the physical health threat scenario, and I welcome the cross-party consensus in the debate in the House today and yesterday. I believe, therefore, that we can reach an historic cross-party consensus on the matter of legislation covering the physical health threats. The matter of the mental health threat may not be as straightforward.

The matter of suicide is a major, delicate and sensitive issue. We must answer the question as to whether and when the threat of self-destruction can be justified as a reason for the termination of a pregnancy. Sometimes I wonder why the Supreme Court got into the medical definition of risks to a mother's life in the first instance having just ruled that medical actions to protect the life of pregnant women are lawful. In that context the threat of suicide is a valid medical threat factor. Personal health risk factors endangering the life of the mother are best left to the medical profession supported by legislation and regulation.

On the one hand it is difficult to understand the reason a simple blackmail threat by a pregnant woman with no personal history of mental health issues, and no evidence of physical health condition other than being pregnant, might ever be accepted as sufficient reason to end a pregnancy. On the other hand there is the case of the pregnant woman Anna Byrne who tragically took her own life when 38 weeks pregnant. The rationale for ending a pregnancy on mental health grounds is an extremely difficult area. Choosing one particular medical health factor, the threat of self-destruction, and making explicit provision for it as a reason for termination seems fraught with difficulty. I would like to hear more from psychiatrists in that regard, and I welcome the health committee hearings to be held in the new year.

I welcome the fact that the stigma around suicide has diminished in recent years and that a more humane and sympathetic attitude now prevails. Nevertheless, we must at all times ensure that as a society we value life, that people know there is always a better way than suicide, and that help is always available. Suicide prevention must always be at the heart of our policies. I am pleased that most suicide prevention policies and treatments are successful, but greater awareness is necessary. Expenditure of greater resources is necessary, and I have huge regard for the pioneering work of my colleague, Deputy Dan Neville, who passed through the House a moment ago, who has been campaigning on this issue for many years both within this House and outside it.

As a society we can do everything possible to prevent suicide yet, regrettably, sometimes the outcome is a sad and inevitable part of the human condition. In this debate on the termination of pregnancy where there is a real and substantial threat to the life of the mother we must deal with the claim that the threat of suicide constitutes a real and substantial threat to the life of the mother thereby justifying the termination of the pregnancy.

In dealing with that situation we must be conscious of the danger of the threat of suicide being formally and legally elevated to an acceptable option or criterion for the attainment of a personal objective, or sometimes becoming a matter of choice. The real danger is dignifying the threat of suicide with a social, moral and legal approval that in effect undermines all the good work being done to prevent suicide being seen as an acceptable solution to a problem in life. Suicide is never a solution to any problem, no matter how grave. We must amplify our message that human life is treasured and ensure that we do not offer a thin veneer of acceptability to a public policy that suicide and the threat of self-destruction sometimes meets with our approval.

Some evidence exists to the effect that there are cases, however rare, in which there is a real and substantial threat to the life of a pregnant woman from suicide but the X case was primarily about the right to travel for an abortion. The Supreme Court reference to the suicide factor was not a primary finding. It is a fact that one judge was against the idea, one references the word "suicide" only once, one references "loss of life", while the remaining two speak of the real risk to the mother's life without any great elaboration, but perhaps a deduction or an assumption to include suicide.

The threat of suicide can be regarded as a conventional experience in mental health practice. There are standard mental health responses to the situation that are employed to remove such a threat. A threat of suicide made by any patient for some guarantee of concession to a different demand would never be entertained by doctors when that demand comes from mental health patients of every age and either sex.

The real challenge for medics and legislators is to distinguish between those pregnant women who are in real danger from a threat to their life from suicide and those who do not belong to such a classification of mental health condition. Among the factors to be considered will be the pregnancy timeline, the medical evaluation factors, the medical evaluation timeline, therapy options, the termination timeline and the emergency timeline. I have no doubt we will revisit this issue in the new year.

The current statistics on pregnant women committing suicide must be clarified but if it is a rare occurrence, it nevertheless requires a response from us.

I commend this report and its authors. They admit that it was not in their remit to adjudicate on legal, medical or political controversies. The doctors on the group were not settling legal issues. The lawyers on the group were not settling medical issues, but they were expert and they did report. We must now respond, and I believe legislation must follow.

