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Dáil Éireann díospóireacht -
Wednesday, 26 Jun 2013

Vol. 808 No. 2

Protection of Life During Pregnancy Bill 2013: Second Stage (Resumed)

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

I wish to share time with Deputy Anne Ferris.

I am pleased that we finally have an opportunity to contribute in the House on this legislation, given that some of us have spent a great deal of time contemplating the heads of the Bill in committee in the other House and given how important the Bill is not just for us as a Government but also because it addresses a key life or death issue. We are aiming to protect women's lives. It is often said Irish people are complacent and that we take everything that comes our way. It is also said we do not take to the streets to voice our anger like people in other parts of Europe when faced with issues such as austerity. However, as we have witnessed, this issue brings people on both sides of the argument out onto the streets to march in droves. It takes a matter of life and death to get people marching.

I remind the House of the key events that have brought us to this point. A referendum led to the Constitution recognising the equal right to life of the mother and the unborn in 1983 and in 1986 the High Court ruled that the availability of information on abortion services outside the State was in breach of the Constitution and undermined the right to life of the unborn. The decision was affirmed by the Supreme Court two years later. In 1993 the High Court ruling in the X case prevented a 14 year old rape victim from travelling abroad for an abortion. She became suicidal when treatment was denied. The injunction on her freedom of movement sought by the then Attorney General, Mr. Harry Whelehan, was appealed to the Supreme Court and overturned, as the mother's life was deemed to be at risk through the threat of suicide. In 1992 two referendums were held and further varied the Constitution by protecting the right of the mother to travel and receive information on services abroad. In 1997 the C case which dealt with a teenager who had become pregnant as a result of rape and sought an abortion in the United Kingdom was heard. In 1999, the Government published a Green Paper outlining several options on the approach to abortion in Ireland and in 2000 an all-party Oireachtas committee published a paper following talks which had failed to capture a consensus on the way forward. A referendum on a constitutional amendment aimed at setting aside the threat of suicide as a ground for a legal abortion was narrowly defeated in 2002. In 2010 three brave women took a case against the State to the European Court of Human Rights which ruled that the State had failed to provide for abortion in circumstances where a mother's life was at risk. In November 2012 the Government established an expert group and finally we have reached the point where we are trying to bring legal clarity to a grey area in order that we can simply protect lives.

It is a national disgrace that we are still arguing over this issue 20 years on from the Supreme Court ruling in the X case. For many Irish women - our sisters, mothers, wives, friends and girlfriends - a pregnancy which puts their life at risk is an agonisingly real fact of life for them and their families. Women still have to travel in secret like fugitives to England to seek life-saving treatment. This is simply appalling. Women are increasingly turning to the Internet to endanger their own lives by procuring abortion pills online. This is done without medical supervision and at huge risk to their lives. Doctors have been left with no legal protection in caring for women whose lives are at risk as politicians during the years have run for cover from this difficult issue until now. However, I am proud that following the failure of six successive Governments to legislate for the X case we have finally stopped kicking the proverbial can down the road and, for the first time, legislation on this critical matter relating to women's lives is before the House. Much of the opposition to the Bill is related to head 4 and the risk of loss of life of a pregnant woman due to suicide. The X case judgment explicitly included suicide as one of the grounds where abortion was permissible because of the risk to the life of the mother. Lest we forget, the reality of that case was a 14 year old girl had been raped and impregnated by a neighbour and, when refused access to a termination, became suicidal. In 1992 and again in 2002 the people were asked if they wanted to specifically exclude suicide from the limited provisions in which a pregnancy could be terminated and on both occasions they said, "No." It is incumbent on all of us to listen to them and ensure this legislation is passed.

A number of campaigners and politicians clearly believe, however, that they have more legal insight into the issue than both the Supreme Court and the people. Democracy is a nuisance as far as they are concerned. Law professor Fiona de Londras noted that in the context of what the people had decided in the 1992 and 2002 referendums, prima facie it appeared to be unconstitutional if the legislation was to exclude suicide. Former High Court and Supreme Court judge Mrs. Justice Catherine McGuinness recently told the Oireachtas Joint Committee on Health and Children that a referendum would be needed if the suicide provision was removed from the legislation. Suicide is a real risk to the lives of a small number of women who are pregnant. It is rare, but it happens. Medical professionals who work with pregnant women and do not hypothesise in front of cameras or microphones, including perinatal psychiatrist Dr. Anthony McCarthy and the Master of the National Maternity Hospital, Dr. Rhona Mahony, confirmed this at the committee hearings. One woman or man dying by suicide is one too many. Pregnant women who are suicidal should be believed and supported. They should not have their real and life threatening distress undermined by the insinuation that mental health issues are somehow not real or that psychiatry is hocus pocus medicine. They should be believed because this is as real a threat as a physical issue.

The implication of this opposition to the inclusion of suicide as a risk to life is that many women will try to manipulate and deceive their doctors into permitting a termination for frivolous reasons by claiming they are suicidal. No woman who decides to have a termination makes that decision lightly for whatever reason. It is also insulting and implies that distressed women will be devious and deceptive and that they will manipulate the truth. It is chilling and disturbing that many believe this would be the case.

Many anti-choice campaigners seem to be of the view that everybody expressing suicidal feelings should be taken seriously, apart from women. Likewise, we often hear concerns being expressed in this debate about time limits in regard to terminations and the issue of early delivery. Under the Constitution, an abortion is not permissible at any stage of pregnancy except where there is a real and substantial risk to the life of a woman. Doubts have been expressed as to whether an early delivery, as opposed to an abortion, will be carried out where a pregnant woman is at risk of death. Many legal experts are actually of the view that early delivery offers greater protection to the foetus than prescribed time limits for abortion.

This Bill is an important step in bringing Irish law into line with the X case ruling, but there is scope for improvement. Of particular concern is the provision which serves to criminalise women and doctors who terminate pregnancies beyond the very limited scope of the legislation. This is a draconian measure which will potentially see a woman or girl face a 14 year prison sentence for terminating her pregnancy. It is also of great concern that the system outlined in the Bill will leave women with life-threatening pregnancies potentially waiting ten days for a decision if their initial request for a termination is rejected. It is not made clear in the wording whether women who find themselves being cared for by a doctor who conscientiously objects to abortion will be guaranteed timely care and information. It also remains unclear whether doctors will have sufficient legal protection to intervene in a timely fashion.

Section 20, which deals with notifications, introduces an unnecessary additional process of reporting. The existing hospital inpatient inquiry system, which is managed by the Economic and Social Research Institute, collects administrative, demographic and clinical data on all discharges from acute public hospitals. It utilises the ICD-10-AM system of coding, a global standard based on the World Health Organization's international classification of diseases. Diagnostic codes are already in place within this system for coding conditions arising under the heading of pregnancy with abortive outcome. Subsection 20(3)(a) is of particular concern in its requirement that the Medical Council registration number of a doctor who performs a termination under the Act be included in the report to the Minister. Experience from other countries suggests that such disclosure could lead to harassment, threats or actual violence against doctors by anti-abortion activists. We must not allow that to happen.

Members will be aware of the representations made by women who have had terminations for medical reasons. The changes they are seeking would spare women the horror of having to travel abroad to procure terminations in circumstances where their child has no chance of a life outside the womb. This issue must be addressed so that women and their families are spared the heartache, health worries and trauma that were described to us by the very brave women who have come forward in recent months.

It is no secret that I am pro-choice in my views on the issue of abortion. In an ideal world, women could obtain terminations in this State and receive the full range of health care and back-up services they deserve.

There has been little mention in all this discussion of the need to review our sexual health policy for young people. I urge the Minister of State to consider this matter. There has been no discussion of how crisis pregnancies can be avoided so that women - who are somebody's partner, sister or daughter - are not faced with the awful decision to have a termination. Of course crisis pregnancies will always happen, but with better education and access to affordable, if not cheap, contraception, we can reduce their number. In ideal circumstances nobody would ever need an abortion other than for medical reasons or in the horrible case of rape and incest-related pregnancies. We must provide age appropriate information for young people on sexual health and preventative practices. That information needs to be out there and young people must have access to contraception. Education is key in all of this. I do not, by the way, put that obligation at the door of our schools but at the door of every parent, youth worker, doctor and nurse. An informed society will help people to make better choices and we must all focus our efforts to that end.

In supporting the Bill I also urge the Minister to incorporate the improvements I have mentioned. There is an obligation on every Member of this House to do all we can to save women's lives.

It has taken 21 years to get to this day. I am proud that this Government has taken on an issue that its predecessors avoided. I am particularly proud of the Labour Party for continuing to apply pressure on the issue. As the only party which included a commitment to legislate for the X case in its manifesto, I am delighted to see that promise realised. It is a good day for democracy and an example of strong leadership from both the Taoiseach and Tánaiste in the face of an unrelenting and nasty campaign of opposition.

This is an issue that is close to my heart, and one with which I am closely associated. There is certainly no shame in that. I will always fight for the rights of women, whether in regard to abortion, domestic violence, justice for those who suffered in Magdalen laundries or the survivors of symphysiotomy. I have not been working in isolation in seeking to effect progress on the abortion issue. The realisation of this legislation is due in large part to the efforts of the thousands of people who contributed constructively to the debate over the years. Many of them would like to see the legislation go further and I share their wish. Unfortunately, however, politics is the art of the possible and to go further is not possible at this time. The reality is that our Constitution severely limits the ability of the Oireachtas to act in this regard. That is not to say that we could not bring forward a referendum to repeal Article 40.3.3°, which I would support. No opportunity has been afforded to the Irish people to make access to abortion less restrictive, even though opinion polls consistently indicate support for that position.

There has been a great deal of debate on the inclusion in the Bill of suicide as a ground for abortion. That inclusion is necessary to give full effect to the Supreme Court judgment in the 1992 X case. We as legislators are not in a position to pick and choose which court rulings we will enforce. The highest court in the land has spoken and we should respect its decision. Moreover, the question of suicidality as a ground for abortion has been put to the people twice in separate referenda. Its removal was rejected in 1992, in the immediate aftermath of the X case ruling, and again in 2002 when the 25th amendment not only proposed its deletion but sought to increase the penalties for assisting a woman to have an abortion.

When we speak of the X case we should remember that it concerned a 14 year old girl who, having become pregnant as a result of rape, faced a real and substantive risk to her life arising from her suicidal condition. There is a face and a real person behind the case. Likewise, other prominent cases such as A, B and C v. Ireland and those involving Miss C and Miss D were about real people with difficult stories. That reality should remain at the heart of the debate. In the same vein, we cannot ignore the thousands of women who have gone abroad over many decades to obtain an abortion. Thousands more will continue to do so in order to access a procedure they consider to be right for them. They include women who have been raped or abused in other ways and women whose foetuses have a fatal abnormality. That will continue to happen even as this debate proceeds and the Bill is eventually enacted. It will continue because while this legislation is necessary, it will only do the bare minimum.

I cannot help but feel angry at the nasty, malicious and underhand campaign that has sought to bully Deputies and Senators who represent the people. The campaign has been relentless and cruel and, I believe, carried out by well-funded, although marginal, so-called pro-life groups. I question from where they get their money and would like to see full disclosure and clarity in this regard. I cannot understand why they have not been investigated more thoroughly. I cannot fathom why so much time, energy and money have been put into the campaign when they would have been better spent in addressing wider societal problems such as homelessness and child poverty. I acknowledge that there are differing viewpoints on the issue, but when the extremes of society are given near free rein to bully and harass Members of Parliament, it is a matter of concern.

I commend the Bill and thank all those who have contributed constructively to the debate, whether for or against the legislation. Once again, I thank the Taoiseach and the Tánaiste for showing leadership and hope that in the not too distant future we can progress the art of possibility when it comes to abortion and realise greater rights for women.

The Bill is long overdue. There are very few Bills which are as long overdue as this one and I commend the Taoiseach and the Tánaiste for having the courage to bring it forward. Consecutive Governments, although bound by a Supreme Court ruling, chose to ignore the plight of thousands of Irish women. I extend my sympathy to Savita Halappanavar's friends and family and all the families of women who lost their lives in pregnancy owing to a termination not being available. There may be people whose names are not known. Some of those who lobbied me to vote against the Bill claimed they had no problem with Irish women having abortions, once it happened on English soil.

