Deputy Denis Naughten has 14 minutes remaining.
Protection of Life During Pregnancy Bill 2013: Second Stage (Resumed)
I was about to make the point last night that the argument about suicide and the defence being made for its inclusion in the legislation is based on the Supreme Court judgment in the X case, that we must act on that judgment because this is now the interpretation of the Constitution and we cannot introduce legislation which contravenes the Constitution. Law is not always logical. Usually the problem arises with historical law, not with new law.
I remind Members of the controversy in this House and in committee in 2009 on the issue of blasphemy. Members will recall that blasphemy is specifically provided for in the Constitution. Bizarrely, since the adoption of the Constitution in 1937, it took until 1961 for such a law to be introduced. In 2009 the issue was debated in the House when the then Minister for Justice said:
As regards the offence of blasphemous libel, I believe we would all agree that the optimal approach and certainly the one that I would probably find most preferable would be to abolish it altogether.
The Minister argued that his hands were tied, that he had no option but to introduce legislation to provide for blasphemy because it was specifically referenced in the Constitution. Yet, when that legislation was first published and brought before the House by the former Attorney General, Michael McDowell, it did not include a provision on blasphemy.
Subsequently, the legislation was pursued by the late former Minister, Brian Lenihan, who did not include a provision on blasphemy either. It was Mr. Dermot Ahern, his successor, who put forward an amendment. During the Committee Stage debate on the provision, there was a very interesting discussion. Deputy Charles Flanagan, Jim O'Keeffe and I contributed, as Fine Gael Members, as did the Minister, Deputy Rabbitte, of the Labour Party and Deputy Ó Snodaigh of Sinn Féin to argue cogently that we should not introduce a law on blasphemy notwithstanding the reference to it in the Constitution. It was proposed instead that the Constitution should be amended at the first available opportunity. It was indicated that we would not be in contravention of the Constitution if we indicated that it was our intention to amend and clarify it at the first available opportunity. It is interesting to look at the contributions. Deputy Charles Flanagan made the point that we were placing on the Statute Book an amendment laced with subjectivity which would be difficult to enforce. He said it was impractical and would create even more problems. The same argument applies to the issue of suicide, which is not specifically mentioned in the Constitution. It figures in the debate on foot of an interpretation by the Supreme Court as to what the Constitution actually means. Where there was a specific provision in the Constitution, a coherent argument was made by Members who are now on the Government benches that it should not be legislated for but rather that we should amend the Constitution to remove an unworkable, impractical provision.
The suicide provision in the Bill is impractical, unworkable and full of subjectivity. I have articulated some of my concerns already. A further concern is that it is impossible to disprove suicidal ideation. Professor Veronica O'Keane, who gave evidence to the joint committee on two occasions, made the coherent argument that if a woman states that she is suicidal, a practitioner has no option but to believe her. There is no way to disprove the claim. I do not believe that women would make false claims, but there is no medical way to assess that whatsoever. I spoke to a psychiatrist during the week who pointed to an electrician who was rewiring a socket and said "That man over there is equally qualified and capable of making the determination in relation to suicidal ideation as someone like me with years of experience". Specifically in relation to suicidal ideation, it is impossible to make the determination. There is no medical assessment available.
It is disingenuous of the Government to talk about implementing the X case judgment. It should be crystal clear. Rather than introduce an Irish solution to an Irish problem, it should be straightforward and honest about stating it wants to provide for a limited form of abortion in this country. In fairness to the Minister of State, Deputy Kathleen Lynch, she has made her position quite clear on that up to now. In fairness to the vast majority of the members of the Labour Party, that is their position and view.
Legislation should be published on that basis to facilitate a discussion of the pros and cons of it rather than to use suicide as a Trojan horse to bring in this particular mechanism.
What about the Constitution?
The difficulty is that the suicide provision provides for a more liberal abortion regime than exists in the United Kingdom. There are no term limits on it, which means it provides legally for late-term abortions. I acknowledge that it is not the intention of the Government or parliamentary draftsman to make that provision, but the Bill as drafted so provides. All the evidence from those in favour or against the legislation which we heard at the joint committee made it clear that late-term abortions can have serious mental health outcomes for women. We can all agree on that.
In raising specific issues of concerns on late-term abortions, I turn to the evidence of Dr. Sam Coulter Smith, the master of the Rotunda. He stated to the joint committee:
The fact that there is no gestational limit in respect of the third scenario relating to suicidality is a major ethical issue for obstetricians. I will illustrate this with two scenarios. First, let us consider the case of a patient who is 25 weeks' gestation. If she is deemed to be sufficiently suicidal to require a termination of pregnancy by one or more psychiatric colleagues, an obstetrician who is tasked with dealing with this situation is faced with an enormous ethical dilemma. Delivering a baby at 25 weeks' gestation could lead to death, due to extreme prematurity or it could lead to a child with cerebral palsy or with other significant developmental issues for the future.
That is the evidence he gave to the committee. What happens to a woman who is suicidal due to having a foetus with a serious abnormality and a very limited lifespan of perhaps minutes or hours after birth? Medical science allows this determination to be made, usually around the threshold of viability at 21 to 23 weeks. What if a woman is suicidal on the basis that she does not want to give birth to this particular baby? In order for the obstetrician to meet the medical requirements set out in the legislation, there is a need for the sake of the woman's mental health and the threat of suicidality that the foetus is not born alive. That means it is vitally important that the foetus is made unviable in utero. That causes huge ethical issues not only for medics but for many in the Oireachtas. I hope the Minister deals specifically with that issue in his reply on Second Stage or on Committee Stage. It is a genuine concern and anomaly in the legislation as drafted. It is a weakness in the legislation that there is no specific provision for the unborn who is potentially viable outside the womb to ensure that a medical procedure shall not impede all efforts to sustain life on the complete emergence of that baby after birth from the body of the woman. These are the terms of an amendment I have put down for discussion on Committee Stage. While it is not the intention of the legislation to create this anomaly, it causes problems as drafted and must be clarified.
It is important to consider suicide and the approach of the courts. I refer to the case of Cosma v. Minister for Justice, Equality and Law Reform. In that case, a woman who did not want to be deported from the State expressed suicidal ideation as her reason for requiring the court to quash the deportation order. She made the case that if she was returned to her country of origin, she would die by suicide. The High Court rejected the evidence presented in support of the claim of threatened suicide. The court found that the applicant had no treatment plan and was not undergoing therapy, without either of which the court could not determine whether there was a real and substantial risk to her life, which is the test set out in the X case. If the High Court is correct on that, its judgment is contravened by the legislation before the House.
If a woman is receiving treatment or an alternative of treatment is available to her for suicidal ideation then she is legally not entitled to a termination under section 9 of the Bill, yet the High Court determination was that in order for there to be a real and substantial risk she must be receiving treatment. There is a contradiction in both of those and the High Court determination is based on the Supreme Court judgment.
The final point I want to make is that the Government, at the time of its initial decision in December last, as I referenced earlier in my contribution, made the point that it would introduce primary legislation and regulations. As the House will be aware, there are regulations to come in this regard. At the time, the Taoiseach made it crystal clear that we would have both the primary legislation and the regulations in front of us to consider during the passage of this legislation. We have not seen any regulations. We have not been given any indication as to the content of those regulations and it is wrong to be considering the primary legislation without the secondary legislation also being before us. Both, in the case of this legislation, work hand in hand. It is difficult to interpret the intention of the legislation and I have raised some difficulties with the interpretation as currently drafted. I presume the Minister's defence in that regard will be that the matter will be provided for in regulations. We were promised by the Taoiseach in December last that we would have the regulations in tandem with the primary legislation. We have not seen those regulations. We should have those regulations. It is difficult for this so-called reformed parliamentary democracy to debate an issue with one hand tied behind its back when we have not seen the other element of the legislation. I would hope that in advance of the completion of Second Stage we would see the publication of those regulations.