It is a full 20 years since Mr. Justice Niall McCarthy stated: "The failure of the legislature to enact the appropriate legislation is no longer just unfortunate; it is inexcusable." We have a duty to respond but regardless of the detail, form or shape the legislation takes it must be governed by rules which are fixed, knowable and certain, with no room for the grey area that currently exists.

Deputy Maloney missed out on his five minutes and therefore I will give him that time now.

I thank the Ceann Comhairle for facilitating me, it is entirely my fault. Thanks are due to Mr. Justice Sean Ryan and the other 13 members of the expert group whose report we are discussing. It is a comprehensive report and, as someone with no legal and medical background, its detail and comprehension is to be admired. It is difficult to be objective given the subject matter but I found it sensitive in how it was drafted and how it sets out the options for people such as us, who must ultimately decide on the issue.

I am pro-life and I have never met a human being, in the House or elsewhere, who is not pro-life. I reject the impression created by a small minority that, somehow, they value life more than people like me or others. I have never been of the opinion that any woman makes lightly the decision to have a termination or to abort her pregnancy. As men, we must say that. It must be a traumatic and emotional decision for a woman to make. We should be sensitive when talking about the subject. It is not a decision any woman makes lightly.

I compliment Deputy Charles Flanagan. I agree with many of his points and he said things that I do not now need to say. His contribution was thoughtful and balanced and included a comment that the debate is about women who became pregnant. Women who find themselves in that situation and find their lives at risk are the priority.

As legislators, over the past 30 years, we have not made much progress but I will welcome primary legislation whenever it arrives in the House. I think is the only way to deal with the issue and I will have no hesitation in making my mind up about the best thing to do. No other woman should die in the jurisdiction when her life is threatened by pregnancy. With regard to the prolonged history of evading making a decision on the matter, I refer to previous Members of this House, the late Jim Kemmy, the Limerick socialist, and Michael D. Higgins, who represented Galway West. They lost their seats in 1983 as a result of the amendment at the time. Some people paid the price at the time and it is now clearer political weather than it was in 1982 and 1983. We must step up to the edge because no woman should die due to a lack of legislation to protect women in danger during pregnancy.

It was stated in the House, and the medical evidence supports the assertion, that Ireland is one of the safest places in the world for women to give birth. I concur, having availed of maternity services on three occasions. I express my deepest sympathies to the Halappanavar family on the loss of Savita. Sadly, it seems the family's tragedy has been hijacked by some as evidenced by the intense lobbying of Oireachtas Members in the past weeks. I talked to some of the young people protesting outside the gates of the Dáil. I discovered they were sincere in their sympathy to the Halappanavar family but confused about the legalities of termination for women in need during pregnancy. They were certain, as I am, that they never wanted anything like that to happen to a pregnant woman in this country again. We must be confident in the level of expertise and care we will receive in pregnancy until pregnancy is completed by the birth of a child. It is a joyful and life-enhancing milestone in most cases. However, pregnancy brings challenges to the healthiest of women. Pregnancies may end in miscarriage or the foetus dying in utero or having a foetus with an abnormality.

We must reflect on how life has been for women in Ireland in the past. They have not had it easy. We must never forget the treatment of single women in their attempts to obtain contraception or when single women became pregnant. Married women and their husbands who wanted to obtain contraception found it very difficult. Women had appalling procedures carried out on them in labour and after delivery, leaving them with lifelong problems or unable to have more children. As a society, we seem to have real problems with the fact that we are human beings in whose DNA it is to procreate. In the past, campaigners even objected to the provision of sex education. Somehow, they believe that keeping people ignorant of their potential to reproduce will prevent sexual activity. As a society, we are slowly but surely acknowledging our human drive to reproduce. In an ideal world, all pregnancies would be welcome but that is not the case. Many of our young women, some barely out of childhood, have been victims of rape and incest, with acts perpetrated on them, in many cases, by the men they trusted most. I am conscious of the sensitivities of these cases and do not want to cause distress but we must never forget how poorly our young women have been treated, resulting in much emotional and psychological damage. We have also heard tragic cases of those who have made the decision to travel abroad for an abortion and the impact it has on their lives thereafter. Debate on this sensitive and human issue exposed the many complexities of the matter.