I recognise this is a difficult issue for many, particularly those women who feel the State has let them down during the years. Up to 5,000 women every year find themselves making the lonely journey to England to access abortions. I met some of them in England when I lived there. At home, those in the corridors of powers chose, at best, to ignore them and, at worst, criminalise them. These are ordinary women - our daughters, wives, neighbours, partners, sisters - all forced to travel like criminals to England and return to live a lie as if it never happened. The State was cold and a very unsupportive place for women and we must change this.

In this House, if we aspire to build a republic on this island, as I do, we must deal with these matters here and not export them as problems to be dealt with elsewhere. In other words, we must cut out the hypocrisy. Since the X case much has changed. Some would say all has changed. We have seen the decriminalisation of homosexuality, contraception become freely available; divorce is now legal and rights for children are now enshrined in the Constitution. The world has not collapsed or turned upside down. These were major steps forward and they have led to a more equal, tolerant, inclusive and mature society.

The current debate has been much more mature and understanding than previous debates about abortion. I take on board what the previous speaker said about some small groups, but the debate has been more mature than other attempts. This is because we have, as a society, become more progressive on these other issues. Opinion polls continue to highlight that the majority of people now believe the circumstances in which a pregnant woman and her doctor find themselves are not simply black and white. We must ensure women become pregnant in a safe, consensual environment, receive the best health treatment throughout their pregnancy and that after the birth, women and children receive the full complement of financial and medical supports. No woman must feel her pregnancy undermines her financial well-being or that her child will grow up in poverty. Women must feel secure in the knowledge that whatever choices have to be made during pregnancy, they do not have to be dictated by lack of finance or support.

For far too long our social policy was dictated by the crozier rather than the Legislature. This was unhealthy and led to bad decisions being made. The Taoiseach's recent statement on this issue was very welcome. Unfortunately, some in the so-called pro-life campaign feel obliged to use old arguments in a present day context. We live in a very different Ireland than that of 1983 when a crude attempt to control women led to an amendment to the Constitution that has straight-jacketed medical practice and views on abortion for 30 years.

I consider myself to be pro-life. In fact, I am very pro-life, but I believe people have a right to make choices in a supportive and tolerant society. Sometimes that decision is about the termination of pregnancy. Sinn Féin believes terminations should be allowed if the woman is the victim of rape or incest, or if her life or health is in grave danger. The Bill does not go as far as our policy, but it is a significant step in the right direction. I hope that when it is passed, it will allow us, as a society, space to debate the issue of abortion in a calmer, more holistic way.

Since the Supreme Court judgment, this House has been under an obligation to introduce the Bill as an absolute minimum. There has been some debate and pressure has been brought to bear on political parties to allow a so-called free vote on the Bill. Each party will make up its own mind on this issue. Sinn Féin debated the issue of a free vote, not at one but two Ard-Fheiseanna. On both occasions a motion was put to the membership calling for Deputies to have a free vote. Our membership debated the motions and on both occasions voted overwhelmingly not to allow a free vote. In doing so it believed, rightly, that ours was a political party bound by policy. Ours is a political party with agreed aims, objectives and policy. It is not like other parties that speak out of both sides of their mouths on this important issue. Our policy on the issues contained in the Bill has not changed in 20 years. That is not because we are stubborn, but after the X case, we debated the matter at length and our Deputies are bound to vote in line with that policy. That is the democratic will of our members. Our candidates have stood before the people in every election since 1992. We have been crystal clear on this issue; we have always pledged our support for legislation in line with the X case judgment.

On close examination of the Bill Sinn Féin has decided to support it. Despite some minor shortcomings, it is a progressive step. Like many others, I have concerns about some of its detail. One issue that does need to be addressed and which the Bill fails to address is that of fatal foetal abnormalities. We need to show compassion and understanding to women who discover that, in fact, their pregnancy will not end in the birth of a bright beautiful baby, but that, sadly, their babies will not survive. That is heartbreaking by any standard and this reality will not be wished away. We must not avoid it for another 20 years. This is the time to address this tragic issue. We must give it careful and compassionate consideration.

Criminalising women who travel to have terminations must be confined to history. If we are to build a proper, tolerant republic, we must do this. We cannot export our problems, or issues such as this which are not problems. We need to deal with them here.

Sinn Féin Deputies will support the Bill and on Committee Stage will address some of the finer detail to ensure it comes into line with our policy.

We are here to debate the Protection of Life During Pregnancy Bill and I will begin by noting the very apt and accurate title which it has been given because that is what we are debating, the protection of life, ensuring the joy of childbirth does not turn into tragedy, that the life of a woman is not lost, that a family does not lose a mother, a daughter, a sister, a wife or a partner, and that a community does not lose a neighbour.

My contribution comes primarily from that perspective. That is what this legislation is about, protecting women, although some have tried to change the nature of the debate, framing it in absolutist and extreme language.

I do not believe the Irish people are interested in that kind of extreme language. I see this, simply as a matter of common decency. I believe it is necessary this legislation is brought in in order that our daughters would never face a threat to their lives simply because they are carrying a child.

This is a difficult issue. We have a long history of difficult debates on this topic in this State going back over many years. The tone has been more moderate and reasonable in that regard on this occasion. In particular, the hearings of the health committee were an invaluable initiative and added hugely to our knowledge and understanding. Much of the general public followed the debate, as the various experts, lawyers, doctors, psychiatrists and elected representatives exchanged views in a manner that, by and large, was respectful and considered. This is the way in which these Houses should do business far more often. While far too little legislation is debated and scrutinised properly, that cannot be said on this occasion. We have had a full debate and we are all the better for it.

On the whole, the public debate has been very informed and respectful also. The public is, by and large, always very respectful and very conscientious on all issues. However, we have seen some individuals and groups behave in a way which has done nothing to support their views and their objections. We have heard of politicians being threatened and intimidated. We have seen from persons of either opinion on this matter offensive and venomous attitudes.

Credit is due to those on both sides who have maintained civil debate. This is an issue about which many people are passionate. Many people are concerned and worried about it. They have put pressure on their Deputies which is legitimate, provided it is done in a civil manner. Deputies should hear and be responsive to the views of their constituents. Many Members have come under pressure to oppose this legislation and there is a vocal lobby against this legislation. Many have found themselves in a difficult position. However, we are legislators. No one said that our duty should be easy. We have a duty to legislate for this court case finding of 21 years ago. We have a duty under our Constitution, as per that case.

In 1992 and in 2002 the electorate in referenda rejected proposals to exclude the risk of suicide as a ground for lawful termination. The A, B and C case judgment in December 2010 underlined the need to legislate for the X case. The European Court of Human Rights stated there was "a striking discordance between the theoretical right to lawful abortion in Ireland on grounds of a relevant risk to a woman's life and the reality of its practical implementation". There is no question that we are legally, as well as morally, obliged to legislate for this. It is important to remember how we found ourselves under that obligation to legislate for that court case.

In that case, X was a 14 year old girl, a child, pregnant as a result of rape and suicidal. The State shamefully took an injunction to stop her from leaving the country for a termination of the pregnancy. Can we even begin to imagine the trauma that she must have faced, the mental anguish, the fear? I would not wish it on anyone, much less a child.

I know some are opposed to this legislation. Many of them do so because they have taken a conscientious decision. I respect that view and know they have not formed that view lightly. However, this is a democracy. I stand with most Irish citizens, in particular most Irish women, on this legislation, namely in favour of it. It is essential we make every effort to save both lives where possible. This legislation provides for that. I hope we will not see this legislation being used too often. I hope as few women as possible face the kind of medical situation where a termination is unavoidable and as few women as possible can see no other way out other than suicide or termination.

This legislation is about ensuring when clear and severe danger exists to the mother's life that we are in a position to help her and that medical practitioners do not feel that their hands are tied. It will ensure that if X came before a doctor today, 14 years old and scared, that the doctor would feel he or she could do what was possible to help without having to consult a lawyer.

It will mean if Savita Halappanavar were pregnant now in a hospital in Galway and her life was under threat, that her doctors would not feel restricted in what they could do to help her and ease her suffering. I accept we cannot be certain whether this legislation would have saved her life. However, it is clear the doctors in her case did feel restricted due to the doubt that is there. I sympathise with her husband, Praveen. Throughout his ordeal he has carried himself with extraordinary dignity. Let us do what we can to ensure his pain is not inflicted on another husband or partner.

There is, of course, a need for certain safeguards and protections to ensure the legislation is in line with the Constitution. I believe they have been built into the legislation. Equally, however, there is a concern as to how the sanctions contained in the Bill will affect women. Under section 22, the legislation allows for a maximum penalty of up to 14 years for women who have terminations outside the scope of this legislation. I have concerns as to the extent of this penalty. We are all familiar with cases in our own areas and constituencies of serious criminals and sexual offenders and persons guilty of similar weighty crimes getting sentences which are much less and often totally inadequate. It would be very unjust and disproportionate were a woman who, finding herself in a crisis situation and under severe mental pressure, were to be jailed for 14 years. None of us can put ourselves in such a situation. The law should show more concern and compassion to women who have, under severe pressure, taken such a decision rather than jailing them for 14 years. The provision is excessive.

Likewise, I have some concerns about sections 7 to 9, inclusive. The point again to be emphasised is that this legislation is not about women who simply want a termination. It is about women whose lives are under threat, whether by suicide or otherwise. These sections will affect women who are undergoing considerable pain and anguish. In some circumstances, they could put these women through yet another ordeal and further pressure. We should not force our women to jump through so many hoops to establish their mental state.

While of course there needs to be mental evaluation, there is also a point where we must trust our daughters and our sisters when they come forward and tell us that they are suicidal. Who are we to doubt them? While there must be some form of mental evaluation, we do need to be careful not to victimise them further and heap further mental strain on them. It is important to be compassionate in this legislation.

According to the World Health Organization, the right to health includes access to timely, acceptable, and affordable health care of appropriate quality. Clearly, if there is to be a right to a termination in the limited circumstances of this Bill, then it is essential that the right is accessible and practicable. I have some doubts as to whether that is the case as regards sections 7 to 9, inclusive.

I will be supporting this legislation because I want to ensure the lives of Irish women are protected and that we will not see families lose the women dear to them.

I welcome certain elements of the Bill, in so far as they pertain to circumstances in which there is a threat to the life of the mother for reasons of physical illness. It is an axiom of nature and logic that where a dilemma arises involving existing and contingent life that the former must take precedence. At all times in such circumstances, the life of the mother is paramount. This is law and established practice. I welcome the clarity the Bill offers to medical professionals by underpinning those principles in legislation. As a husband and father of two young girls, I also welcome the reassurance it offers women that every necessary treatment can be provided to protect the life of the mother where it is subject to real and substantial risk.

However, I continue to have several serious concerns about other aspects of the Bill. Foremost among these is section 9 which threatens to defile the Statute Book with the absurd premise that the suicidality of one human being can be abated by the destruction and killing of another.

This principle was conceived not in centres of medical excellence or centres of medical research but in the courts where judges are so often faced with tragic human dilemmas that defy the perfections of theory. Essentially, hard cases make bad law and there is no doubt that the Attorney General v. X case, in all of its heartbreaking detail, which Deputy Sandra McLellan outlined in her contribution, was one such hard case.

Two decades on, the precedent with which it has left us has brought the Oireachtas to the verge of enacting a deeply flawed and dangerous piece of legislation which will undoubtedly make bad law. Proponents of the Bill have taken shelter in the argument that we are bound to legislate in line with the precedent set out in the X case. However, in a functioning democracy the role of the Legislature must not be merely to codify what is already law but to challenge existing laws and debate what should be the law.

It is no slight on the courts or the Constitution to call for a referendum to be held in order to address the incompatibility of certain aspects of the X case judgment with contemporary medical evidence regarding abortion and suicidality. Many have said that the question has been put to the people on two previous occasions and that is the case. However, in the intervening years since the X case and, crucially, since the two subsequent referenda were put to the people, compelling medical evidence and research has emerged affirming that abortion is not an appropriate course of action in the treatment of a patient presenting with suicidal ideation. In fact, the provision of abortion in such circumstances has been shown to result in more mental health problems than it would seek to negate.

The development of medical knowledge relating to this area in the period since the X case and abortion referenda is reflected in changes to the UK Royal College of Psychiatrists guidelines, which were amended in recent years in cognisance of the growing body of evidence regarding the increased risks of mental disorders following abortion. The Supreme Court did not have access to such evidence in reaching its decision in the X case. Equally, the people of Ireland voted in the referenda of 1992 and 2002 operated in an information vacuum regarding the appropriateness or otherwise of abortion as a treatment for suicidality.