I am sharing time with Deputy Donohoe.
I am glad that I had the opportunity to hear Deputy Naughten, a man whom I respect and whose knowledge of matters in this House is fairly extensive, but I must say, with no disrespect to the point of view that he expressed, that when one resorts to the minutiae of Supreme Court interpretation in a Second Stage debate, it would appear that many on the other side of this debate recognise that the country has moved on in this matter and a rearguard action is being engaged in.
I welcome the Bill to the House. As the second longest-serving Deputy in this House, I have for many years witnessed first hand the division, pain and political reluctance to deal with the sensitive issue of abortion since the Eighth Amendment of the Constitution Bill was passed in 1983. That referendum was an inspired political stunt to win the support of the so-called pro-life lobby during one of the most tumultuous periods of our democracy. Prior to the calling of the 1982 general election, the then Taoiseach, the late Mr. Charlie Haughey, published the wording of an amendment to protect the life of the unborn that had been imposed upon him by the pro-life lobby. Immediately and sadly, former Taoiseach, the late Dr. Garret FitzGerald, endorsed it and promised a referendum on it in April 1983. I have always been of the personal view that the wording in that amendment was flawed from the outset. While it may have been an astute political tactic to win votes in elections, the wording of the amendment was anything but astute.
The pro-life lobby had become exercised by the jurisprudence of the Supreme Court in the 1970s, which, the lobby claimed, had begun to find unenumerated rights within the wording of the Constitution. The case which generated most concern in this regard was McGee v. Attorney General, where the Supreme Court held that the imprescriptable rights of the family conferred a broad right upon spouses to privacy in marital affairs and, in effect, legalised the import of contraceptives. The fear that the courts may introduce abortion rights through the back door was what led the pro-life campaign to amend the Constitution. The irony is that once they extracted a pledge from intimidated politicians to do just that, the wording of the eighth amendment actually gave rise to the very situation which they sought to avoid. If we are to learn anything from this episode, it is that the Constitution is not something to be tampered with lightly.
Indeed, I recall the Attorney General of the Fine Gael-Labour coalition of that time, Mr. Peter Sutherland, providing legal advice which stated that the proposed wording would essentially pit the rights of the mother against the rights of the unborn child. In the event, with Deputies under intense pressure from the pro-life lobby, the alternative Sutherland wording was rejected, yet that alternative wording was endowed with accuracy and foresight. The X case, in 1992, to which many in the House have referred already, shocked and appalled Ireland. It also led the Supreme Court to rule that the Eighth Amendment meant the right to life of the mother had to be balanced against the right to life of the unborn child.
Ever since, we have known what is the constitutional interpretation of Article 40.3.30. There is, of course, a right to life for the unborn child, but there is also a constitutional right for the mother to have her life protected. However, that fundamental, constitutional right has never been vindicated in real and practical terms by these Houses. Instead, over many years we have had to watch a steady stream of women travel to Britain to access abortion services to uphold their health. I hope the stream will be reduced somewhat by this legislation.
I want to put on the record of the House my personal appreciation and admiration for the three brave women who took A, B and C v. Ireland to the European Court of Human Rights in Strasbourg in recent years. I want to reflect for a moment on the different personal circumstances of these three women because they are sad examples where, in 21st century Ireland, the human rights of women to have an abortion here may have been accepted in theory but were denied in practice. They are good examples of why we need this legislation.
The first applicant was unmarried, unemployed and living in poverty. She became pregnant unintentionally, believing that her partner was infertile. She had four young children, all at that time in foster care as a result of problems the applicant had experienced as an alcoholic. During the year preceding her fifth pregnancy, the applicant had remained sober and had been in constant contact with social workers with a view to regaining custody of her children. She considered that a further child at this critical moment in her life would jeopardise the successful reunification of her existing family. She decided to travel to Britain to have an abortion. The United Kingdom's National Health Service refused to carry out the operation at public expense and she had to borrow the money for treatment in a private clinic from a moneylender. Her difficulty in raising the money delayed the abortion by three weeks. She had to travel to England alone, in secrecy and with no money to spare, without alerting the social workers and without missing a contact visit with her children. On her return to Ireland she experienced pain, nausea and bleeding for eight to nine weeks, but was afraid to seek medical advice because of the prohibition on abortion.
The second applicant was single when she became pregnant unintentionally. She was advised by two different doctors that there was a substantial risk that it would be an ectopic pregnancy, where the foetus develops outside the uterus. The applicant was not prepared, either to become a single parent or to run the risks associated with an ectopic pregnancy. She travelled to England for an abortion. On her return to Ireland she started passing blood clots and, since she was unsure whether this was normal and could not seek medical advice in Ireland, she returned to the clinic in England two weeks after the abortion for a check-up. The impossibility for her to have an abortion in Ireland made the procedure unnecessarily expensive, complicated and highly traumatic.
For three years, the third applicant was treated with chemotherapy for cancer. The cancer went into remission and the applicant unintentionally became pregnant.
When she discovered she was pregnant she was unable to find a doctor willing to make a determination as to whether her life, not her health, would be at risk if she continued to term or to give her clear advice as to how the foetus might have been affected by the tests she had undergone. Given the uncertainty about the risks involved, the applicant decided to have an abortion in the United Kingdom.
These cases are all incredibly sad and damning indictments of our long reluctance as a country to legislate for the X case. For too long, our democracy has been cowed by vested interests into fear and submission and into not legislating for the constitutional rights of pregnant women to have their lives protected in a medical emergency. I very much welcome the fact that we are, for the first time, dealing with this issue in a way that might make some of these cases a thing of the past. I am impressed by the reasoned and mature contributions from Deputies on all sides of the House. I welcome that this Parliament is dealing with this matter not on strict party lines but as legislators with one common goal, to ensure the constitutional rights of women in Ireland are upheld and vindicated. In doing so we must have regard to the judgment of the Supreme Court in its entirety.
For over 20 years, successive Governments have dodged this issue. I am proud, as a Labour Party Deputy, a social democrat, a feminist and a father, to be at last speaking on this Bill. We have waited so long. I believe it will give women access to the rights they are entitled to under the Constitution of this Republic. However, I would like us to be able to go further. We should be able to legislate for abortion in the cases of the health of the woman, fatal foetal abnormalities and other reasons as well. In essence, I believe it is the woman's right to choose and that we, especially men, should both respect and support their decisions. Many hold the view that our Constitution does not allow us to go beyond what this Bill proposes to do, but that is no reason that it should not be supported. The best should not drive out the good, so to speak.
Finally, this Bill will not be compulsory when enacted. People who abhor abortion in any form whatsoever will not be compelled to avail of its provisions. Ninety-seven years ago in this city the Proclamation of the Republic proudly proclaimed a new kind of Ireland. In a republic, different faiths and moral points of view should be both heard and respected but no faith, however dominant and however sincerely held by those who profess it, should be allowed to prevail over the wishes of minorities of citizens, particularly when it is intended to enshrine those beliefs into law. At one time the dominant church in this country held the view that it could impose its belief system on the law of this land in the name of the Republic. That day is over, and the enactment of this legislation will ensure that we arrive to a point where women in the Republic of Ireland do have the right to choose.