I welcome the recent report of the expert group on the judgment in the A, B and C v. Ireland case. I have strayed off the agenda but it is important to reflect on where we come from. The terms of reference of the expert group were clear. The first was to examine the judgment in the A, B and C v. Ireland case in the European Court of Human Rights. The second was to elucidate on its implications for the provision of health care services to pregnant women in Ireland. The third was to recommend a series of options on how to implement the judgment, taking into account the legal, medical and ethical considerations in the formulation of public policy in the area and, more importantly, the overriding need for speedy action. I thank Mr. Justice Ryan and the members of the expert group in their work producing the report and their careful consideration and production of options. As a Legislature, we must carefully consider the options presented. It may be guidelines, regulations, legislation or legislation and regulations but all must be considered carefully. The report will help us to come to a decision on the best for society. This society has tried to grapple with various sides of the arguments for and against the ending of the life of the unborn child. Ethical, social and religious points have been debated but the fallout is that deep divisions were created, with many people fearful of revealing what they really felt. Like many colleagues, I received passionate and emotive lobbying from both sides. The termination of a pregnancy can be performed where there is a real and substantial risk to the life of the mother. Our Constitution also has a provision to defend and vindicate the right to life of the unborn. In this case, we must make our choices and learn from other jurisdictions. That does not mean we should slavishly follow what they do. At this point, we need a reasoned and calm debate as it is one of the most significant decisions the Government must consider. Emotion and hysteria will also only serve to cloud the issue.

The most significant issue is whether or not the medical profession have the clarity they need. They have made it very clear that they need clarity on the point at which a termination is permissible so that the 1861 Act will not be hanging over every decision they make in future.

Allied to that, I believe human life is sacred. Both the mother and the unborn child need our protection. I also know that no matter what decision is made, there will be dissenting voices. I sincerely believe, however, that here in the Dáil we will achieve consensus on how to proceed and that political posturing and opportunism will be left to one side so that we can arrive at the best decision and be united in where we go with it.

I reassure those who are concerned that legislation will lead to abortion on demand or abortion by the back door that this is not the case and is not my intention. The Taoiseach and the Minister for Health have been clear on this. We must make a decision based on the report of the expert group. I support the fact that the Government will be making a decision next week. We will all participate in the hearings, listen carefully to them and ensure that, finally, we get it right this time.

I am glad to have an opportunity to speak on this particularly important debate. Like THE Cheann Comhairle and a number of others I was here when the original debate on this topic took place. I recall with great clarity the strongly held views on both sides of the argument and how they created more division in society than any debate I have known before or since.

I do not know if it is a good thing that I survived the intervening period or not.

We still enjoy Deputy Durkan.

I thank Deputy Buttimer. I try to create as much enjoyment as possible in other spheres as well.

I am conscious, however, that we are having this debate in the aftermath of the tragic death of Savita Halappanavar. I do not know enough about the circumstances of her death to comment on it. Those circumstances have not been made public, but I hope the findings of a full investigation will be made available to the Houses of the Oireachtas so that we can come to a judgment as to how to prevent a recurrence of this tragedy, if prevention is possible. I do not know that either. It is sad that a tragedy has been the catalyst for this debate. Of course, the bigger issue is the report of the expert group which was heralded long before the death of Ms Halappanavar.

I am certainly not in favour of abortion. I never have been. I am not in favour of abortion for social reasons or as an optional extra. I believe the people, in their response to previous referendums, were also thinking along those lines. I studied the judgment of the Supreme Court and its interpretation of the judgment of the people in the referendums. It is clear to me that the Supreme Court expected legislation to follow that would give protection, security and assurance to the medical profession, to the people and to pregnant women, who were the people directly affected then and would be in the future. Everyone in the country has had a mother. Some of our mothers are, gladly, still alive.

Like other Deputies, I have received hundreds of e-mails and letters on both sides of this argument. No matter which side we come down on we will annoy somebody. Our duty as legislators, however, is to make the right decision, having regard to all the evidence available to us, and to read up as much as possible on the issues. To have lived through the controversies of the past is also an advantage.