It is incumbent on us, as legislators, to make the decisions that we make, with regard to the best possible information available to us at any given time. If, for example, we were to frame legislation concerning the health of women in pregnancy based on the best advice that was available 30 years ago, we could be looking at providing for symphysiotomy in the legislation. If we were to frame legislation concerning the health of women in pregnancy based on the best advice from a further 30 years back, 60 years ago, we could be looking at providing for the administration of thalidomide in the legislation. We are in the process of framing legislation for the protection of life during pregnancy today in 2013, and we must be guided by the evidence available to us today, not bound by a decision manufactured in the courts in 1992.

The Oireachtas Joint Committee on Health and Children provided a forum earlier this year where eminent representatives from the relevant fields of expertise came before us to present evidence to inform the framing of this Bill. I regret to say that we appear to have wasted their time. Psychiatrists appeared before the committee and affirmed that abortion is not an appropriate course of action in the treatment of suicidal ideation. They challenged the central premise for this tenet of the legislation, and were unequivocal that it had no basis whatsoever in medical evidence. Looking at the Bill that has subsequently come before the House, it is clear that those psychiatrists were listened to but not heard. It seems the hearings were a charade, a ploy to preoccupy dissent and mask the whole process with a veil of complicity and inclusion. In formulating the proposed legislation, the Government has ignored everything that those experts had to say and has come up with a Bill that has been shaped by political considerations rather than medical evidence.

In truth, abortion is no more a treatment for suicidal ideation than suicide is a treatment for suicidal ideation. We are poised to perpetuate in legislation, a fundamentally flawed premise that will be deeply damaging for women and devastating for the unborn.

The contents of the Bill, in so far as they pertain to suicidality, have been hammered out between the parties of Government over the Cabinet table. What we have as a result has been decided on the basis of what is best for the politician - the Labour politician in particular - rather than what is best for the mother and child.

Section 9 of the Bill also threatens to normalise suicide and represents a departure from best practice as outlined in suicide prevention guidelines. We are proposing to codify in legislation the premise that suicide is a legitimate option, the contemplation of which has the potential to make legal something that is otherwise illegal. Suicide is not an option. It is the manifestation of the false perception that there are no other options. Our efforts to date in suicide prevention have centred on getting the message out there that there are options, that one can seek help and that there is support available. Our guidelines state that suicide must never be represented as a valid choice. This Bill conflicts with that and it threatens to normalise suicide as a legitimate response to anxiety and distress. If a woman presents with suicidal ideation due to an unwanted pregnancy and she is granted an abortion on the basis that it is the only course of action that can avoid her suicide, what message does that send out to others, who are suicidal because of financial pressures or other identifiable causes? Are they to understand that, if the material circumstances causing their suicidality cannot be changed, that there is no prospect for them ever to feel better?

No less of a concern is the absence of a gestational time limit in the proposed legislation, which raises the prospect of gravely troubling scenarios with devastating outcomes for both mother and child. One such scenario is that of a pregnancy terminated under section 9 at 23 or 24 weeks' gestation, when the unborn child is on the very cusp of viability. The child may survive the termination of pregnancy but being prematurely induced at that stage exposes it to high risk of incurable conditions such as cerebral palsy, autism or respiratory disorders, perhaps consigning the child to a future of institutionalisation and disability. It is not difficult to envisage how a child needlessly damaged like this could ultimately have recourse to the courts arising from the State having failed in its duty of care.

The legislation will herald a fundamental shift in the culture of care in Irish hospitals. Our health care professionals in making every effort to protect the life of the mother and that of the child, in accordance with their own guidelines, have made Ireland one of the safest countries in the world for women in pregnancy, but what impact will this legislation have on that culture of care if one day a doctor is striving to save the lives of women and babies and the next he or she is gowning up to perform a procedure that will result in the intentional death of an unborn child? There are also legitimate concerns that the legislation, as proposed, has the potential to effect consequences far beyond its intended remit. Accordingly, the Bill has won the support of Members of this House who have professed a desire to see a much more liberal abortion regime than is envisaged here. It is seen as a stepping stone by those Members, some of whom we know to sit among us on this side of the House. One might not agree with the methods that were used to extract their points view but in a front page article in the Sunday Independent in recent weeks two Labour Party backbenchers clearly expressed that view, that they see this as a stepping stone to a more liberal abortion regime in the future.

It has also become apparent to me in recent months that people's understanding of the Bill is clouded by misperception and misrepresentation of the changes it effects in Irish law. The tragic death of Savita Halappanavar last year in my constituency of Galway West, in particular, has been a lightning rod for such misperception and has been wrongfully used to further one side of the debate. Her case has been cited as an example of why we need this legislation in order to avoid the same fate befalling another woman in an Irish hospital ever again. Let us be clear; the Bill does not change the law in so far as it applied to Savita's case. Had the gravity of the threat to her life been detected, a termination of her pregnancy could have been carried out under the existing law, as occurs on an average of 30 to 40 occasions per annum in Irish hospitals. That is the evidence we heard at the Oireachtas hearings. As the clinical review into her death affirmed, a failure to recognise the increasing risk to her life prevented hospital staff from taking the appropriate action in time.

Sadly, had this legislation been in effect at the time of that tragedy the outcome would have been no different. We can only speculate whether the confusion surrounding such matters has impacted on the results of recent opinion polls, but I am under no illusion that the stance I have adopted concerning this legislation is not popular or prudent from a political perspective. It is a decision for which I am likely to pay a heavy price. However, if political isolation and electoral defeat is the price of doing what I believe to be right and acting in the best interests of the people I represent, then I will gladly pay it. Too often in the past, our decisions have been guided by what is popular and political foresight has extended only as far as the next election. It is because of that mindset that we find ourselves in the economic crisis from which we are now trying to recover. It is time to look in a different direction towards what is clearly right rather than what is momentarily popular. I hope those of us with shared sentiments on this most sensitive of issues can be accommodated within Fine Gael. There should be no doubt that if the enactment of this legislation gets the political sanction of those who stand against it, Fine Gael, not my colleagues and I, will have digressed from our party's values. Fine Gael made a promise prior to the last election that it would uphold the duty of care to the life of the unborn. I made a similar commitment on the doorsteps during the election campaign. That is a commitment I intend to keep. A senior Minister recently asked: "Isn't that what you do at election time?" It is not what I do at election time, and it is not what I intend to do in respect of this Bill.

Given the seriousness of the matters before us and the deep concerns held by a number of Members of the Fine Gael Parliamentary Party, I am disappointed that no concession has been made to accommodate our views. This has left my colleagues and me in an unenviable dilemma in which we are being forced to choose between our careers and our consciences. It is particularly disappointing that dissenting views have not been accommodated given that Fine Gael has precedent in so doing. In 1993 the party decided to modify the application of penalties for breach of the Whip to accommodate three Deputies who indicated that they would vote against the party in support of a Bill proposed by the late Tony Gregory to ban hare coursing. The three Deputies, one of whom was our colleague, the Minister for Justice and Equality, Deputy Alan Shatter, were allowed to remain in the parliamentary party after they voted against the Whip on that Bill. Regrettably, it appears that Fine Gael will accommodate a vote of conscience on legislation concerning the welfare of hares but it will not do so in respect of legislation concerning the welfare of women and children. Speaking in the debate in relation to that Bill, the Minister, Deputy Alan Shatter, said:

There is a need in this Parliament for us to grow up. There are fundamental issues of economic and social policy which require political parties to impose a party Whip to ensure a degree of political discipline and coherence. There are other issues to which the tyranny of the Whip or, indeed the protection of the Whip, should not apply....If all of the major parties allowed a free vote on issues such as this, Governments would not fall, nor would political parties disintegrate. There would be no political cataclysm. The institutions of the State would not collapse. The removal of the Whip might also restore some of the general public's faith in politicians.

Regardless of whether a free vote is granted, I accept that I stand in a minority in opposing the Bill and that it has sufficient support to ensure its passage through the House. I intend to submit amendments on Committee Stage to address the concerns I have expressed. I expect that the absurd principle underpinning this legislation will end up where it began, before the courts.

I can understand why the Government concluded that it was required to legislate in this area. I have studied the reports of the hearings of the Joint Committee on Health and Children, during the course of which a range of principles and arguments were expounded. The arguments ranged from the sound and sensible to the truly bizarre. I apologise if I single anybody out but I was particularly struck by Professor de Londras from Durham University, who argued that if the Bill simply stated that suicidality was not to be included in matters considered to pose a risk to life for the purpose of the legislative system, it may avoid a finding of unconstitutionality. I do not think any Attorney General could sign off on legislation of the kind proposed by Professor de Londras. Even if such legislation ultimately turned out to be constitutional, we would have a ludicrous situation in respect of threats to the physical life of a mother. As Deputy Sandra McLellan noted, nobody questions the daily medical practices of Irish hospitals as they pertain to protecting maternal life. If anything, the Bill requires medical practice to be underpinned by certain principles and procedures. For example, operations have to take place in certain locations. If we took on board Professor de Londras's arguments those restrictions would apply in the case of termination based on a threat to physical health but the question of threatened suicide would be left entirely unregulated. Such a position would be untenable.

I agree with Catherine McGuinness and others who have stated that the Government does not have a legal obligation to legislate as a result of the X case, although moral obligations are a different matter. The question arises, however, of whether it is legally obliged to act on foot of the A, B and C case. Dr. Marie Cahill of UCC believed it was not obliged on the basis that the A, B and C case involved physical and medical risks to the mothers' lives and as such is not relevant to abortion on grounds of threatened suicide. She believed it would be possible to remove the latter provision and remain in conformity with the judgment of the European Court of Human Rights. That may be correct but, having studied the judgment in the A, B and C case, I am of the opinion that it obliges the Government to legislate. If I differ from Dr. Cahill, that is too bad.

I do not want a liberal abortion regime in this country. I recognise that people who advance that opinion are often exposed to the charge of hypocrisy given that thousands of Irish women travel to the UK annually to secure terminations. It is not an easy journey for any of these women and it is particularly traumatic for some of them. However, many practices that are banned under Irish criminal law are legal elsewhere. Irish people have the right to travel out of the country to places where such practices are legal. Does that mean we should legalise all these practices in Ireland? That is the logical outcome of arguing that those who do not want a liberal abortion regime in this country are hypocrites.

The Minister for Health wants to bring certainty to an uncertain situation. The issues are not uncertain when it comes to the physical threat to the life.

He wants to bring certainty to the situation where somebody is threatening to commit suicide if they do not have a termination. Practically nothing has happened in this regard since the X case all those years ago because of uncertainty on the part of people who might feel they want a termination and on the part of people who would be expected to provide that service. When one legislates to bring certainty where there was uncertainty previously, one obviously creates a situation where demand for terminations in this country will increase. There is no doubt about that. It does not matter who is in power or who writes the legislation. That is the situation one brings about when one writes the legislation. As somebody who does not believe in a liberal abortion regime, I have to ask myself whether the legislation being proposed by the Government is sufficiently watertight - I accept there can be no guarantees - to reduce the risk of this turning into a liberal abortion regime, in so far as that is possible to do. I have some serious doubts in that regard. Time does not permit me to go into a number of technical matters. I hope they will be discussed and viewed benignly by the Government on Committee Stage.

I want to spend a few minutes on one thing that strikes me. The Government has put forward the notion that if this legislation does not lead to the tightly controlled regime it is trying to provide for, it will change it, review it, stop the practices taking place under it or suspend it. I cannot find a reference to that promise in the legislation itself, however. Section 15 of the Bill, which states that "the Executive shall ... each year, prepare and submit to the Minister a report on the operation" of this legislation, is followed by nothing. It is like a drama in several acts in which the first act is used to set the scene, but the other acts have disappeared and one is supposed to guess what happens after that. Given that we are trying to regulate how legislation of this importance will operate, that should be set out in law. It should not be a matter of the whim of an individual Minister. I am not talking specifically about the Minister, Deputy Reilly, who thankfully will not be Minister for Health forever. I am also talking about his successors. There is no obligation to publish the review that is provided for in the legislation before us. There is no obligation to have it debated in the Joint Committee on Health and Children.