Any attempt to understand the human condition and what it means to be human must focus on the role of empathy, the ability to imagine the circumstances of another and to envisage their pain, conditions and hopes. Empathy is central to our efforts to create rules and norms for our society and to live peacefully with those we do not know. It demands that even if we do not know our neighbour, we should strive to imagine their plight.
However, empathy has limits. There are some circumstances that are beyond the ability of some of us to imagine. Ideation, to borrow a concept from this debate, can only get one so far. I find myself in this situation when discussing this Bill. As I have said previously, I find it impossible to imagine the terror and despair that a woman will experience when facing the potential loss of her own life while carrying life and the potential of life within her. Perhaps that is one of the reasons that discussing and deciding on this Bill is so fraught.
Jonathan Haidt, an American psychologist, has recently described the nature of these debates in his book The Righteous Mind - Why Good People are Divided by Politics and Religion. In this work he argues that we are intrinsically moral and that this makes it possible "to produce large co-operative groups, tribes and nations without the glue of kinship". He concludes that "morality binds and blinds". While there is great wisdom in his understanding of how morality binds us together, I disagree with his conclusion regarding its divisive consequences. My experience, based on hundreds of conversations on this Bill, is that everybody is genuinely striving to empathise. However, I cannot achieve this. While I might be able to walk in the shoes of others, I cannot identify with the journey to the hospital or for thousands of others the journey to the boat or the aeroplane.
Faced with this difficulty, I have continually focused on two duties: first, that the State must do everything possible to keep mother and child alive and healthy; second, that those involved in this dilemma must be protected by the law as they operate within the law. These two duties lead me to two consequences. The first is that the law must be absolutely clear. We have learned to our catastrophic cost the price of lack of clarity in the law in other parts of our society. Why should this be any different? The second is that a woman faced with the risk of losing her life should not face the vista of the State making a choice for her. It is our responsibility, as legislators, to create a framework within which such choices can be made and not make those choices for her.
That is the reason I support the Protection of Life During Pregnancy Bill. In the aftermath of the publication of the Ryan report I articulated in this Chamber my view that we should legislate for the 1992 Supreme Court ruling in its entirety. That judgment is affirmed by this Bill. As many Deputies have noted, the X case ruling identified that a woman has a constitutional right to termination in certain circumstances. Sections 7 to 9 of this Bill identify how these circumstances will be identified and responded to. Sections 10 to 14 prescribe how a review of this response must happen. Section 15 of the Bill makes clear how the wider State can ensure that the operation of this Bill is always consistent with its intent and aims. While new legislation will be passed by the Oireachtas, we are not changing the law. We are operating within Bunreacht na hÉireann. This is an incredibly narrow set of circumstances but that should not blind us to the intrinsic pain and solitude of each circumstance, the need for clarity and our duty to provide it.
I will make three points about the Bill. The first is about the issue of conscience. An impression has been created that some of us voting for this Bill are doing so against our conscience and our will.
If there were a free vote on the Bill in this Chamber, I would vote for it because the bare minimum that we, as legislators, must be able to provide for those we serve is clarity and certainty. It is abundantly clear, to anyone on either side of the debate, that clarity and certainty are lacking. I reject the inference that my conscience is not present in the hundreds of conversations I have and decisions I make on other issues.
The second point is on the concern that, by providing clarity and certainty, terminations will be more likely and abortion for social reasons will be inevitable. Of those who have this concern I ask how the regulation of something can make it more likely to happen. A retort is that by enshrining this Bill in primary law, precedent and purpose are created. However, this primary law is operating within the framework of the Constitution and specifically governed by Article 40.3.3°. It operates within the Constitution and the law; it does not change it. The contention about the wider availability of abortion in other jurisdictions appears to ignore the inconvenient truth that the people living in these jurisdictions want it. It also ignores that truth that many legislators in these jurisdictions are seeking to amend the law based on their own views and those of their people. I am against the availability of abortion for social and economic reasons. I support the Bill because it deals with other reasons.
The third point I wish to address is that some of the voices in this debate should reflect on their past judgments and the consequences of Article 40.3.3° and the defeat of a referendum that sought to deal with the issue of the threat of suicide. Let me quote Francis Bacon: "It is as hard and severe a thing to be a true politician as to be truly moral." I really know what that means now in regard to this Bill. However, we have a duty to be consistent with our own laws and judged by our own courts, on which our citizens, including women, depend. The Bill upholds that duty.
I acknowledge the Government's determination in bringing forward the Bill. That it took the death of Savita Halappanavar and the spotlight of the world's media to bring about action is a tragic shame, as has been acknowledged by very many in government.
I am afraid that the Bill has been divisive. It is truly a disgrace that such an important issue has been so starkly simplified as involving a dichotomy between the pro-life and pro-choice sides. If the debate should be pro-anything, it should be pro-women’s health and welfare. That is what was spoken about in the Supreme Court. In bringing forward the Bill the Government is attempting to legislate for a 21 year old Supreme Court ruling. I will be supporting the Bill. I would be loath to do anything to delay its passage. The unfortunate paradox is that, considering the 21 years it has taken for an Irish Government to get off the fence and finally legislate for the Supreme Court's ruling, the Government's response is minimal. It is dated and takes no responsibility for current concerns surrounding abortion, on which all opinion polls have been clearly decisive.
The Bill will provide no reassurance for the estimated 1,200 Irish women carrying a foetus with a fatal abnormality who must travel abroad for a termination every year. Neither will it offer any support to those women who are pregnant through incest or rape. Women who did not want to become pregnant face enormous consequences for their having been violated.
The number of sexual offences rose by almost 50% between 2007 and 2011 and by another 6.3% last year. It must be acknowledged that only a small percentage of rapes, for instance, are reported. Of the nearly 2,000 sex crimes committed in 2011, only one in six resulted in charges being brought. Financial support for domestic abuse services is being hacked away year on year. It is interesting that the Safe Ireland survey entitled, On Just One Day, showed that on 6 November last year 22 pregnant women sought help from domestic abuse charities. Campaigners believe the number of pregnant women who are being abused could be as high as one in eight. Despite this, instead of supporting women who become pregnant as a result of violence, the Bill carries the potential sentence of 14 years imprisonment for those who procure an abortion in this country. That is warped justice.
The Bill lends far too much credence to the suspicion clearly held by some Deputies to the effect that women may falsely claim to be suicidal in order to procure an abortion in this country. We have no idea how many pregnant women die by suicide. A pregnant woman faces the same risk of death by suicide as a non-pregnant woman. Many suicides are actually recorded as open deaths. Faced with the prospect of proving their state of mental health, many distressed women, I strongly suspect, will travel discreetly to the United Kingdom to have an abortion rather than subject themselves to the inquisitorial process the Bill prescribes for those wishing to avail of its provisions.
With regard to the possibility of false claims of suicidal ideation, there is no denying that desperate people do desperate things. If I were the parent of a 14 year old child pregnant as a result of rape who wanted to have an abortion, would I take her to the general practitioner and tell him or her my child was suicidal? I would if it meant she did not have to travel to another jurisdiction. Can we not think about this? At least 12 women travel outside the country every day for an abortion.