I have no doubt of what was expected of the Oireachtas by the Supreme Court. There was an expectation of legislation to protect the three elements I have referred to. Similarly, the Supreme Court did not intend that legislation should give effect to widespread availability of abortion, for social reasons or whatever. I do not think that was anticipated. By rejecting two proposed amendments to delete the element of suicide, the people made it clear they were not happy to delete suicide as a possible ground for intervention in pregnancy. In the backs of their minds, the people remembered that there may be women who would find themselves faced with a situation they could not tolerate. People have varying capabilities when it comes to dealing with pain and stress. Some people can deal adequately with a great deal of pain and stress and some people can not. Should we legislate for only one set of people? We must legislate for all. It is our job to legislate for all creeds, shades of opinion and colours, without exception. I hope we will do that.

I congratulate the members of the expert group on an excellent report. They have laid out the options quite clearly. My interpretation of what they have said is that we must legislate. We cannot exclude the possibility of suicide. It is clearly laid out for us to accept or reject it, but we cannot reject it.

The people have said they do not want abortion to be generally available ad lib for everyone in all circumstances. The women, the mothers and the pregnant women of Ireland do not want that either. However, where a rape takes place, particularly statutory rape, the final decision as to whether the unfortunate child should be forced to carry on with the pregnancy should not be taken by a third party, whether that is a court, legislators or the medical profession. The parents, because the child is a minor, and the girl herself should have some opinion as to what should happen. They are the people who will have to live with the aftermath and the consequences.

There are those who will say the unborn child had nothing to do with the rape and committed no crime. That is true and I am conscious of that, but neither had the victim of the rape. What should we do, as bystanders who are removed from the situation? Should we make the harsh decision that what happened was a bit unfortunate but that the woman must accept the consequences of it? That is not within our remit and we should not do it. It would be very harsh to do that.

I am quite clear that the opinion of the pregnant woman, or the parents in the case of a minor, should have some bearing on the outcome. I am not going down the road of free choice, but there must be some regard for the view of the woman or girl who is pregnant. After all, when a man goes into a hospital for a procedure how would he like it if the decision whether to receive the procedure were handed over to a third party group, whether psychiatrists, judges, doctors or commentators, to be debated?

The whole thing is ridiculous; it is utterly crazy. How can one understand such a situation? We must put our feet in the shoes of the person in that position. People will say women have been having babies for millions of years and in most cases without any great difficulty but occasionally a problematic pregnancy occurs. What do we do then? What do we do in any medical situation? Do we debate the matter or do we attend to it? We have no option as a humane society other than to give the best possible treatment to the person presenting with the problem, it is as simple as that. If we depart from that in any shape or form, we are doing ourselves an injustice.

There are those who would say that as a man, I should not have a view on this sort of thing. I do not mind, I am still a member of the population. I do not necessarily agree with the notion only women should make this decision. If a woman presents to a hospital with a difficult pregnancy, the time is long past for other people, men or women, to comment. The only person who is in the eye of the storm is the patient presenting in the hospital. I cannot see for the life of me how anyone could have a prior right to set out the procedure to be followed, particularly if there is a threat to the life of the mother.

We fully accept the 1983 amendment. As we now know, however, the Attorney General at the time pointed out the potential conflict. We debated that ad infinitum at the time. Time, however, has passed and society has learned. We are not all God, and we cannot make these decisions as if we were. Even God himself would have a difficulty coming to a conclusion in some of the situations presented to us from time to time. I do not have any daughters so it easy for me to comment but other people do have daughters and in that situation the future pregnant mothers in this country must be reassured we the legislators understand their predicament and in the event of a doubt about their health during pregnancy, they will not be prevented from receiving the treatment that might be required, the most compassionate and optimum treatment at that particular time. To do otherwise is to shirk our responsibilities and to move away from the situation and leave the matter in the hands of others to be decided. We are a humane society, notwithstanding some of the things we say from time to time, and we must come to a conclusion and follow the options laid out in the report of the expert group.

I do not believe that there should be a free vote on this. We do not come in here to have options, we must stand up and be counted. If it is the consensus in the House that we go a particular route, having regard to the situation unfolding before us, we must make our minds up. I strongly advise against a free vote because we know all about what can happen from past history.

I compliment everyone on all sides in the debate so far. It has been a rational debate and has taken into account all of the issues that must be addressed. I hope we make the right decision and do not have recriminations. Our job, however, is to legislate. We cannot do everything. We can make provision for the issues highlighted in the expert report and have regard to recent events and past events. All of us in this House over the years have dealt with situations where questions were raised in our minds as to why particular procedures were not followed. We live in a litigious society and there could be a case where third parties might intervene to prevent a medical procedure that was urgently necessary at a particular time and that would be tragic.