I do not doubt that the Minister will introduce a few amendments on Committee Stage to assuage some of his backbenchers. While a proper review procedure would be desirable, it would not be sufficient. The Minister has said he will do A, B and C, but where is that in the legislation? We are expected to accept his word. I recall watching some black and white footage of the Kennedy-Nixon campaign in the 1960s, when the Democrats used a picture of Richard Nixon looking particularly elusive with the caption "would you buy a used car from this man?" I must say I would not buy a car from the Minister, Deputy James Reilly, if it came straight off the assembly line. The Minister said he would get rid of trolleys, but one cannot get into the Mid-Western Regional Hospital in Limerick because one's way is blocked by trolleys. He said he would reduce waiting lists, but they have got longer. He said he would introduce a universal system of health insurance, but we are further away from that than ever. He said he would get rid of prescription charges, but instead they increased threefold. Are we supposed to take his word in this case? I think it was the great film director Cecil B. DeMille who said that in the movie business, a verbal promise "isn't worth the paper it's written on." The verbal, written and other promises we have received from the Minister carry no weight with me. All we have is his word, and I am sorry to say his word is no good, in my view. In the absence of a proper review procedure to regulate this situation - it needs to be written in statute - I will find it extremely difficult to support this legislation.

I thank Deputy Willie O'Dea for giving me an opportunity to make a short contribution to this most important debate. We all rise to contribute to the debate on this Bill with mixed emotions. According to a report published on thejournal.ie recently, "almost 90 per cent of respondents to a nationwide survey of psychiatrists have expressed concern with the Government’s plan to include the risk of suicide as grounds for an abortion under forthcoming legislation". The Government's proposals are flawed and need to be reconsidered. This is quite worrying for the Government and for society as a whole. Under the suicide clause contained in the Bill, two psychiatrists and one physician will be brought in to adjudicate on the issue. If 90% of experts disagree, this needs to be changed or withdrawn.

As a pro-life Deputy, I will vote against this legislation. I have been consistent on this matter during all my time in this House. I believe in the protection of the mother as well as the protection of the unborn child. The issue itself is quite divisive. People seem to be forgetting about the bigger picture. The Constitution recognises and declares that people living in Ireland have certain fundamental "personal rights", one of which is "the right to life". Article 40.3.3° of the Constitution provides that "the State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right". The House needs to take note of the recent comments of Mr. Eamonn Barnes, who is a former Director of Public Prosecutions. He was quoted as saying that the Bill tabled by the Government is unconstitutional because "the foetus gets no chance to have its right to survival advocated" or vindicated. Under this legislation, who will vindicate the life of the unborn, the right of the father and the right of the mother?

Lord Steel, who brought forward Britain's abortion legislation in 1967, was recently quoted as saying this country's Government will make a "mistake" if it goes ahead with plans to legislate for termination on the grounds of a threat of suicide. This shows that there are serious flaws in the legislation and that change is needed immediately. If this suicide provision is voted through, the next step will be abortion on demand. The right of the unborn, as well as the right of the mother, needs to be protected. Who will be the voice of the unborn? Who will stand back and examine what is actually being proposed in this legislation? In light of the comments of the person who brought in abortion in the UK, it is pretty obvious that this approach is flawed and unjust. I again pose the question: who will vindicate the right of the unborn?

Last month the Spanish Government proposed to row back on that country's liberal abortion laws, which shows that this issue is not confined to Ireland. It is also being considered in other European countries. I will fight tooth and nail to resist abortion in Ireland. My stance has been pro-life and pro-life it will remain. In 1990, King Baudouin of Belgium notified the Prime Minister of that country that he could not and would not sign abortion legislation. His conscience meant that he had to resign rather than support the legislation. Rather than being confined to Ireland, this issue is recognised as an international problem. Where is the leadership from the Government? Does conscience not matter to the Government today?

No specialised psychiatric evidence was delivered to the Supreme Court hearing on the heartbreaking and emotive X case in 1992. Given that the legislation is proposing to give psychiatrists a central role, I wonder whether there is a political dichotomy in this regard. In that context, why is the Taoiseach not extending a free vote to the members of his parliamentary party? Our party leadership is to be applauded for listening to members of our parliamentary party and offering us a free vote. Our party is democratic. Every member has a fair and equal say. When a free vote on conscience grounds was suggested, I supported it wholeheartedly. I know there are genuine people in Fine Gael who are appalled at this legislation.

It is worth returning to and discussing the rights of the father. Who will vindicate the rights of the father, the rights of the mother and the rights of the unborn? We are discussing the rights of the mother and of the unborn, but what are the rights of the father? Should the father have a say in these cases? Should he be involved in the decision-making process? What are his rights? Should he not have a say, if he wants to be a good and competent father who supports his partner and his unborn child? This legislation does not mention this. We are in the world of gender equality, but it has to work both ways.

Who will vindicate the father's rights, the mother's rights and the rights of the unborn? In a global study of abortion, Dr. Gilda Sedgh of the Guttmacher Institute in the United States found some very disturbing figures about abortions. In Europe, marginally under 30% of pregnancies end in abortion. Do we just want our people to be statistics? We need to fight to protect the rights of mothers and fathers and the rights of the unborn. Another expert, Mr. John Smeaton, said:

The truth is that countries with strict laws against abortion have lower maternal death rates than countries which allow abortion widely. Ireland, where abortion is banned, has one of the world's best maternal health records.

We, as policymakers in this House, need to represent the people and we need to protect the mothers of the State. If abortion is legalised, we are going down a slippery slope. Protection of the Irish people is needed, not an attack on their civil liberties.

I will be voting with my conscience against the Bill. I also think the debate on Committee Stage should be held in plenary session here in this Chamber in order that experts can be brought in to discuss the legislation in detail. I am voting to protect the unborn and to protect the mother and the father. If the Government wants to show real leadership and real credibility, I implore it to put the ultimate decision to the people. On an issue of such divisiveness, we need real leadership and we need the Taoiseach to show it. He was elected to govern, to lead and to inspire. He should listen to his conscience, give a free vote to the members of the parliamentary party and, if the legislation is passed, put it to the people by way of plebiscite or referendum.

Section 9 on the issue of suicidal ideation is where the principal sticking point is with this legislation. I appeal to the Government, at the eleventh hour, to reconsider and to withdraw section 9 of the Bill.

I am pleased to see this legislation, which finally addresses an issue that has been the subject of a great deal of discussion, not only in recent months but for several decades. While that debate and discussion was sometimes extremely heated in the past, it has been much more calm and reasoned in recent months, a change I very much welcome. Nonetheless, the fact the Oireachtas was waiting two decades to address the issue of the X case is something I would not want to see repeated. I believe all Members of this House should consider whether postponing such an issue because it is uncomfortable is a wise course of action in terms of serving the interests of those who send us here.

I think it essential to point out that Article 34.4.6° of the Constitution states: "the decision of the Supreme Court shall in all cases be final and conclusive." The X case is the law - that is the reality. A termination of pregnancy arising from a risk to life, specifically from suicide, was deemed lawful under the X case judgment. It is true to say that it was not raised in the Supreme Court. However, testimony around the issue of suicide was accepted at the High Court hearing and no appeals to the Supreme Court regarding it were raised. Therefore, it was accepted by the Supreme Court.

The X case was revisited in the judgment of the European Court of Human Rights in the case of A, B and C v. Ireland, which placed Ireland under a legal obligation to put in place and implement a legislative or regulatory regime providing effective and accessible procedures whereby pregnant women can establish whether a termination may be carried out in accordance with Article 40.3.3° of the Constitution as interpreted by the Supreme Court in the X case. Last December, the Government approved the implementation of the judgment of the European Court of Human Rights in the A, B and C v. Ireland case by way of legislation with regulations, within the parameters of Article 40.3.3° of the Constitution. As I stated on a previous occasion when I spoke on this matter, I have never had as much contact from my constituents on a single issue, which I believe speaks volumes about how seriously the people view the matter of the X case. A minority were opposed to any action being taken, but the vast majority of them made it crystal clear to me that they wanted action on the matter.

I stated in this House last year, when the expert group issued its report outlining the options for the Government to take, that one of those options was to implement legislation with regulations. This is the option the Government has taken, and I fully support this approach.

The main purpose of the Bill is to provide legislation to allow abortions to take place in Ireland when there is a risk to the life of the woman - when there is a risk of her dying. Put another way, when the equal right to life as stated in Article 40.3.3° of the Constitution is no longer equal, a process will be provided that provides access to a lawful termination of pregnancy in accordance with the X case and the judgment of the European Court of Human Rights in the A, B and C v. Ireland case. A woman will know whether she can have treatment or whether she cannot. The reality at present is that a woman is never sure whether she can or cannot avail of treatment. This Bill does not confer any new rights; it confirms existing rights and addresses how they are exercised. I say that as a parent and grandparent with a daughter and a granddaughter.

Section 9 of the Bill is the relevant section that deals with suicide cases. A perinatal psychiatrist, of which there are only a few in the State, is not required. If one was required, I consider the legislation might be deemed to prevent access by women to the procedures that this legislation enables them to avail of.

Section 10 concerns the appeals process. The woman, or a person acting on her behalf, may appeal if she is unhappy with the outcome of the original panel. There is no provision for medical staff making appeals themselves, which is a positive aspect. This ensures that a positive initial decision cannot be overturned. Women are entitled to be heard at the appeal under section 14 of the Bill. This is crucial and had not been present in the heads of the Bill.

Under section 22, with regard to sentencing, while I am happy to see the relevant sections of the Offences against the Person Act 1861 repealed, there is still one point I am certain of in regard to the new legislation, namely, no reasonable person wishes to see a woman who obtained an abortion go to prison for any length of time. I believe this would be inhumane. Women who seek abortions seek them because they are in crisis. That crisis should not, in my view, be something that results in a prison sentence. That said, sentencing has been watered down and now refers to prison sentences "not exceeding 14 years". This is an improvement over the heads of the Bill, which provided penalties in the form of a flat sentence. The legislation allows discretion and the opportunity to deliver light sentences, or no sentencing at all, to women who have experienced a crisis pregnancy and chose to have an abortion.

I would like to address the issue of fatal foetal abnormalities. I have been contacted by individuals who have expressed their wish 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. Dealing with such cases under this legislation is, I believe, outside the scope of the Constitution. This is a serious problem in Irish law. As I have said previously in the House, women in these situations must endure a very difficult physical and emotional crisis, and if they choose not to endure it, they must leave this State in order to end it. I have heard much testimony from women who have been through all of this. It is heart-rending to listen to and read of their experiences, and I believe it is wrong that they have to suffer so much. I am extremely sympathetic to the view that these cases be addressed under Irish law.

What the majority of people want, at a minimum, is to see difficult, sad and traumatic cases dealt with. In order for us to do that, there needs to be a serious debate about Article 40.3.3° and whether there is a need for a referendum to remove it or replace it with a less onerous provision. I believe it could easily be the case that, at some future point, Ireland, as a state, will be found to have violated a woman's right to privacy, her right to a family life or her right to bodily integrity. We should not allow this to occur and I believe we should address this matter ourselves, for Irish women, our fellow citizens.

It remains to be seen how many women will avail of this legislation, even if it applies to them. I strongly suspect that women with the resources to travel abroad will continue to do so, as is at present the case for women with a fatal foetal abnormality, in cases of rape or incest, or in regard to the many other reasons for which Irish women have abortions. Approximately 12 women a day are believed to travel from Ireland in order to obtain an abortion. Ultimately, I believe the Irish people will need to decide upon this matter again, and that the Oireachtas and the Government need to enable a referendum process that allows them to decide this issue in a nuanced way, not in the way of previous referendums, and then to legislate on the basis of a result from that process. Based on previous polling of the Irish people and from what I have heard myself, the majority would agree with me on this. I do not want the Oireachtas to wait another 20 years to address these matters. We in the Oireachtas need to serve the needs of the people who elect us, and to do so in a timely fashion.

Deputy Shane Ross is to share his time with Deputy Joe Higgins.

I have as long an experience as anybody in this House, bar the Taoiseach and maybe one or two others, of being present for discussion of this issue. I was unfortunate enough to be here, in the other House, in 1984; I was unfortunate enough to see this being debated in the 1990s; and I am unfortunate enough to see it still unresolved in 2013. It is sad to see us being reluctantly, once again, dragged into it, not voluntarily but by tragic events elsewhere which force us into it, or being pushed into it by the courts. It is an act of political cowardice on all our parts that we have been unwilling to address this issue because it is so emotive, difficult for people and, as a result, difficult for politicians. In an ideal world these are exactly the issues we should be here to address and upon which we should lead, confront and challenge public opinion, take decisions and show leadership. We do not live in an ideal world and I sympathise with those who have been put under great pressure during this campaign.