Anecdotal evidence suggests hundreds of women are using DIY abortion pills bought online, thereby risking excessive blood loss, womb infection, blood poisoning and even death. There has been a significant rise in the seizure of unregulated Internet ordered pills by the Customs service in recent years. There are many reasons women seek an abortion and we cannot continue to push these cases under the carpet and pretend they are not happening. The women concerned are asking to be heard, but they are being ignored.
I acknowledge and respect the closely held and widely varying views of Deputies on this issue. I will not be arrogant enough to demand that anyone should change his or her views, although I have been literally tormented by some of the pro-life crowd to change my views, in spite of the fact that I have told them consistently that I will not do so. What has happened to some Deputies who happened to be speaking about women who had been raped, who were carrying a child with a fatal foetal abnormality or who had been victimised has been well recorded. We have been called everything; we have been sent offensive, obscene literature, and people have come to our houses after midnight. The most offensive remarks have been made to us and even members of our families. How Christian is that? We live in a democracy and must allow people to act according to their conscience.
I call on the Government and all political parties to stop hiding behind the Whip system. Someone asked me whether the Whip would be applied if one were to make the death penalty mandatory. It would not be applied because the death penalty is absolute. How many horrendous mistakes have been made across the world in this regard? I accept that one cannot remove the Whip on the Government side; if it were, the country would not be governed at all. There has to be some order and discipline, but perhaps the Whip should have been removed on this issue.
It is a matter of showing compassion on both sides. I have met some people on the pro-life side who show no compassion when they say a woman who is raped and becomes pregnant should have to go through the pregnancy for nine months. Yesterday I met a group concerned about fatal foetal abnormalities.
Someone did say, I believe, that if the remains of the foetus were to live for one second, that would be it. What about the trauma women suffer, which affects some of them for the rest of their lives? Compassion must be shown.
With regard to commercial abortion, if a woman wanted an abortion after seven months, I would have to think about it. I would be open minded, but I am not absolute on everything. This is where the pro-life movement - I hate using the description "pro-life"; I am pro-life because I do not like to see a child die anywhere in the world - has lost the argument. The people are way ahead of all of us on this issue, as opinion poll after opinion poll has shown. Between 75% and 78% support the Government regarding this Bill, while 83% believe that if a woman is raped, forcibly impregnated and violated, she should be able to have an abortion and 87% say that abortion should be allowed in cases of fatal foetal abnormality. Why do we not listen? We are always quoting what the people want, and this is what they want. It is disappointing that provisions relating to rape and fatal foetal abnormality are not included in the Bill, but I have no hesitation in supporting it.
I welcome the opportunity to contribute to the debate on this important legislation. The Bill comes before the House following years of inaction, but I commend the Government on putting those years of inaction to an end. I will support the Bill, although it does not go far enough in a number of cases, which I will outline, and it provides for a number of penalties, which should not be included. As previous speakers said, the people are way ahead of politicians on this issue and they have shown much more compassion and understanding of the difficult situations in which many women find themselves. The issue of terminating a woman's pregnancy to save her life, or even her physical and mental well-being, is much less controversial outside the House than inside, and this has been the case for much longer than people care to realise.
Although the eighth amendment to the Constitution, made after the 1983 referendum, asserts that the unborn have an explicit right to life from the time of conception, subsequent referendums strongly suggest that public opinion began to focus on the rights of the mother. In the immediate aftermath of the X case, the Government put three referendums to the people: the twelfth, thirteenth and fourteenth proposed amendments to the Constitution. The twelfth amendment provided for the removal of suicide as a ground for abortion, the thirteenth amendment provided that women be given the right to travel outside the State for abortion, and the fourteenth amendment provided that information about abortion be available in the State. If Ireland is as opposed to abortion as suggested by some, one would have expected the twelfth amendment to pass and the thirteenth and fourteenth amendments to fail, but the opposite happened. By a two-to-one majority the people voted to reject the twelfth amendment, thereby endorsing the Supreme Court's decision on X. They also voted to allow women the right to travel for abortion and the right to information about abortion. In doing so, a majority of the people demonstrated their support for abortions in line with the X case.
A decade after the original case, the then Taoiseach, Bertie Ahern, held another referendum, effectively asking the same question as in the failed referendum in 1992 regarding suicide. The people gave the same answer: "No". In 2013 this issue has again become the topic du jour although, despite the controversy, opinion polls show that a clear majority support legislating for the X case, including the so-called suicide clause, and polls even show a majority in favour of terminations in cases of fatal foetal abnormality, incest or rape or when a woman's health is at risk. By continuing to ban abortion, we do not prevent it; we just export it, disguise it and deny it, instead of addressing these women's genuine needs, not all of which are provided for in this Bill. I am sceptical about accessibility for those that are addressed, but I recognise that this is a step forward.
While I understand that provision for abortion for instances of rape and incest would need to be put to the people, there is scope to legislate for abortion in cases of fatal foetal abnormality without infringing the Constitution. It is possible to interpret Article 40.3.3° in such a way that "the unborn", which is protected therein, does not include foetuses with fatal abnormalities. The courts have not considered this legal issue and there is no binding precedent excluding such an interpretation. Moreover, the Legislature has the power, and the duty, to legislate under the Constitution. When Mr. Justice McCarthy criticised the Legislature for failing to regulate the terms of Article 40.3.3° in the X case in 1992, he was speaking of a duty that existed prior to that case. The interpretation and regulation of Article 40.3.3° is not limited to the circumstances arising in the X case. That case showed how the general principle of vindicating unborn life with due regard to the equal right to life of the mother justified a termination in the particular circumstances of suicide risk. A different set of factual circumstances, such as those of fatal foetal abnormality, could also legally justify a termination of pregnancy given that these unborn foetuses will not live independently. It is, therefore, within the Legislature's power to act on this possibility and regulate for these circumstances and, in such instances, the Legislature has a moral as well as a legal duty to act now and include abortion in cases of fatal foetal abnormality in the legislation. The State argued in the European Court of Human Rights that if the women had gone before the Irish courts, there was a strongly possibility they would have ruled in their favour, and, therefore, the question of constitutionality does not arise.
I would like to address a number of arguments and misconceptions regarding this Bill, which it is important to clarify. There has been much discussion to the effect that the lack of a time limit in the Bill will result in late-term abortions, but this is not an accurate assumption. However, the omission of a timeframe for termination of pregnancy is necessary in order to deal with instances in which a woman's life is at risk late in pregnancy. If there was a timeframe, legally, the mother would be left to die, and in that instance both the mother and foetus would die, thereby contravening the protection of life. Where the foetus could live independently, the pregnancy would be terminated - whether as a result of risk to life from physical illness or from suicidal ideation - by induction rather than abortion. This aspect in particular is causing a great deal of confusion. There is, unfortunately, an opinion spouted by some that women will fake suicidal ideation, but this is a flawed argument. While everyone speaks of removing the taboo from mental health, in this debate some people are suggesting that women would go so far as to lie to a three-member panel of medical practitioners because they feel like having an abortion. If a woman truly felt that way, she would get the boat to the UK. The scenario is so restrictive in the Bill that someone who is suicidal would probably travel to the UK anyway to avoid such scrutiny. However, overall, this argument results in further stigmatisation of the sensitive issue of mental health and is most unwelcome to the debate.