The debate we are having on the report of the expert group on the judgment in the A, B and C v. Ireland case is very important. For the past two months, this has been in people's minds. At the forefront of our thoughts must be Savita Halappanavar and her family but also the State must address the findings of the expert review group and the Government must act. We must see action so there is an end to the procrastination.

As a child born ten weeks early during a crisis pregnancy in the 1960s, to me the gift of life has been given to me. I try to adhere to words of Swift, "May you live all the days of your life", because I have been the lucky one. My mother was in trouble, she knew that as a midwife herself, but she was not listened to at times and thankfully the birth resulted in a healthy child and she had three more children afterwards. That has shaped my philosophy and ideology in life. I am pro-life by ideology but we must park our ideologies in this debate.

I heard Deputy Flanagan speaking about single male colleagues and I am a single male man who will not have any children. That does not mean I cannot contribute to the debate. We must all listen to the views not just of women but of all people. Women are very important in this debate because if we do not listen to them, we will have lost a sense of empathy and understanding and we must try to seek consensus on this. That is why the establishment of the expert review group was important. It took less than a year to report and we are now debating that report. In discussing it, our debate and the Government decision, and the hearings in the Joint Committee on Health and Children, will stand as a template for how we as a society have learned from the debates in the 1980s.

I was a teenager then and I remember those debates vividly. I hope in our deliberations on this report we will bring legal clarity to the medical practitioners and women who find themselves in difficult circumstances. I compliment Mr. Justice Ryan and the group on the way in which the report is presented. It is easily readable and sets out its core ideas. As part of that process it was right and proper to wait for the report to be published so we could have a debate instead of jumping through hoops to satisfy one interest group over another. Our duty as legislators is to listen to all sides and not to engage in a knee jerk reaction on either side.

Chapter two of the report sets out clearly the current legal position, which has evolved over the last 30 years. From the 1861 Act, to the constitutional amendment, to the X case, to the provision of information, the report lays out the current legal parameters.

I welcome the publication by the Irish Catholic bishops' committee earlier this year on their day for life where they again reaffirmed that the Catholic Church has never taught that the life of a child in the womb would be preferred to that of a mother and that by virtue of their common humanity the mother and her unborn baby are both sacred with an equal right to life. This report should be read by everybody in Irish society.

I join Deputy Charles Flanagan in saying that the Government should make this report available because the report will form the template of the debate we will have later. It is important that people are informed irrespective of their viewpoint. Chapter 3 of the report goes into great detail about the historical development of our law. It goes into each of the pertinent court cases, the background and the legislation involved in each referendum. It also looks at the all-party committee reports and Green Papers. It looks at each of the times when we, as a society, have considered the issue. For anybody who is unsure of the exact legal provisions or who wants a balanced and detailed overview of how our law has evolved and developed, chapters 2 and 3 are essential reading.

Before the report sets out its recommendations, it outlines four guiding principles. These principles have been based on a position that "the State is entitled and, indeed, obliged to regulate and monitor the exercise of [the existing constitutional provision] so as to ensure that the general constitutional prohibition on abortion is maintained". For those who are worried about the motives of the report and what will happen next, I hope that acknowledgement offers some comfort. The report is about working within our constitutional provision; it is not about changing our Constitution.

The termination of a pregnancy, whether by direct intervention or as a consequence of medical treatment, is a profound and serious matter. In all of our discussions, regardless of where we are coming from, we cannot lose sight of that. If medical professionals are saying they are faced with difficulties posed by our current situation, we have an obligation to make this position clear. We have heard from women who have faced similar difficult decisions, and we have an obligation to give them clarity. We must provide clarity and certainty, and we must end the mind games and vitriol. No matter where we stand in the debate, we must ensure the position is clear and unambiguous and that doctors know what they can and cannot do.

As citizens and legislators we must end the uncertainty, create certainty and give a sense of confidence to the medical professionals and the women of the country. As I said in the debate on the Private Members' Bill, let us put aside our political differences and ideology, whether we are pro-choice, pro-life or in the middle. The issue is far too important to be bedevilled by the playing of a game. For 30 years it has bedevilled Irish society and political life. There has been a failure on all sides to debate this issue maturely and act on it. It behoves all of us, who have an interest in humanity and life, to be calm and to debate the issue, as we are about to do as a Parliament and, more importantly, as a society. We need a thought-out, considered and timely response to the report of the expert group, and today is part of that process.