I will vote in favour of the legislation. What is being done is right and proper. However, I deeply regret two things as a result of this campaign. One is the extremism that has marked this campaign on both sides. There is a moderate, common-sense, middle way on this issue and the reason politicians are unwilling to address it is the extraordinary nature of extremists on both sides of the argument. The obsessive nature of many on this issue is difficult to confront, even in a very robust political world. All politicians have been lobbied on this, as they have been on other issues, but there is an especially hysterical side to some of the extremists in this campaign. They ambush one in one's home, on the telephone and at meetings that are irrelevant to the issue with a fanaticism, on both sides, which is unhealthy and difficult to cope with.

This is a special issue with regard to people's emotions and conscience and I cannot understand why the Government does not allow a free vote on it. Fianna Fáil has allowed a free vote, presumably because political circumstances have forced it to do so, but there is nothing to be lost in showing political maturity and saying this is an issue on which people feel so strongly that they can be released from the party Whip. This is partly because it will be passed anyway, but partly because it is an issue of conscience about which people feel very uncomfortable. It is no coincidence that this is the only issue on which Fine Gael members are taking in such large numbers a very dramatic step which will exclude them from the parliamentary party and possibly mean that they will not have a way back, because they feel so strongly about it. Politicians very rarely take that road. A free vote would be a reflection of the depth of feeling about this issue and an option that a mature Chamber should be perfectly happy to give to its Members, particularly when the Government is not threatened. On the merits of the case the Bill should definitely be passed, and I ask the Government to think about a free vote, as have so many other people in this debate.

The Protection of Life During Pregnancy Bill 2013 makes the very narrowest possible provision for termination of pregnancies in Ireland and only in extreme cases where the woman's life is in very grave danger. In drafting this legislation, the preservation of the Fine Gael Parliamentary Party took precedence in the minds of many members of the Cabinet over the real needs of women in crisis pregnancies in this country. On any reading of the Bill it is clear that the Government did the absolute minimum to try to say it has legislated for the exigencies that arose after the Supreme Court decision on the X case in 1992 and, subsequently, the demands of the European Court of Human Rights following the cases of problem and crisis pregnancies it dealt with.

Section 8 of the Bill, entitled "Risk of loss of life from physical illness in emergency", is the only section of the Bill that is clear-cut, satisfactory and as it should be. It provides for an immediate decision by a medical practitioner who believes there is a grave threat to the life of a pregnant woman. One hopes this will remove the "chilling effect" that the European Court of Human Rights spoke about regarding the fear on the part of doctors of the Offences Against the Person Act 1861, which provides for life imprisonment for a person who carries out an abortion. The court referred to the case taken by Ms C, who was unable to obtain, in Ireland, proper information on the impact of pregnancy on her health and life as she was suffering from cancer at the time.

Much more than this is needed by women. There should be a very clear provision regarding inevitable miscarriage, which is not catered for in the Bill. That came very tragically to light and to the nation's attention in the case of Savita Halappanavar. It should be legislated for and provided for in this Bill. Pregnancies involving foetal abnormalities that mean the foetus is non-viable and cannot survive are not dealt with either. That is shameful and cowardly, particularly in view of the harrowing testimonies of women who have been in the dreadful situation of finding they had to make a decision on the termination of non-viable pregnancies. This morning in the Dáil the Taoiseach was trying to express understanding of women in this horrific situation but failed to do so.

He referred to women he knew whom he said had taken a decision to carry to term - that is, of course, an absolute right, one that should be assisted and resourced - but, equally, he refused point blank to see the rights of women or couples who did not want to do this and did not want to be subjected to the awful trauma of continuing in an horrific situation that they simply wanted to end. It is shameful that women are forced to leave this country every year to deal with this issue. The figure for fatal foetal abnormalities is given as approximately 1,500 a year, a substantial figure. When one considers the number of women in this traumatic situation who make the decision to leave the country, the trauma and the alienation of having to leave home, to leave their support base, their family and most of their loved ones and the significant costs involved, it is heartless and the issue should be catered for in this legislation.

Even worse, under the Bill a woman who finds herself in this situation, who wants to deal with the issue and have a termination of an unviable pregnancy in Ireland will be criminalised and subject to 14 years imprisonment under section 22; likewise, a doctor who assists her. Section 22(3) states a prosecution of an offence under this section may be brought only by or with the consent of the Director of Public Prosecutions. This is an attempt to avoid an X case scenario developing where the prosecution of a woman might come out of the blue, take a Government and a whole system by surprise, as the X case did in a different circumstance. There would be consternation in society and the same opposition and horror would be expressed among a majority of people such as happened when the X case came to light and a child was ordered to be interned on this island for a period of time to prevent her from having a termination following a rape. What the Government is attempting to do in the Bill is two-faced; it is an attempt to satisfy, on the one hand, the strong opponents of abortion by stating it is criminalising abortion and taking a tough stance and then, on the other, by involving the Director of Public Prosecutions as a kind of safety net, it is stating to people who are in favour of the right to a termination that it really will not happen, that it would not get by the Director of Public Prosecutio1ns, but it could. For my part and that of the Socialist Party, we will have to consider this issue very carefully. To vote for this kind of criminalisation would be reprehensible to us. I am of a mind to abstain in the vote on Second Stage on the basis that this criminalisation should be removed. With others, I will be tabling amendments to seek to have it removed in the course of Committee and Report Stages. If it is not removed, we will have to carefully consider our attitude in the final vote. I would vote for the Bill otherwise, even with its hugely restrictive nature, but criminalising women in this way is barbaric and cannot be countenanced.

Just how restrictive the provisions of the Bill are can be seen on reflection, particularly with regard to suicidal women. How many women in this traumatic situation will run the gauntlet, first, of three medical practitioners - two psychiatrists and one obstetrician - and then three more if they have to appeal? It is not going to happen in the majority of cases involving such trauma. Because of the stress and trauma involved, most will opt to go abroad, about which there is no doubt. The idea that this provision will allow what opponents call abortion on demand, which is an inappropriate term to use as if a woman looks for an abortion as if she were walking into a shop, is offensive. It is farcical. In fact, what will happen is that women will decide to go to England. Similarly, I believe women pregnant by rape who want to end that pregnancy should be catered for. Rape is an horrific violation of a woman and forcing her to carry through to term a resulting pregnancy is barbaric.

I believe the health of a woman is not catered for at all in the Bill. The health of a woman should be a factor and on which she makes a choice. Thousands of women from this state travel to Britain, mainly, every year to secure a termination of pregnancy. The view that it is hypocritical was criticised in an earlier contribution, but it is hypocritical because if England or some other jurisdiction was not there and we had had the horror of back street abortions and women dying or being horribly mutilated as a result, the issue would, of necessity, have been dealt with much earlier.

I stand for the right of a woman to make her choice and for that choice to be respected. That is my position on the issue of termination of pregnancy. When I was a child, in rural Ireland we used to hear disdainful talk of pagan England, even as 1 million of our penniless young men and women found homes and lives there. Similarly, in this case, it is an English solution to an Irish problem.

Sa chúpla nóiméad atá fágtha agam, ba mhaith liom a rá go bhfuil an Bille um Chosaint na Beatha le linn Toirchis, 2013 ró-chúng amach is amach. Ní théann an Bille fada go leor chun déileáil leis na cásanna crua ina bhfaigheann an-chuid mná sa tír seo iad féin gach bliain, maidir le toircheas ina bhfuil dainséar don bhean. I gcás féatas mínormálta nach féidir fanacht ina bheatha, measaim go bhfuil sé barbartha iachall a chur ar mhná dul go dtí deireadh théarma an toirchis. Ba cheart go mbeadh cabhair éigin leagtha amach sa Bhille atá romhainn mar fhreagra ar an ngéarchéim seo. Dá bhrí sin, ba cheart dúinn leasú a dhéanamh ar an reachtaíocht seo chun na cásanna áirithe sin, agus cásanna difriúla eile, a chlúdach. Measaim freisin gur cheart go mbeadh sláinte na mban chun tosaigh. Ba cheart freisin tús áite a thabhairt do chinntí na mban maidir leis an méid a theastaíonn uathu i gcásanna toirchis i ngéarchéim. Chomh maith leis sin, tá mé go mór in aghaidh gnímh choiriúil a dhéanamh d'aon chinneadh a dhéanann bean deireadh a chur le toircheas sa Stát seo, go mórmhór os rud é go bhfuil sé i gceist téarma príosúnachta de 14 bliain a ghearradh ar an mbean sin agus ar aon dochtúir a chabhraíonn léi. Dá bhrí sin, tá an-chuid leasuithe le déanamh. Déanfaimid iarracht iad a dhéanamh ar Chéim an Choiste agus ar Chéim na Tuarascála, agus ansin feicfimid.

Perhaps unsurprisingly, this issue is the one on which I have received the most correspondence since my election to the House. I have received emails, letters, postcards, telephone calls and messages on social media. I have met hundreds of people, sometimes in Leinster House, but mostly in my constituency and at clinics. I was the only politician from the constituencies of Galway West and East to attend a meeting in the Westwood Hotel in Galway on the May bank holiday Monday to listen to and answer questions from pro-life groups. The people I met were compassionate, interested and concerned and I spent an hour and a half on my feet explaining, defending and answering questions on this subject. I have taken the time to listen to almost everyone and every shade of opinion on this most sensitive and complex matter.

Notwithstanding the diversity of views which abortion prompts, it is helpful to start with the position of most citizens. Most citizens expect that all that is humanly possible will be done to help expectant mothers and unborn children, should assistance be required. Irrespective of whether a person contacting me has been pro-life, pro-choice or adopted whatever other labels are used, I have made it abundantly and unequivocally clear that, collectively, as citizens and legislators, we have a duty to uphold the principles and vindicate the rights espoused in the Constitution. Defending the Constitution requires accepting the interpretation of the law of the chief interpreters of Bunreacht na hÉireann, the Supreme Court. The sole purpose of the Protection of Life During Pregnancy Bill is to codify and set out the legal position as it already stands. It is nothing less and certainly nothing more. As I have done in many meetings and interviews, I reaffirm my pro-life credentials. The Bill will not lead to abortion on demand, to use that phrase. If I believed otherwise, I would not support it. I dispute the accusation that to be in favour of the Bill while claiming to be pro-life is to involve oneself in what one colleague called "verbal gymnastics".

Listening to the contentious - often fraught - debate, one might receive the impression that in the X case the Supreme Court was concerned solely with suicide. It is worth reiterating what the court stated in the X case judgment. It held:

The danger [arising from a risk to the life of a woman] has to represent a substantial risk to her life though this does not necessarily have to be an imminent danger of instant death. The law does not require the doctor to wait until the mother is in peril of immediate death.

To be clear, the court stated the risk to the life of the woman included the danger of suicide. Looking back at our recent history, I regret to say I cannot report that we in Ireland have covered ourselves in glory in addressing the issue of mental health. To be blunt, mental illness and its treatment have come a poor second to physical illness. The stigma attached to mental illness, which persists to this day, is testament to this. To our shame, mental illness was treated until recent decades by locking a person away - out of sight, out of mind. I am deeply dismayed, discouraged and unsettled by the attitude of some citizens inside and outside Leinster House on the connection between this legislation and mental illness. To borrow a phrase from a recent mental wellness campaign, mental health matters. Sadly, to some, mental health matters, but not if one is a woman and pregnant. The dismissive attitude towards psychology and psychiatry, both of which are measured, verifiable and vital branches of medicine, has been astounding. During the second round of extensive hearings by the Joint Committee on Health and Children the Chief Medical Officer of the Department of Health, Dr. Tony Holohan, made certain pertinent and valid remarks which ought to be remembered by all involved in this debate. He stated:

Psychiatry is a clinical science based on scientific method and research. It is not some form of hocus-pocus that operates without evidence ... We simply cannot say the circumstance of a real and substantial risk to a woman's life could never occur as a consequence of suicidal ideation.

However, some commentators are absolutely convinced that once this legislation is passed, the women of Ireland will suddenly pretend to be suicidal simply to access an abortion. The contention is preposterous. It is disgraceful and demonstrates a complete lack of trust and regard for the women of Ireland. Many people have cited the situation in the United Kingdom which does not have a written constitution and its legislation provides for abortion where there is a risk to the health of a woman. In Ireland such a provision would require a referendum to change the Constitution.