Let us not forget that the Bill will not amend the law on abortion. It is legislating for something that has been deemed legal since 1992 by conservative middle-aged men in the Supreme Court and it is a far cry from abortion on demand and the inaccurate perception that the same thing that happened in the UK will also happen here. If people cared to read the British legislation enacted in 1967, they would realise that a referendum would be needed to allow legislation even remotely similar to that Abortion Act, and there is no possibility of the same thing happening here through this Bill and the Constitution.
I have concerns about the legislation. Conscientious objection allows for a personal opinion to interfere with a professional duty. I understand that not all relevant medical practitioners would be comfortable with carrying out the procedure, but if that is part of their job, I can see this being problematic in the longer term if and when such cases arise.
What will happen in an emergency situation, for example, where no other practitioner is available to carry out the procedure at that point in time? The Bill should include a provision to the effect that medical practitioners with a conscientious objection have a duty of care to patients in those types of emergency situations to ensure they are transferred without delay to the care of another professional who does not share that objection.
I also have concerns regarding the powers the legislation bestows on the Minister, especially the power to suspend a service where there is an ongoing investigation. While I appreciate the need to ensure these provisions are not exploited by any person or institution, it is also important that no Minister should have the capacity to exploit the legislation. Suspension of service must take place only when it is completely necessary and should be revoked as soon as possible to avoid potential loss of life during the suspension period.
It is vital that any procedures deemed permissible under this legislation are carried out without undue delay. In cases of risk to life from physical illness, any such risk should not have to be immediate or inevitable before doctors can act. The certification process envisaged in the legislation should include a timeframe for terminations to take place in order to ensure that any delay does not lead to an emergency.
That can be done via regulation.
Section 22 of the Bill states that it is an offence for a woman to "intentionally destroy unborn human life", an offence for which she will be liable to imprisonment for "a term not exceeding 14 years". If the Bill is not amended in this regard, there are serious implications for women seeking an abortion for any reason other than the avoidance of an immediate threat to their life. It will be perfectly lawful for those women to travel outside the State and have an abortion for medical or social reasons. It will be perfectly lawful for clinics outside the State to give them all the information they need on how and where to have that abortion. However, if a woman has an abortion on this side of the Irish Sea, she is liable to imprisonment for up to 14 years. The crime that merits this sentence is not having an abortion but having it in the wrong place.
The State, through the Health Service Executive, currently offers post-abortion medical and support services in locations throughout the country. These services provide what is described as non-judgmental follow-up treatment for women who have had abortions. What will happen if a woman, having taken an abortion pill she ordered online and now experiencing complications, seeks medical treatment or is rushed to hospital haemorrhaging? Under the proposed legislation, if she reveals what she has done, the hospital surely cannot be expected to be non-judgmental in the face of what the Oireachtas is defining as an appalling crime. It is fundamentally wrong that a woman in that situation would face imprisonment for up to 14 years.
An estimated 4,200 women travel from the Republic to Britain and other European countries each year to end a pregnancy. For most of them, this Bill will not permit them to have the procedure in their own country. More could have been achieved in this legislation. I do, however, recognise its importance and, as such, I will be supporting it.
I thank the Ceann Comhairle for allowing me time to contribute to this debate. The safety and well-being of mothers, babies and families - of every citizen of this country - have been very well served by the medical professions for as long as I remember. That is because every doctor, upon qualifying, makes the hippocratic oath, the solemn pledge which underpins the wonderful care and service they provide to society and to individuals, regardless of gender or age. Hippocrates was born somewhere between 470 BC and 460 BC and did not belong to any religion. Christianity had not yet even arrived. The taking of the hippocratic oath by all newly qualified medical practitioners is confirmation of the seriousness of their position in society and the commitment they make to the care of patients entrusted to them during their lifetime. Doctors need constant reminding of the seriousness of that pledge and it should ideally be displayed in all medical institutions.
The text of the hippocratic oath is as follows:
I swear in the presence of the Almighty and before my family, my teachers and my peers that according to my ability and judgment I will keep this Oath and Stipulation:
To reckon all who have taught me this art equally dear to me as my parents and in the same spirit and dedication to impart a knowledge of the art of medicine to others. I will continue with diligence to keep abreast of advances in medicine. I will treat without exception all who seek my ministrations, so long as the treatment of others is not compromised thereby, and I will seek the counsel of particularly skilled physicians where indicated for the benefit of my patient.
I will follow that method of treatment which according to my ability and judgment, I consider for the benefit of my patient and abstain from whatever is harmful or mischievous. I will neither prescribe nor administer a lethal dose of medicine to any patient even if asked nor counsel any such thing nor perform act or omission with direct intent deliberately to end a human life. I will maintain the utmost respect for every human life from fertilisation to natural death and reject abortion that deliberately takes a unique human life.
With purity, holiness and beneficence I will pass my life and practice my art. Except for the prudent correction of an imminent danger, I will neither treat any patient nor carry out any research on any human being without the valid informed consent of the subject or the appropriate legal protector thereof, understanding that research must have as its purpose the furtherance of the health of that individual. Into whatever patient setting I enter, I will go for the benefit of the sick and will abstain from every voluntary act of mischief or corruption and further from the seduction of any patient.
Whatever in connection with my professional practice or not in connection with it I may see or hear in the lives of my patients which ought not be spoken abroad I will not divulge, reckoning that all such should be kept secret.
While I continue to keep this Oath unviolated may it be granted to me to enjoy life and the practice of the art and science of medicine with the blessing of the Almighty and respected by my peers and society, but should I trespass and violate this Oath, may the reverse be my lot.
This is the profound and solemn oath which doctors take upon themselves. The Bill before us asks doctors in this country to break that oath. Section 9(1), which deals with the risk of loss of life from suicide, states:
(1) It shall be lawful to carry out a medical procedure in respect of a pregnant woman in accordance with this section in the course of which, or as a result of which, an unborn human life is ended where—
(a) the medical procedure is carried out by an obstetrician at an appropriate institution, and
(b) subject to section 19, three medical practitioners, having examined the pregnant woman, have jointly certified in good faith that—
(i) there is a real and substantial risk of loss of the woman’s life by way of suicide, and
(ii) in their reasonable opinion, that risk can only be averted by carrying out that medical procedure.
This presents a dilemma for medical practitioners, as those of us who attended the hearings of the Oireachtas Joint Committee on Health and Children already know. No Government Minister attended those hearings in May to any significant extent, although they may have done in January.
Not for long.
I was there for an entire morning.
I said no Government Minister attended. With respect, you are a junior Minister. The 15 senior Ministers have collective responsibility.
This must be the first time the Deputy has introduced respect into his contributions on this issue.
The psychiatrists said that if a woman is in a very distressed situation, and anxious, which is very understandable, and says that she does not wish to accept the medical treatment they may offer, the only way left to avert the risk of suicide is to certify this as a lawful procedure. That goes against the hippocratic oath. They explained that dilemma to us. Furthermore, when the psychiatrists have certified that the procedure has been complied with, the obstetrician receives that certificate to carry out the procedure. They said that this is a dilemma that is repugnant also to their hippocratic oath, knowing that their fellow doctors have been, as it were, checkmated into that situation. This is a very grave matter. It was brought out in the hearings. It is a matter of enormous weight that a human life - that of a little baby, maybe under 15 weeks - can be ended. Another doctor, Mr. James Sheehan, who with Maurice Neligan and others founded the Blackrock, Galway and Hermitage clinics, and who has given more than 50 years' medical service to families, to men, to women and to babies - to everybody throughout his career - said only yesterday, with the wisdom of a long career, "Peter, when people terminate a pregnancy at that stage, it is killing an unborn baby, and you are to use that word, because we in the profession have to do that procedure. It is killing an unborn baby." That is very sad. That is why, at the core, I cannot support this Bill.