The Government has given its clear intent on what will happen in the next few months. Following this debate, the Government will decide on which options it will take. From there the parliamentary process will begin to consider the guidelines, statutory regulations or legislation as is required. In the new year I, as Chairman of the Oireachtas Joint Committee on Health and Children, and my colleagues on that committee will hold a series of meetings on 8 to 10 January. We will consult widely and listen, and we will debate maturely. We will do so in the interests of the people. That is why I, as Chairman of that committee, and my colleagues will not be found wanting. We will meet next Thursday in private session to discuss how we intend to proceed, and that will be done on a cross-party basis. Our hearings will be fair and there will be a process of dialogue to ensure a wide range of voices are heard. We will consult wisely and widely. People will be asked to make a contribution.

Today's debate is necessary for us as a society. I hope it has been a constructive debate. I pay tribute to the parliamentarians in this House who have been constructive. This issue is far too important to be used to try to score political points. The outcome of what we do will reflect our views as a society. I conclude by quoting the words of Martin Luther King: "Our lives begin to end the day we become silent about things that matter."

We have reached a certain position after many years and we are where we are right now. I have met people and we have all been lobbied strongly on this issue. I have met people from the Pro-Life Campaign. One of its documents states:

The most important option not contained in the report is to reverse the Supreme Court decision of 1992, which would allow for abortion up to birth [according to it]. If people do not want to introduce such an abortion regime in this country, this is the only political option and it has to be confronted.

That is one option. After having had two referenda, I am not sure the people would agree with what the Pro-Life Campaign wants. My feeling is that they would not. I met some people from the Pro-Life Campaign and they said the same. They said they thought the people would not reverse the Supreme Court decision of 1992. We could possibly have a "preferendum" on it or some other kind of poll. I note that recent polls agreed with that. Putting that aside for the moment, we are where we are. The Medical Council guidelines published in 2009 state:

Abortion is illegal in Ireland except where there is a real and substantial risk to the life (as distinct from the health) of the mother. Under current legal precedent, this exception includes where there is a clear and substantial risk to the life of the mother arising from a threat of suicide. You should undertake a full assessment of any such risk in light of the clinical research on this issue.

That is the current situation as interpreted by the Medical Council in its guidelines and advice to its members. Recent research has found that 94% of people say that doctors are trustworthy, which is good.

The fifth progress report of the all-party Oireachtas Committee on the Constitution makes for fascinating reading. Five minutes is not much time to give to this matter. That report refers to rare and complicated cases and states that protecting the life of the mother is paramount. It states that the scientific basis for medicine changes regularly. It also states that suicide rates in pregnancy are low at one sixth of the expected rates for women who are not pregnant and one 20th of actual rates. The numbers are small and the risk is small. Some of the experts who gave evidence in 1999 and 2000 said there is no failsafe way of saying a person will or will not commit suicide. They spoke about intervening to help individuals, to treat depression, to help stop drinking and so on. They also maintained that suicidal thoughts can be transient. Some experts maintained that the majority of people, who attempt or threaten suicide, are actually not mentally ill. They may have some kind of psychosis or feel they are a bad or unworthy person. They also quoted a Finnish study that indicated that abortion increases the chances of a woman committing a suicide after the abortion. Interestingly they said that an abortion will not undo rape.

Having said all that, we are still where we are legally and constitutionally. They talk about the law of the land and, as the Medical Council has stated, the basic law is our Constitution and it trumps every other law. Any law this House might pass must be in compliance with this, as interpreted by the Supreme Court. The Supreme Court has ruled and only the people in a referendum can undo what it decided. Now we are where we are and we have to abide by this. There are issues here. For instance the fifth progress report referred to the difference between abortion and miscarriage. It also states that a baby after 24 weeks is probably viable and that doctors at that stage are obliged to recognise that and to do everything they can to save a baby's life after 24 weeks.

This is another major issue because we have heard reports that pregnancies in other countries have been terminated after 24 weeks and the babies left to die. My interpretation is that after 24 weeks, doctors here are obliged to try to save the baby and keep him or her alive. The issue arises regarding how to deal with a suicidal person before 24 weeks and the risk that one could lose both.