The undeniable and inescapable fact is that if suicide is excluded from the Bill, we will not be giving effect to the constitutional rights the Supreme Court has already found to apply. Despite assertions to the contrary, the law is not being altered. Neither the Supreme Court nor the European Court of Human Rights has sought a change to the law. Rather, both institutions have sought clarity through a legislative or regulatory framework which clearly sets out rights as they apply. Respect for the law and the Constitution concerns not just decisions of the Supreme Court but also Article 40.3.3° which was inserted on foot of the eighth amendment to the Constitution. Article 40.3.3° requires that the right to life of both the mother and the unborn is vindicated. The Bill has been framed with this in mind and will operate within that context. As an additional safeguard, the Minister for Health will be empowered to act where the provisions of Article 40.3.3° are not being observed.

There are two other important points which must not be forgotten. First, a termination of pregnancy will be permitted when it is the only option available. Second, medical professionals will be obliged to take every action possible to safeguard the life of the unborn where compatibility with life outside the womb has been reached. If the Bill is passed, it will not end the abortion debate. There will still be concern regarding the right to abortion for women who have been subjected to the most heinous crimes of rape and incest. The legislation does not provide for the exceptionally tragic matter of fatal foetal abnormalities, whereby an unborn child is incompatible with life outside the womb. Such cases have been deemed to fall outside the current constitutional provisions and, as such, can only be dealt with by the people in a referendum. The debate will continue long after the passing of this legislation by the Dáil. While the legislation is about providing clarity and setting out visibly the position of everyone concerned, I fear there is little clarity for women in the aforementioned situations. These are tragic circumstances for any expectant mother to find herself in. I have heard all sides on these matters. If they are put to the people in a future referendum, there will be a serious and prolonged debate.

We have witnessed the consequences of a lack of clarity before. While there were several factors in the untimely death of Savita Halappanavar, nobody can deny that legal uncertainty contributed to the tragedy. Medical professionals were unsure of when an intervention could legally be made. It is regrettable that some in the House have suggested clarity, as provided for in the Bill, would not have played a role in facilitating speedier intervention in this tragic case. The Government parties - the Labour Party and Fine Gael - committed to addressing the lack of certainty and clarity. Following much consideration and examination, many meetings and reports by numerous groups, the creation of a statutory framework by way of legislation and regulation has been deemed the best way forward.

I have no doubt that the contents of my speech will be scrutinised, examined and, perhaps, used against me by some. I make no apologies for being against abortion for lifestyle or social reasons. I reaffirm that I am against a liberal abortion regime in the State, to which the Bill will not lead. I make no apology either for supporting legislation which will vindicate rights already found to apply.

I welcome the opportunity to speak on an important Bill. There is no doubt that the legislation is the most difficult and contentious ever to be considered by the House. My colleagues in the Dáil and the Seanad would be much happier if it were not necessary to deal with the issue. However, our job is to legislate.

I am deeply saddened that it has taken us over 20 years to deal with the X case and that we had to be informed by the European Court of Human Rights to bring clarity. It is about time that it was dealt with.

In this case, on an issue that has already been decided by the interpretation of the Supreme Court and by the people in two referenda, it is important that we understand the current legal situation. As it stands, terminations are allowable in certain cases where the life of the mother is at risk.

The inclusion of suicide has been a big issue. However, the Supreme Court's interpretation of Article 40.3.3° of the Constitution considered that a real risk of suicide in extremely rare circumstances is a reason for a termination. That is the situation today, without any regulation or guidelines. The result of this is that doctors differ and, consequently, are unaware exactly when a termination can or cannot be carried out. This uncertain situation cannot be allowed to continue as it is about saving lives. The legislation that this House is now considering will put in place a process for a woman who finds herself in an extremely difficult situation where she feels her life is at risk and for the first time, there will be a procedure to ensure that a clinical diagnosis is reached and medical support provided by a psychiatrist. In the extremely rare cases where two psychiatrists and an obstetrician agree that a woman's life is at a substantial risk and that all other avenues have been exhausted, a termination may be approved in order to save her life. In the Constitution, as it stands, one doctor can diagnose a woman's termination where there is a threat of suicide as opposed to a risk and without further medical diagnosis. This legislation will make it a criminal offence for a person to intentionally destroy an unborn human life which can result in a prison sentence of up to 14 years. This legislation ensures there is a transparent process and, most important, the patient - in this case, a woman - will have the best care possible when in a very vulnerable place.

This legislation also brings clarity for the medical profession which is much needed where there is a physical illness during pregnancy and where the pregnant woman's life is at risk. An obstetrician now has clarity on what medical procedures can be carried out. This legislation also ensures that in the case of an emergency, medical procedures required to save a woman's life can now be carried out. This legislation is long overdue.

I believe that the passing of this legislation ensures clarity is brought to the Supreme Court's interpretation of the Constitution in the X case and we have a constitutional obligation to uphold the wishes of the people as expressed in a referendum. Equally, it is our obligation to respect and abide by the decisions of the Supreme Court as this is clearly laid out in the Constitution. We are also required to bring clarity by the European Court of Human Rights.

As a woman and a mother, it is important to me that a woman's life is always protected. Where a medical issue arises and there is a risk to a woman's life during pregnancy, the medical profession needs clarity. Often in these circumstances time is of the essence in saving and protecting lives.

Pregnancy is often taken for granted as a normal condition. Thankfully, most women have safe pregnancies and deliver healthy babies. However, for others this experience is very difficult and fraught with turmoil. An unplanned pregnancy is a very lonely place for any woman. Rape, incest, abnormalities and many other circumstances are not covered in this Bill. We need to look at how we support crisis pregnancies to give women the support they need in situations that are not covered by this legislation and that will be for another day and for the Irish people to decide.

The Minister for Health, Deputy James Reilly, the Attorney General and legal experts have made every effort to ensure that this legislation is robust and will stand up to Supreme Court scrutiny. We are acting strictly within the Constitution with this piece of legislation, ensuring that we save lives during pregnancy. As I stated on many occasions, I believe this is long overdue, it finally brings clarity and we are acting within the Constitution. I welcome the Bill. For all the reasons I have outlined, I will be supporting it.

I have already contributed twice on this matter, both in this House and in the Upper House. As we all will be aware in this House, it is a complex issue. It is both emotive and highly personal. Of the many concerns that have been raised through many different forums, different voices and different organisations, the two issues that strike me are the ultimate protection of the unborn and giving a voice to the unborn, and the issue around suicide. Where people have been in contact with me, that contact has been in the main cordial.

On the suicide issue, there has been a somewhat flippant discourse on the issue of suicide which must be acknowledged. Suicide is a very real and complex difficulty for many citizens and for many families that have endured the loss of loved ones. If there happen to be women who are pregnant and have suicidal ideation, it is important that we encourage them to present themselves to the proper social service teams - able staff the length and breadth of this country - and create the proper pathways where we can bring them in and where they will feel safe and will be listened to. We should be doing everything in our power as a society and in the professional medical service to exhaust every avenue with those females who present with suicide ideation and it should not be treated in the way it has been discussed to date. If they have suicidal thoughts, we should encourage them to come into the health care system and help them along with the assistance that they need.

On the concerns around precedent, the precedent in California, in France and in the United Kingdom is alarming. The figures are alarming. People are genuinely concerned that if this legislation is introduced the floodgates will open. It is important to highlight the fact that enshrined in the Constitution is the protection of the life of both the mother and the unborn and we must trust the Constitution that this will be ultimately protected following this legislation.

We need clarity around terminations. I do not have the information to hand on all of the individual hospitals in this country. We do not have clarity on the numbers of terminations. For obvious reasons, there are terminations in this country. It is hoped that the legislation will provide clarity and more protection in terms of protection of the life of the mother.

I have concerns in relation to rights of the father. I am glad the Minister of State at the Department of Health, Deputy Alex White, is here tonight. One of the churches raised this issue of the rights of the father in regard to this legislation. There is a need to explain and define more clearly what are the rights of the father. I am aware that in different countries the rights of the father differ.

On the 1861 Act, there will be a change in the penalty for the offence of intentional destruction of unborn human life, from life imprisonment to 14 years. However, there are questions around access to abortive pills over the Internet in the first stages of pregnancy - up to 12 or 13 weeks. We need clarity where women have access to abortive pills, get into medical difficulty and present themselves to the GP, and we also need legal protection for GPs who will ultimately assist women who have taken abortive pills.

In the short time available to me it is not possible to discuss all of the different concerns and questions raised by many people. However, in a nutshell, the core fear of many men and women is the question of the suicide provision leading to the opening of the floodgates. We must have protection against this. The psychiatric profession has a very important role in preventing the opening of the so-called floodgates. It is a real live concern for many and we must be cognisant of this as the Bill passes through the House.

Regarding the debate about the Whip, I believe every Member of the House will take his or her conscience into consideration when he or she makes his or her decision. Certainly, I will make my decision on the Bill based on what I believe is right and ultimately what I believe is right for the protection of the life of the mother and that of the unborn and to give a voice to the unborn.

I welcome the opportunity to make a contribution to this debate. The debate so far today and the general public debate on this issue have been respectful. I have always believed one does not have to agree with someone to respect him or her or to listen carefully to his or her views.

I will oppose the Bill for one primary reason. I have continuing concerns that the termination of a pregnancy on the grounds of suicidal ideation is not evidence based. In fact, the evidence from the experts who support the Bill and also those who oppose it is that abortion cannot in any way be regarded as a treatment for somebody who is genuinely suicidal. My baseline position on this issue is that I believe in protecting life. I believe in protecting the life of the pregnant mother and the life of the unborn baby. I have a wife, a mother, a daughter and sisters and to suggest, as some do, that those of us with sincere concerns about aspects of the Bill do not trust women is absolute nonsense and a distortion of the debate surrounding the Bill.

Any legislation to protect lives in pregnancy should be based on evidence. I followed the two sets of hearings at the Oireachtas health committee as closely as I could. On the medical side, the evidence was very clear. Practitioners believe additional legal clarity is required to allow them to intervene to save the life of the mother when there are medical complications, whether those complications derive from a life threatening physical illness such as cancer or a medical emergency. On this point, the evidence from clinicians was categorical and I have no difficulty with those aspects of the Bill. For complete clarity, I believe that where a medical issue arises which poses a risk to the life of the mother; the clinicians must be empowered to do whatever is necessary to save her life. I accept that there will be times when this results in the loss of the unborn baby. I understand this type of intervention happens in maternity hospitals throughout Ireland between 30 and 40 times a year.

On the question of suicide, the Government's essential argument is that the Supreme Court's decision in the X case which provides for a termination where there is a real and substantial risk to the life of the mother, including the threat of suicide, must be legislated for. It also cites the decision of the European Court of Human Rights, ECHR, in the A, B and C v. Ireland case, although I note and accept the Government has stated the ECHR judgment did not require it to legislate for suicide as a ground for an abortion. I listened carefully to the legal arguments made at the health committee on whether Ireland had to legislate for suicide as a basis for abortion. On one side, some eminent legal experts argue that the X case judgment is the law of the land and must be legislated for. Other equally eminently qualified legal experts argued differently. The key question is whether the Supreme Court's interpretation of Article 40.3.3o in the X case is definitive in all circumstances and determinative for subsequent legislation.

Dr. Maria Cahill, a lecturer in constitutional law in University College Cork, who gave evidence to the Oireachtas committee said the X case was in a separate category of judicial decisions because of what it did not decide. She went on to say a precedent was only binding relative to the points decided in the case. The evidence in the X case on the suicide question was not contested and, according to Dr. Cahill, did not constitute a precedent. I am not a constitutional lawyer and Deputies with different views on the Bill can quote other legal experts to support their argument. I accept that. However, when I hear legal experts, all of whom I respect, fundamentally disagreeing on the key question of whether the State has to legislate for abortion on the grounds of suicide, I must make up my own mind on the basis of what I believe to be right and wrong.

The key issue for me is that there is no evidence whatsoever to suggest a real and substantial risk to the life of the mother caused by suicidal ideation can ever only be averted by the termination of the pregnancy. That is what the Bill provides for in section 9, that an abortion can only be permitted on suicide grounds where it is the only way of averting the suicide. When the Oireachtas is making decisions, it turns to experts, particularly when deliberating at committee level. The experts in psychiatry are overwhelmingly telling us the same thing, that abortion is not a treatment for suicidal ideation. I am entitled to ask the question: is abortion ever the only answer for somebody with suicidal tendencies? Even more importantly, is it ever the answer?