We have heard different discussions about the legal situation and we have been misled. I want to read into the record the following article that appeared in the Sunday Business Post, written by Dr. Maria Cahill under the headline "There is no legal requirement for suicide exemptions":
Although the European Court of Human Rights specifically requested that Ireland provide legal clarity in relation to lawful medical treatments in pregnancy, the political rhetoric surrounding the introduction of the Protection of Life during Pregnancy Bill has been a model of legal obfuscation.
The government has been keen to emphasise that it is obliged to legislate to introduce abortion on the grounds of suicidal intent, and both the Taoiseach, Enda Kenny, and the Minister for Health, James Reilly, have, on countless occasions, presented this 'obligation' as deriving from law: from the Constitution, the European Court of Human Rights or the Supreme Court.
As long as this political rhetoric about legal obligation holds sway, frank debate about the terms and merits of the legislation is almost impossible. Indeed, so long as this political rhetoric is unchallenged, there is no necessity for the minister to present the legislation as medically justifiable and legally legitimate; he can simply say that he has no choice.
Is the government constitutionally obliged to legislate for a Supreme Court judgment? No, as a matter of law. The Constitution gives permission to the Dáil and the Seanad to legislate, rather than imposing such an obligation on them. There are examples dating all the way back to 1965 of the court establishing that various rights exist, only to have 14 successive governments decline, in the lawful exercise of their discretion, to legislate to provide an express statutory footing for these rights.
The only constitutional obligation is that legislation must remain within the terms of the Constitution. In this instance, the right to life protected in Article 40.3.3 must be fully vindicated.
Is the government legally obliged to legislate for a suicide-based exemption from the right to life because of the European Court of Human Rights ruling in the case of ABC v Ireland? No, as a matter of law. The rules of the committee of ministers require that Ireland should adopt measures that are "effective for preventing the recurrence" of the breach that was found in the case of ABC v. Ireland.
Applicant C, following an internet search, diagnosed that her cancer might return during her pregnancy, and then went to England to have an abortion. She was not suicidal. A suicide-based exemption from the right to life would not have clarified her legal position at all.
Apart from the fact that the Oireachtas is under no constitutional obligation to legislate for the X case, is a future court bound by that precedent to allow suicide-based exemptions from the right to life? No, as a matter of law. The X case is in a separate category of judicial decisions because of what it did not decide. As every first-year law student learns, a precedent is only binding in relation to the points that were decided in the case. All the points that were “entirely overlooked or conceded without argument" are not part of the decision, as the Supreme Court itself ruled in 1965. If a point is not argued before the judge, the judge cannot make a decision on that point, and there is therefore no precedent on that point. If it were to be otherwise - if precedents could be made based on what the judges did not decide in court - then we would not be living under the rule of law.
I sat in the Chair yesterday and heard Deputies making their speeches, very importantly because of the gravity of the Bill and the responsibility on our shoulders. Those in the medical profession have vindicated the lives of mothers and children, and more beyond, through their superb service, making Ireland one of the safest places in the world to be a patient or to be looked after in the course of pregnancy. The Minister of State should read and re-read the article I have read out, because it shows that there is no necessity to legislate. In a telephone conversation this morning Mr. James Sheehan of the Blackrock Clinic said that the men and women who are his peers qualified before and around the time of legislation for abortion in England, and they know exactly what happened in England: young doctors did not wish to go into obstetrics and gynaecology as a speciality and there was a fall-off in the numbers going into those disciplines, because this legislation was at variance with their hippocratic oath and with all their good instincts to serve society, families and people. Introducing such a legal framework here will almost certainly have the same result.
Another person who told me she was against this legislation is Sister Consilio Fitzgerald, who runs Cuan Mhuire. She has served Ireland and dealt with the fallout from abortions, including the addictions that often follow abortions. She is a midwife too, by the way. People do not know that. She knows that no expectant mother ever wanted for the best attention and for everything necessary to save her life.
I go back to the repugnant dilemma that this law puts on psychiatrists and obstetricians in certifying the unavoidability of suicide. I want to read into the Official Report, on a matter of personal conscience, the letter I wrote to the Taoiseach last Friday:
Re: Personal Conscience and Passage of Proposed Legislation for Abortion in Ireland under The Protection of Life during Pregnancy Bill 2013 and Articles in Bunreacht na hÉireann.
Dear Taoiseach Enda,
I have carefully considered the above Bill and Bunreacht na hÉireann.
In recognition of the deeply and sincerely held conscientious reservations of many Fine Gael Parliamentary Party members (Legislators) and in accordance with Article 115 (page 8) of the EPP Party Platform Document adopted by Fine Gael at the EPP Statutory Congress, Bucharest, Romania, 17-18 October 2012 which states:
"We consider that it is necessary to respect the right of conscientious objection.",
the only reasonable and correct basis for voting in respect of the proposed Legislation is that there should be a Free Vote, without imposition of a Whip, for each Fine Gael Parliamentary Party member, out of respect for the informed personal conscience of Legislators in voting on such important proposed Legislation which goes to the core and impacts directly Articles 40.3.1, 40.3.2, 40.3.3, 15.5.2, and 28.3.3 of the Constitution all of which Articles deal with matters of Life and basic Human Rights.
I respectfully ask that you would support a Free Vote for each Fine Gael Parliamentary Party member out of respect for informed personal conscience during passage of the above Bill.
I wish to assure you of my loyalty to Fine Gael, traditional Fine Gael values and the values of the EPP.
I fully respect your Presidency of the Fine Gael Party, your Leadership of the Fine Gael Party and your Office of Taoiseach of the Government of the Republic of Ireland.
Please accept my kindest personal best wishes,
The Minister for Health also received this letter. When doctors qualify they voluntarily take the hippocratic oath to serve the people of this country. We too make a solemn prayer every morning before the commencement of business in the House:
Direct, we beseech Thee, O Lord, our actions by Thy holy inspirations and carry them on by Thy gracious assistance; that every word and work of ours may always begin from Thee, and by Thee be happily ended; through Christ our Lord. Amen.
This is not a Catholic badge to put on the oath to which doctors have sworn from the time of Hippocrates, 500 years before Christianity. This is basic philosophy on the dignity of human life.
At the public hearings on abortion, people who had the experience of abortion had asked to give their gentle and truthful testimony but were declined. Some of those people attempted suicide after their abortions. They now have teenage and adult children. They could have told us of their first-hand experience, what this law seeks to address, yet they were declined. We have a Bill going through on prostitution and prostitutes were listened to. This is not right. I hope we are in a civilised society and everyone understands the gravity of what we are about. I hope everybody has - I expected the same when I joined this House - the right to speak on matters as grave as this.
Since Thursday, I have received over 100 letters, texts, e-mails and phone calls from doctors who said this Bill is wrong. The last letter I got today was from a consultant gynaecologist, Dr. Courtney, with 35 years’ experience who was in charge of Cavan hospital. In it he stated:
I worked for 35 years as a consultant with the best results in Ireland and the UK and was never curtailed by law to save women’s lives.