I would be very interested in hearing the debate in the Oireachtas Committee on Health and Children on this issue. This forum is probably not the best one to tease out the detail and the committee will probably be the place to do that. I do not think we can or should have a referendum because we have to deal with the legal situation as the Constitution outlines and as the people have spoken way back. It is very complicated from a medical and legal point of view but we should be able to-----

For the sake of other Deputies, I must ask Deputy Stanton to conclude because we must finish at 4 p.m.

We should be able to move forward.

I welcome this debate.

This debate is not concluding today.

It is a very important debate. I have listened to the debate on this subject, which has been widely discussed recently. The public is looking for a consensus on the issue. It is fair to say there is a broad consensus among politicians and the general public that there is a need to legislate and regulate for best medical practice. What we must do is ensure that we preserve the reputation of Ireland in terms of medical practice as one of the safest places in the world for a mother to give birth to her child, both for mother and child. In that regard, the investigations under way into the tragic death of Savita Halappanavar need to be carried out in the quickest possible fashion. They need to be made public both in terms of her husband and family receiving the truth. It has been a tragedy. The investigations will also help inform best medical practice in this area.

In respect of suicide, on which there is no consensus, it is imperative for us to hear the best available medical evidence, particularly in psychiatry. There is a need for education and for politicians and the wider public to be properly informed. The public wants that level of knowledge. As legislators and representatives of the people, it is incumbent upon us when deliberations get under way in the Oireachtas Committee on Health and Children to consult widely. We are looking at best medical practice and the lives of both the mother and child. We cannot lose sight of the fact that in Ireland, we have a terrific medical system. We have excellent doctors and nurses across the spectrum who deliver babies daily in hospitals and seek the best situation for the mother and child.

Like everyone, I have thought long and hard about this issue. We need consensus and to be properly informed. I was delighted to hear the chairman of the Oireachtas Committee on Health and Children, Deputy Buttimer, say that he is looking to consult widely and bring in a range of medical expertise from across the spectrum. This is vital. People have come a long way and there is broad agreement on the need to legislate for best medical practice. It is there in guidelines but in terms of bringing clarity to the situation, it is extremely important that this takes place. Working in that framework of consensus, it is critical that the committee brings in psychiatrists and other personnel such as the masters of the various maternity hospitals and gets a proper overview of the current situation from a medical perspective. I welcome the debate which was extremely important for the House and I look forward to further deliberations on the issue.

Deputy Griffin can commence his contribution and I will ask him to adjourn at 4 p.m. He can resume on the next occasion.

I welcome the time allotted to Deputies to make statements on this matter and commend all those Deputies who have availed of the opportunity to do so. I acknowledge that I am another man standing up to speak on a sensitive topic that will never directly affect me. When I use the word "directly", I use it in the context of my own body. On a personal basis, as the husband of an expectant mother, this is a matter about which I feel very strongly and by which I am indirectly affected, as is every man in the country. It should not be forgotten that men are also affected by this matter. As public representatives, we have a duty to speak on this matter and make our views known. Before I go any further, I want to express my sympathy to the women and families affected in any way by this topic and acknowledge that public discussion, be it here in the Dáil or on radio or television, is very painful for many thousands of people throughout the country.

I welcome the report of the expert group and the fact that progress is being made. It has been said that six Governments have ignored this topic and thankfully this seventh Government will not do so, which is very welcome. My understanding is that the legislation on this matter to protect mothers' lives will be brought forward and I would be happy to support it. We need to provide legal clarity to protect the lives of pregnant women in all circumstances, including mental health grounds. It is a very difficult area to legislate for but we must do it. There are 166 Members in this House with probably 166 differing views on the topic. Very few people would have exactly the same views on this matter. It is such a complex health, justice and ethical area that one will never get total consensus but we need to work towards the broadest possible consensus we can find.

While the report of the export group deals with the judgment in the A, B and C v. Ireland case, it does not deal with cases involving rape or incest. These are difficult areas to deal with but we must face up to the reality that it happens on a regular basis. I echo a recent observation made by a colleague, that had it not been for our proximity to the UK this matter would have been dealt with by our Parliament much earlier. It is not acceptable for the country to continue to bury its head in the sand with regard to this issue.

The Dáil adjourned at 4 p.m. until 11 a.m. on Tuesday, 11 December 2012.
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