The Government has made the point that it is not possible to introduce term limits for abortion in the Bill because of the provisions of the Constitution. One aspect of this issue causes me great difficulty. That is where an abortion is permitted and the unborn child is around the viability threshold. A baby born now at 24 or even 23 weeks gestation stands a good chance of survival. However, we all know that premature babies can suffer from serious complications. I am deeply uneasy about the possibility of the State deliberately inducing the birth of a baby at such an early stage in the knowledge that by doing so the baby may well have profound lifelong disabilities or suffer from serious medical complications. While I hope this will never happen, the Bill opens up this scenario and I believe it is one with which most people would have a real difficulty.

I acknowledge that mental health has been the Cinderella of the health service for far too long. I acknowledge that suicide is pervasive in our society. In many ways, it is a silent killer and, as a people, we have not given it anywhere near the level of attention it deserves. I acknowledge that suicidal ideation among pregnant women can and does happen, albeit very rarely. I just do not believe intentionally taking the life of the unborn child is the answer, nor do the experts in psychiatry who have spent their lives studying and working in the field.

It is no secret that, from the outset, I supported a free vote for Fianna Fáil Deputies and Senators on the Bill. I did so because I believed the issue of protecting human life was an issue of personal conscience like no other. I was strongly of the belief no member of our parliamentary party should be able to impose his or her view on the Bill on another member of the party. That is my belief, irrespective of whether my view on the Bill is a majority or minority view within the parliamentary party. All parties should allow their members to vote in accordance with their conscience on this issue.

The Labour Party has long called for legislation to be introduced on the X case, but the same cannot be said for Fine Gael. In fact, during the last election campaign Fine Gael actively courted the support of those involved in the pro-life campaign on the basis that it would not introduce legislation on abortion. For that reason, I have enormous sympathy for the many Oireachtas Members within the Fine Gael Party who are deeply uncomfortable with the Bill. These Members went to the people and received their support on a Fine Gael platform of no abortion legislation. They now find themselves subject to a parliamentary Whip to support a Bill that their party promised it would not introduce. Regardless of whether one agrees with the Bill, that is deeply unfair to those Deputies and Senators.

I accept that the Bill will be passed by the Oireachtas, probably with a very large majority in this House. I ask the Government to monitor its implementation extremely closely.

As an opponent of the Bill, I have not subscribed to the view that the floodgates will open as soon as it is passed. However, the interpretation of the Bill and the practice of its implementation could well change over time. I am pretty certain they will.

Suicide is tragic in all circumstances. We heard evidence during the Oireachtas committee hearings that suicide among pregnant women is, I am thankful, extremely rare. The incidence is somewhere between one in 250,000 and one in 500,000 pregnancies.

Once the Bill is enacted, the Minister will need to assess the data coming through on the actual number of abortions being carried out. Over time, information on the number of abortions under this legislation will answer the question of whether we are moving towards a more liberal abortion regime on mental health grounds.

The Constitution provides for an equal right to life for the unborn and the mother. There are Deputies who wish to remove that clause from Bunreacht na hÉireann, but I disagree with them. There are those who believe the Bill is a stepping stone to a more liberal abortion regime. I hope they are wrong but genuinely fear they are right. I will be voting against the Bill for the reasons I have outlined.

I welcome the chance to speak on the Bill and I, too, welcome the tone of the debate in this Chamber thus far. Since Thursday, the debate has generally been respectful of the very divergent views on this divisive subject. The subject goes far beyond the traditional political battle lines in this Chamber. The work done by the Joint Committee on Health and Children is a significant element in contributing to the tone and informed nature of the debate. The Chairman and members of that committee deserve credit for the way in which they ran their hearings and facilitated people's views. They also deserve credit for allowing for the airing of the experts’ views that we require to make a judgment on this Bill. As we conclude the parliamentary discussion on this Bill, I hope we will maintain the air of respect for divergent views. As Deputy Seán Kyne said, this debate will continue far beyond the implementation of the Bill. It is now very likely that it will be implemented. I agree wholeheartedly with Deputy Michael McGrath that robust monitoring will be required when the Bill is implemented to ensure its provisions are not abused or extended beyond the intended scope.

I heard many Government Deputies, particularly Fine Gael Deputies, cite today their personal respect for the Taoiseach and the Minister for Health. They expressed the view that the Taoiseach and the Minister would never want to see this Bill go beyond its intended purpose, and I accept that. I am a constituency colleague of the Taoiseach and accept his bona fides on this. However, it is clear that there are Deputies on the Government side, including in the Labour Party, who have stated in their manifestos for many years that they regard this type of legislation as a stepping stone to a more open regime. The difficulty will arise when the current Taoiseach and Minister are no longer in the House and when future Ministers and Taoisigh are in office. It is then that the legislation could open the doors to the liberalisation of the abortion regime. What are the intentions of those introducing the Bill? I fear that once the door is opened, those intentions will be trampled upon.

Sections 7 and 8 of this Bill will bring legal clarity to the treatment of a pregnant woman whose life is at risk arising from a physical illness. There was no disagreement during the hearings on these provisions and the need to tighten them. There is an agreed medical understanding of the path of a physical illness, and there is generally agreement on a relevant and effective treatment path to restore the health of the woman in question. However, this does not apply regarding section 9. The hearings demonstrated that there are considerable professional differences when it comes to understanding of the causes of suicide and, consequently, there is no professional agreement on detecting and treating the underlying causes.

I absolutely agree with Deputy Joe McHugh that we should assist those with suicidal intent in presenting themselves immediately to the health service, in whatever condition, for treatment, but the reality is that the country is undergoing a crisis in regard to suicide and mental illness. One reason is that we do not have an agreed understanding of the causes of suicide and what would bring somebody to the suicidal state. If we did, we would intervene to prevent it. Nobody in this House wants anyone to experience the pain that suicide brings to a family. We would do everything to prevent suicide if we understood it and if we were in a position to work with those who seem to get to the point at which they feel there is no support for them.

In this legislation, we are being asked to end unborn human lives - the legislation uses the phrase "to end an unborn life" - as a treatment for a condition that we do not properly understand. As a legislator and given the professional and medical vacuum, I cannot bring myself to support that concept. We must make a decision on this as legislators today. Judges can make a decision on legal arguments. There is a considerable legal vacuum also. Various medical professionals may have medical disagreements but legislators are being asked to allow the legal ending of human life. In the absence of legal and medical agreement, I cannot bring myself to do that. I cannot support the Bill as long as this measure is in place and as long as the disagreement continues.

There are other difficulties with the legislation despite all the work that has gone into its drafting. The language is still considerably loose. Loose language in legislation will lead to avenues being pursued that people might not have envisaged. In legislation that proposes to end human life, one cannot do that. The language associated with term limits is still very loose, and the language of the provision dealing with the potential to bring a foetus on the cusp of viability to early birth is very vague. The Minister for Health, Deputy James Reilly, more or less admitted this some weeks ago on "The Week in Politics" when he stated that babies with disabilities could be born as a result of the measure. We cannot have that in this legislation.

I agree with the opinion of the former Director of Public Prosecutions. I stated the opinion before he did. In section 9 and elsewhere, we are unbalancing the principle outlined in Article 40.3.3°, namely, the equal right to life of the mother and child.

Legislators do not have the comfort of the Judiciary which can publish an opinion and then have it parsed by legal experts. The burden of acting on that opinion and influencing the lives of the unborn or born falls on us. That is a heavy burden in this context. Given the medical and legal vacuums, I will not be able to and cannot support the Bill.

When listening to Deputies Michael McGrath and Dara Calleary, I noted the traditional political approach of dividing the coalition parties by saying the Labour Party had always made one point, while Fine Gael always made another, thereby implying they were totally divided on an issue. We are not divided; this legislation was agreed as part of the programme for Government and we agree that it is to pass through this House. We heard the old canard from both Deputies that the floodgates would open and that this really was the thin end of the wedge.

This legislation will carry out the wishes of the people as expressed in several referendums which are part and parcel of the Constitution. That is our duty as legislators. We do not have the privilege of exercising our conscience on matters of this nature. We had the privilege of exercising our conscience when we voted in the referendums, but once something is an integral part of the Constitution, we, as democratically elected legislators, must implement the will of the people. This legislation reflects this. That is expressed in the Constitution and we must enable it through legislation. That is why after so many years we are grasping this nettle which was not grasped by many Governments. We are providing clear regulations in order that the medical profession, the responsibility of which is to deal with this issue, has direction. It has had no direction until now and it is operating in a vacuum. We cannot allow that to continue forever because there is a constitutional imperative that we must address.

I welcome the opportunity to contribute to the debate and I am pleased this long overdue legislation is finally before the Oireachtas. Six successive Governments have failed to address this crucial issue. The Government knew it was intolerable to avoid dealing with such an important issue any longer. It is more than 20 years since the X case and medical practitioners must finally be given the legal clarity they require to act in the best interests of their patients. This is essential to ensure the lives of pregnant women are protected. For many years the Labour Party was the only party calling for legislation to deal with the X case judgment and a commitment was made in the programme for Government in 2011 to establish an expert group to establish the best way to proceed. The group which reported earlier this year offered clarity on the options available to deal with the implications of the Supreme Court ruling in the X case and the ECHR judgment in the A, B and C v. Ireland case. The Government has acted as quickly as possible to introduce legislation, while allowing ample time for debate. No guillotine will apply to this legislation.

It is difficult to fully comprehend what it must have been like for the 14 year old girl at the centre of the X case. Following two years of abuse by a man known to her family, she was raped and became pregnant. Her parents tried to help and protect her in any way they could, but the State intervened to prevent a suicidal rape victim from leaving the country to obtain a termination. She found herself the "defendant" in a High Court case. The court ruled that she should be prevented from travelling to protect the life of the unborn child. In March 1992, however, the Supreme Court ruled that the decision of the High Court should be set aside and that the threat of suicide was grounds for an abortion. The referendum in November 1992 clearly showed that the people supported the freedom to travel outside the State for an abortion and the freedom to obtain or make available information on abortion services. Moreover, the constitutional amendment that would have resulted in the Supreme Court ruling on the X case being rolled back was rejected. The rejection of the 2002 referendum also ensured the risk of suicide continued to be sufficient grounds to allow an abortion.

On two occasions referendums have attempted to remove suicide as lawful grounds for a termination and on each occasion the people rejected the proposed changes to the Constitution. Article 40.3.3° states: "This subsection shall not limit freedom to travel between the State and another state. This subsection shall not limit freedom to obtain or make available, in the State, subject to such conditions as may be laid down by law, information relating to services lawfully available in another state". Clearly, the context was that the termination would be made available in another state. The people spoke on this issue and we have to recognise that was the wording put before them and that it is the law of the land. Enabling legislation is needed to elaborate on it to allow the medical profession to carry out its business properly, yet even with these referendum results, previous Governments continued to prevaricate. In the A, B and C v. Ireland case in 2012 the ECHR found that Ireland had violated the European Convention on Human Rights by failing to provide a clear procedure by which a woman could have established whether she qualified for a legal abortion under current Irish law.

The tragic death of Savita Halappanavar in October last year again highlighted the urgent need to legislate. This heartbreaking case drew attention to the problems medical practitioners could face when acting to save the life of a women during pregnancy. A common thread running through each of these cases is that the women involved found themselves in desperate situations and were then failed by the State and legislators. This cannot be allowed to continue. A great deal has happened since the X case, but until now no progress has been made in dealing with the clear need to legislate for it. The provisions in the Bill address scenarios where a woman's life is at risk from either a medical emergency, a medical condition or a risk of suicide. They are workable and it is welcome that they closely reflect the expert group's recommendations.

Legislating for the X case is a serious and legally complex issue. However, it is primarily about protecting the life of the woman. We cannot continue to put the lives of women at risk. It is essential that we finally face up to our responsibilities as legislators and obey the will of the people as expressed in the Constitution to ensure this legislation is enacted.

I am grateful for the opportunity to contribute to the debate. Twenty one years is a long time to wait for a Supreme Court decision to become law, but the fact that the Bill is before us represents progress. It will be an historic day next month when it is enacted.

As the Minister of State said, the Labour Party has campaigned for this legislation since the Supreme Court judgment. We knew it was essential in the context of the debate on women's health. The programme for Government contains a commitment to implement the recommendations of the expert group on the ECHR judgment in the A, B and C v. Ireland case and the Supreme Court's judgment in the X case. I am proud that this commitment has been met in the legislation.