Wars come and go. Famines come and go. But abortion comes and stays and eats its way into the heart of a people as it has done in England. Seven thousand, four hundred [abortions] in 1966. One hundred and fifty thousand in 1972. Two hundred thousand today.
I must ask the Deputy to conclude.
The letter continues:
As Lord David Steel has discovered when it comes, it does not go. Abortion is the most heinous deed a man or a woman can be part of. James Reilly’s claim that he will control it is childish.
James Sheehan, Sister Consilio and their colleagues have said that once the legislative framework comes in with section 9, we can be certain, by reference to other jurisdictions in which they have worked, that it will lead to increased numbers of abortions. James Sheehan told me that every time a procedure, as it is called, or a termination happens in those circumstances, it is killing an unborn child. We have got to do it. That is what is repugnant.
I rise to speak on this issue with a heavy heart. I acknowledge the great difficulty and no little effort on the part of everyone associated with the preparation and consultation in the writing of this legislation. I am particularly mindful of the Minister for Health and his staff, the Government as the Executive, the health committee chairperson and its members and those who made contributions to the committee, as well as the vast numbers of members of the public who sought to advise, educate and solicit information from Members.
I also acknowledge members of the public who sought and continue to seek to persuade, to guide and to direct Members in a certain direction. The majority of them did so and are doing so in a respectful and dignified manner. Many of my constituents have discussed the proposed legislation with me. Some had preconceived opinions, some opinions evolved as the process developed, some had opinions based on religious beliefs and faith. I respect their stance and their views. I respect their rights as constituents to engage with me and others who they elected to legislate.
That is, of course, the essence of democracy. That is democracy at work and, ultimately, we will all be elected or defeated on our ability to listen, to learn, to engage, to advise, to draw conclusions and to decide and legislate. Having decided to support or reject this legislation, it is incumbent on all Members to explain their actions and set out their reasons. To that end, I welcome this prolonged debate. I welcome the opportunity to speak on the legislation and to explain the reasoning and methodology behind my motivation and intention to support the legislation. I implore all Members to do likewise and to explain their reasons for voting in favour or against the proposed legislation.
Some may say they are obliged to vote in favour of the legislation because of the imposition of the Whip. They may want to explain they are not necessarily in favour of it but are voting for it or vice versa. It is only right, fair and proper that such duplicity is explained to their constituents. Some Members wish to sit on the fence and check the way the wind is blowing through opinion polls. They may have a preconceived idea that because their constituency is perceived to be conservative, they then should not support the legislation. It may sound crazy to think that this might be the way some Members perform on many issues, particularly this one. Unless all Members avail of this opportunity afforded to them in this debate, then that perception and accusation may well follow such Members for many years to come.
One of the most abiding conversations that has stayed with me over the course of recent months is one I had with a priest in my constituency, not my parish in case people draw the wrong conclusion. We discussed the legislation briefly, its contents, its ramifications and its merits or otherwise as the case may be. I explained I felt compelled and torn by virtue of one’s obligation to adhere to the Supreme Court decision. Whether we agree with that decision, it obliges this House and its Members to act on its instructions as legislators and provide legislation which reflects its interpretation of Article 40.3.30 of the Constitution.
The decision of the European Court of Human Rights in the A, B and C v. Ireland case obliges us also to provide legal clarity for medics to carry out their duties, without fear of retribution, in their efforts to adhere to the constitutional right of the mother at the unfortunate expense of the unborn in limited circumstances. The priest's response and contribution to that conversation was to say that one had to be firm and true to one's beliefs and interpretations specifically in this regard. Any member of the public would be cognisant of the sincerity of that viewpoint and of that stance. Any effort to stray from that or to court popularity or the popular persuasive influence of others within one's constituency would be rightly exposed.
Termination of pregnancy in these limited and most awful of circumstances, no matter how limited the occasions, and in the case of the threat to life by means of suicide - which has only been once as per the X case in 30 years - is a very sensitive and complex issue, and I continue to respect all views in the regard.
Like the Taoiseach and many others here, I am a Catholic; I was reared and educated in what I believe to be the best Catholic traditions. I espouse its principles and beliefs. I cannot claim, no one can, to always adhere to much of its teachings and so forth, but I am confident, comfortable and at ease with the decision that has to be taken. I almost wish that it could be that I was of a different mind or had drawn different conclusions or opinions of my constitutional obligation to legislate according to the Supreme Court decision. That decision has become very controversial and many people disagreed with it at the time it was taken and people still disagree with it. It was for that reason that there were two constitutional referenda seeking to reverse the decision by excluding the right to termination on the grounds of self-destruction, referenda in which I voted "Yes".
When the Tánaiste, Deputy Gilmore, in his efforts to pronounce and exaggerate a soundbite - I am sure he was very sincere in his own right - said that doing nothing, as had been the case for 20 years, was no longer an option, that was disingenuous and untrue. It was possibly an effort, as was the case recently and since the election - because the election was fought and won fairly and squarely by the current Government and it wants to rerun it on numerous occasions - to slur and sully Fianna Fáil. That is a trait, I might add, and I hate to bring this into this debate, that is now shared by the Taoiseach, Deputy Kenny, who this week, in response to the Anglo Irish Bank tapes, could not resist the temptation or the obligation that he feels to accuse Fianna Fáil of collusion with Anglo Irish Bank. No matter how wrong or how obscene that allegation was and is, let it be known that that statement alone has the potential to put the deathknell on the credibility of an Oireachtas inquiry into the banks.
To return to the issue at hand, the reason for those referenda was that there was no doubt but that the law in the country, as a result of the interpretation of Article 40.3.3o by the Supreme Court in the X case, was that a woman was entitled to a termination of her pregnancy if there was a real and substantial risk to her life, including a risk from self-destruction. If that was not the law then there would not have been any need for two referenda, so the law stands. If a pregnant woman presents herself at a maternity hospital today claiming to be suicidal, the law and the medical guidelines have at their disposal the right to termination.
If the proposed legislation excluded termination on the grounds of self-destruction, such a right would still exist in Irish law, and women would still be legally entitled, as they are now, to seek a termination on the grounds of self-destruction, notwithstanding that it is not contained within the legislation. If the proposed legislation expressly excluded a right to termination on the grounds of self-destruction, it would clearly be in conflict with the Supreme Court decision in the X case and, consequently, would be unconstitutional.
This is the reality of the situation that I face as a legislator and that is the basis on which I will be voting on the legislation. The constitutional reality is inescapable. I believe that the prevailing law, which has been set by the Supreme Court, needs to be defined in legislation. My personal opinion is that the Bill is a good faith measure. It is very restrictive, more restrictive than the status quo. I would not support any legislation which I believe would open the floodgates to an unrestricted abortion on demand regime.
As I have repeatedly said, I respect all views, even if I differ in my own. It is essential that all views are aired in this our republic. With regard to this matter, views have been aired twice in national referenda. We now have to legislate in compliance with the Constitution.
I cannot support this Bill as it requires me, as per sections 9 and 22(4) to legalise the intentional destruction of unborn human life where there is a real and substantive risk of loss of a woman's life by way of suicide. In other words, if a woman is in such a difficult place that she is contemplating suicide as a result of her pregnancy, this Bill will legalise the direct and intentional killing of the unborn child. This is in spite of the fact that almost 100% of medical practitioners have given evidence that abortion is not a treatment for suicide and, in so far as it can be established, it is more likely to cause long-term damage to the woman and certain death to the unborn. If these sections are removed I have no difficulty in supporting the remainder of the Bill, and I hope the Minister will remove them or give a commitment to remove them in the next few days.