The issue before us has the ability to divide opinion in Ireland like no other. I vividly recall the 1983 referendum campaign and the strength of feeling in both camps at the time. I was in college and recall debates late into the night on the issue. Then, like now, the debate has brought out the best and the worst in people on both sides. Over time, the moderate voice has often been drowned out easily when the debate has been in full flow. While this legislation was in process, I received all types of correspondence and it was all different in tone and content. I received postcards, DVDs, text messages, handwritten letters, telephone calls, e-mails and visits to my office. Most of this communication has been civil, but some of it has been unpleasant. If those campaigners had put as much energy into campaigning for children's rights, Ireland would be a different place.

The debate is about the lives of women and making sure they have access to the medical treatment they need when they need it. When the Bill is passed, there will be improved clarity on what procedures can be carried out when they are needed. That will be a positive development for women's health, although I fully accept that the legislation will mean that some women who need terminations because of fatal foetal abnormalities will still have to go overseas to ensure their lives are protected. We should not export health care problems. I trust women to make their own decisions about their bodies and health.

This legislation is long overdue and its introduction is in line with the commitment given in the programme for Government. It reflects the recommendations of the expert group and the intentions of the people. I support it for all these reasons.

I welcome the opportunity to contribute to this debate. As others have said, it would have been far more comfortable for the Government to do as six of its predecessors did by simply ignoring the need to address the constitutional position on abortion. However, the European Court of Human Rights has pointed to our obligation to give certainty on that position either by way of legislation or regulation. We have had neither since the approval of the eight amendment to the Constitution in 1983. Last night we voted on the legislation which paves the way for the referendum to be held on the 31st amendment. In the years since the approval of the eight amendment, 22 other amendments have been put to the people and, where necessary, acted upon by way of legislation or regulation. If the Supreme Court had determined in 1992 that suicidality was not a ground for abortion, I am in no doubt that there would have been demands for legislation to that effect from some of those who claim this legislation is not necessary today. Moreover, I am sure that such demands would have been met.

The purpose of the Bill is to reflect and restate the general prohibition on abortion and uphold the eighth amendment. In addition, however, it must reflect the fact that the Government is duty bound to provide legal certainty for the medical profession as to the circumstances in which it is permissible to perform an abortion. The Constitution provides that a termination is permissible where the life, as opposed to the health, of the mother is at risk. Taking account of the decision of the Supreme Court in the X case which arose from the provisions of the eighth amendment, the Bill includes provision for abortion where there is a risk to the life of the woman arising from suicide. Several commentators have argued that the decision in that case was based on insufficient evidence. Section 9 of the Bill offers assurance in that regard in its stipulation that an abortion will only be permitted where it is found to be the only possible treatment for suicidality. That is a condition which is very difficult to ascertain beyond all doubt. There may be cases where a history of mental illness and perhaps threatened or attempted suicide will make it possible to state unequivocally that there is such a risk. In general, however, it will be difficult to arrive at that conclusion. The Government was duty bound to reflect that reality in these provisions.

We can assess the Bill on the basis of whether it achieves these basic requirements. Everything else flows from them. The Bill is short, given the scope of the issues it is attempting to address, issues which were not dealt with by previous Governments. Even if no Member of the House was subject to the Whip on this proposal, it falls to every one of us to examine whether the control measures that surround the basic principles of the Bill can be reconciled with our personal views. For me, the Bill satisfies that test of conscience. If I had my way, suicidality would not be included as a ground for abortion. As the Minister of State observed, however, that is not a luxury open to us. We are duty bound as legislators to reflect the constitutional position.

I would also have preferred if provision were made in the Bill to address the issue of fatal foetal abnormalities. As I understand it, the current position is that early induction can take place, at 35 or 36 weeks, where a foetal abnormality, which means the foetus is totally incompatible with life outside the womb, is diagnosed beyond all doubt. Other Members and I have met parents who went through that experience and their anguish is palpable. They are making a case for legislation in this area, not for themselves - one hopes they will never go through the same experience again - but for the benefit of those who will go through the same ordeal in the future. As I said, I would have liked to see the matter dealt with in this legislation. I understand, however, that the Attorney General's advice is that it cannot be done because it would contravene Article 40.3.3°. I accept that position reluctantly. In any case, it is an issue that should be dealt with outside this debate.

I do not accept the argument that the Bill represents the wedge that will allow the abortion floodgates to open. It has been clearly articulated that any change to the existing constitutional position would require a referendum. Even if we decided tomorrow to abandon these proposals and allow the next Government to deal with the issue, those people who are seeking a more liberal abortion regime and greater choice for women would not cease their efforts. That push will continue, regardless of what happens today, tomorrow or next week. We must put our trust in the people if at some time in the future they are asked to make a decision in that regard. It is not for us to tell them what to do. It may be a matter for the Government to decide to hold a referendum, but after that, it is up to the citizens of the State. When people refuse to put their trust in this legislation, they are effectively refusing to put their trust in what others, their fellow citizens, will choose to do in the future. We must keep that context in sight when considering these proposals.

It is unlikely that a more divisive Bill will come before any of us during the course of our careers, whether long or short, in this House. I absolutely respect the opinions of others and recognise that they are heartfelt and sincerely held. I hope everyone would do the same. I do not like the labels of pro-life and pro-choice. I consider myself to be as pro-life as anybody. I do not want to see a regime in place which allows abortion on demand, but I recognise that there are some who are up-front in supporting exactly that. On the other hand, some are of the view that anybody who would attempt even to introduce legislative provision to reflect the current constitutional position on abortion cannot call themselves pro-life. I reject that assertion.

People have found plenty of scope to complain about the Government and this Dáil. In this instance, however, there is reason to commend the conduct of the debate. There is certainly an element of divisiveness, but, in general, people are concerned to articulate their firmly held beliefs rather than to score political points. That is most welcome. It is important that as many Members as possible put their view across in this debate. I commend the Bill to the House.

I thank the Members of the Technical Group for allowing me some of their speaking time on this most important subject. The Government has repeatedly claimed that this legislation, entitled the Protection of Life During Pregnancy Bill, is designed solely to enhance and promote the best possible care for pregnant women in order to ensure no woman dies because of her pregnancy. If I believed that were true, no Deputy would be more supportive of the Bill. I am firmly of the view that Irish women are entitled to the very best standards of health care during their pregnancies. Moreover, I am certain that in the vast majority of cases that is precisely what they receive. I acknowledge and very much respect both sides of the argument in the abortion debate. That being said, it is my personal view that from the time of conception, the unborn child is a human being and should be fully protected. It is of vital importance that all right-thinking politicians support that viewpoint. The unborn child cannot speak for itself and so we should speak on its behalf.

Aside from my view on the broader issue, there are several points that should be highlighted in the context of these provisions. We have been repeatedly told that this legislation is required because of the ruling of the European Court of Human Rights in Strasbourg. The reality, however, is that the court merely stated a requirement for us to clarify existing law. That could have been done and could still be done by way of guidelines. There is no need to legislate. I challenge the myth that legislation on this issue must be based on the judgment of the Supreme Court in the X case and the finding of the European Court of Human Rights in the A, B and C case.

The X case lacks psychiatric evidence, that is, there is no evidence. No studies have indicated that abortion is a treatment for suicidal intent. The decision in the A, B and C case involved a pregnant patient looking for what treatment was available to her. As she was not suicidal, an abortion based on mental health grounds would not have applied. In a modern republic people are supposed to be equal before the law. Under the Constitution, as written, the unborn child has an equal right to life, but as the former Director of Public Prosecutions and a former Taoiseach, Mr. John Bruton, have pointed out, the Bill does not give the unborn child an equal right to life. It directly discriminates against the unborn. Where is the republican ethic in this?

The complete lack of a justification for the procedure for the unborn child is not equal or just. The Bill has no provisions stating an option for the child to be delivered prematurely in cases based on mental health grounds, suicidal intent. If the child would be able to live if delivered prematurely, why is that option not considered? The Bill also does not state it is the duty of medical professionals to take into account the welfare of the unborn child when deciding on intentional termination of the pregnancy. Equality, clearly, is not present in this legislation.

The legislation does not set a time limit for the termination of the pregnancy making it unsafe for the mother. Even the most pro-choice of individuals believe terminating a pregnancy after 28 weeks is dangerous and not medically smart. Furthermore, if abortions are only granted on mental health grounds, the likelihood of a restrictive and rigorous assessment on which the decision will be based is very questionable. Who says the two high threshold tests to determine the decision will be satisfied? The fact that there must be a real and substantial threat to the life of the woman and that the risk involved can be avoided only by a termination of the pregnancy is not enough on which to base the granting of an abortion. The guidelines are not enough. They will only widen through time and future circumstances. The woman has a right to withhold consent to any medical treatment in which termination of the pregnancy can be the only option remaining to save her life. She might find a loophole, but it does not reflect the Government investing in the interests of women's health.

The Government's fine words about women's health have a very hollow ring when we look at its total failure to follow up on the revelations of the disgraceful conduct of staff at certain Irish Family Planning Association, IFPA, clinics where women were told to lie to their GPs and say they had had a miscarriage, not an abortion. That was disgraceful and it was highlighted here a few days ago by Deputy Mattie McGrath when he spoke on this very important matter. It was disgraceful. They were told to do this if they had had complications following an abortion. The Master of the Rotunda Hospital said this advice could threaten women's lives. What IFPA counsellors were engaged in is an unbelievable scandal. If the Government was really concerned about women's health, it would have ensured such reckless behaviour was rooted out of a service which the taxpayers funded. Instead, after promises of an inquiry, little if anything has been done by a standards investigation set up by the Health Service Executive, headed up by the former head of the IFPA. I raised this matter by means of a parliamentary question a few days ago when I asked whether it was an inquiry or what type of investigation was taking place because it changed from one thing to another. As far as I can see, it was only a cover-up.

It is an absolute disgrace and makes a mockery of the Government's much-heralded care for women.

During the course of this debate we have witnessed a lot of grandstanding by the Government on the need to become a more modern country. Abortion will not necessarily treat suicidal intent or depression. I would like to give a couple of true examples that are documented and backed up by real people. One says her boyfriend, the father of the baby, committed suicide on the anniversary of the abortion, that her father became very depressed and ended up in hospital. Another says she was a happy-go-lucky girl until the abortion, but now she is always depressed. She has tried to commit suicide. She could not cope with her other kids after the abortion. Now they are being minded by somebody else. She is pregnant again and says she is in a far worse situation than the first time. After having an abortion, women usually suffer panic attacks, isolation, low self-esteem, nightmares, depression, etc. They were not warned about the mental effect of an abortion.

I thank the politicians and other witnesses who attended and gave a great deal of time to the Oireachtas Joint Committee on Health and Children hearings, but it was a disgrace that the committee did not hear from groups such as Women Hurt, women who regret their abortions. Many of these women have visited the Oireachtas in recent months and they are deeply saddened by the way the Government dismisses their stories-----

They wanted to come in.

-----and the hurt and pain they carry following their abortions. If the Bill is also based on evidence, why has that evidence not been presented? It is as if one wrote an academic paper in a university and did not source any of one's information. One would receive a fail grade and be in trouble on grounds of plagiarism. Where is the evidence to back up the provisions included in the Bill?

Likewise, the Government cannot claim that it has reached out to the women affected because it has not. It has ignored them every step of the way. It is interested in only one side of the story. That is not democracy and not the way of a true republic. The Bill is not life-saving. If it were, I would be the first to support it, but I cannot support it and will not vote for it. I compliment Deputy Micheál Martin and the Fianna Fáil Party on allowing a free vote because it is proper and right to allow people to make up their own minds and not to impose the Whip system on people elected by the people in their constituencies to come here to use their intelligence, their own research and experiences of life.

Responsibility.

Yes, responsibility, exactly. They were elected to be responsible for themselves and their own vote. They are answerable first to themselves, their own heart and soul, their own brain and intelligence and then, of course, their electorate. It was wrong of the Taoiseach to impose the party Whip system. It is extremely disrespectful, particularly because of the enormity of the issue we are discussing.

I want to go back to 1967, the year I was born. In England at the time politicians, who I honestly believe thought in their own hearts and souls that they were doing the right thing, voted for the changes which allowed the system in place today.

Debate adjourned.
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