Some Members have spoken about the vitriolic material they have received. We all received this. It is inexcusable. It happens on several issues. Some members of the public are angry at what they see as a break in trust as many Deputies and Senators gave commitments and played on the beliefs and fears of the people. In so far as I can establish, I did not send out any letters at election time or issue press releases in support of any pressure groups on this issue and I am not aligned to any pressure group.
However, the most worrying material I have received is that which has come from certain medical professionals who, with a few rare exceptions, are totally opposed to legislating for the threat of suicide as a ground for abortion. I have all the material to hand, to which very few Members have referred. We heard from 11 psychiatrists on 13 December; 120 psychiatrists in a petition, some representatives of whom came into the Chamber to inform Members; 12 gynaecologists on 9 December and only yesterday from 39 GPs from Cork and Kerry. That is what worries me, not the material that threatens me and dooms me to hell or otherwise, but material from the medical professionals who are the people who will have to implement this legislation and who, almost to a man and a woman, are totally opposed to section 9 of the Bill.
I have heard many fine speeches in the Oireachtas on the issue of human rights since I was first elected to this House. While in the Army, I served with the United Nations in Lebanon and saw at first-hand how important and difficult it was to defend human rights. Many Irish people lost their lives in doing so. Speeches come easily, but deeds are a little harder. This legislation is primarily about human rights because it proposes to violate the most basic human right, namely, the right to life, of the most vulnerable section of our society, unborn citizens. Whether one is a Catholic, Hindu, an atheist or Jewish, the core issue is the same. If the Bill was run through a computer programme, it would fail to pass. It is built on sand and history will show that to be the case.
There are many similarities between the approach the House and the public are taking to this legislation and to the bank guarantee and the economic boom. There seems to be broad support from the media and those with a different view are painted as being out of step or having an ill-founded basis for opposition. The collapse of the economy and recent revelations on the bank guarantee clearly show how ill served the public was by the herd mentality, but we learned nothing. I will rehearse what the mainstream media had to say in late 2008 about the economic boom and the banking crisis. An editorial in the Irish Examiner on 1 October 2008 headed "€400bn bailout - A welcome and decisive move" stated: "It was a brave positive move, the government has acted on a national scale with the financial future of all of us in mind". On the same day the Irish Independent stated: "Lenihan's masterstroke has bought us time to sort out our own problems ... Finance Minister Brian Lenihan has made a wise choice". The Irish Times cautioned, however: "While Taoiseach Brian Cowen and Minister For Finance Brian Lenihan are being commended for their leadership and the template of the solution provided, the devil, as always, will be in the detail".
Dealing with serious social issues during economic difficulties is not good practice. I propose to break my contribution on the strangely named Protection of Life During Pregnancy Bill 2013 into two parts. First, I will speak about the Bill and its flaws and, second, discuss the process of the policy decision.
The core of the Bill is section 9 and the risk to life of the pregnant woman from suicide. In seeking to understand and deal with the Bill I attended the Oireachtas hearings in January and May and met many groups and individuals inside and outside the Oireachtas. I respect all of the views held on this most emotive of issues and many of those to whom I have spoken have experienced great tragedy and suffering. However, it is clear from reading the Bill that for the first time an Irish Government is proposing to introduce a law that provides for the direct and intentional targeting of the life of the unborn child. This is clear from sections 9 and 22.
I acknowledge the time and effort all of the witnesses who attended the Oireachtas hearings put into their contributions. Some have received more coverage than others. One of the witnesses at the January hearings who strongly supported the legislation spoke about saving women's lives and sought reassurance that she and her colleagues would not go to jail. I am confident that everyone in the House would support any measure to address such concerns. However, the following correspondence was subsequently sent to the Chairman of the Joint Committee on Health and Children:
Dear Mr Buttimer,
I would be grateful if you could present the enclosed statement to your committee tomorrow, Thursday. It goes as follows:
"We the undersigned obstetrician/gynaecologists see no obstetrical advantage in changing the current law on abortion.
We are concerned that legal intervention could interfere with Irish obstetricians being able to treat pregnant women to the best of their ability."
The letter was signed by Dr. James Clinch from Dublin, Dr. John Monaghan from Ballinasloe, Dr. Michel Brassil from Ballinsloe, Dr. Eileen Reilly from Galway, Professor Michael Foley from Dublin, Dr. Eamon McGuinness from Dublin, Dr. Trevor Hayes from Kilkenny, Professor Dermot MacDonald from Dublin, Professor Michael Foley from Dublin, Dr. Hugh O'Connor from Dublin, Dr. Naveed Kwaja from Ballinsloe and Professor Colm O'Herlihy from Dublin. Prior to the hearing in May, I contacted one of the signatories of the letter who did not give evidence and he expressed the view that the legislation would not clarify the matter because the medical practitioner would ultimately have to make a clinical judgment call. I ask the Minister to show me where in the legislation are women's lives saved.
I am happy to support the Bill, with the exception of section 9. I have received countless representations from members of the medical profession on the provision on suicide and section 9 who have been almost unanimously opposed to this measure. One of the more profound examples was the evidence presented by Dr. Sam Coulter-Smith, the Master of the Rotunda. I will rehearse his submission in the hope commentators will read it before making glib comments in the media. I ask them to deal with the issues he raised rather than accusing me and others who hold similar views of ulterior motives. He stated:
My name is Dr. Sam Coulter-Smith. I am master of the Rotunda Hospital in Dublin. My submission to the committee today is based on my views and the views of my consultant colleagues at the Rotunda Hospital following consideration of the draft heads of the Bill ... In respect of loss of life from self-destruction there are a number of issues that need to be raised. First, this is an extraordinarily rare situation with the incidence of suicide in pregnancy of the order of one in 500,000 pregnancies as per United Kingdom figures. Second, our psychiatric colleagues tell us that there is currently no available evidence to show that termination of pregnancy is a treatment for suicidal ideation or intent and, as obstetricians, we are required to provide and practice evidence-based treatment ... It, therefore, creates an ethical dilemma for any obstetrician who has requested to perform a termination of pregnancy for the treatment of someone with either suicidal ideation or intent. Third, this legislation, I am sure, is designed to create clarity and reassurance for both health professionals and patients alike.
The fact that there is no gestational limit in respect of the third scenario relating to suicidality is a major ethical issue for obstetricians. I will illustrate this with two scenarios. First, let us consider the case of a patient who is 25 weeks' gestation. If she is deemed to be sufficiently suicidal to require a termination of pregnancy by one or more psychiatric colleagues, an obstetrician who is tasked with dealing with this situation is faced with an enormous ethical dilemma. Delivering a baby at 25 weeks' gestation could lead to death, due to extreme prematurity or it could lead to a child with cerebral palsy or with other significant developmental issues for the future. This outcome would be entirely iatrogenic and the responsibility of those clinicians who have agreed to be involved in the process. This is a source of serious concern for myself and my colleagues.
Another clinical scenario which provides a difficult ethical dilemma is a situation whereby at a woman's 20 week anatomy scan a significant but non-lethal malformation is discovered. The patient, for a variety of reasons, may decide that she cannot continue with the pregnancy and it is causing her significant mental health issues with risk of suicide. The obstetrician is left in the unenviable position of, by law, having to look after the best interests of the baby but also the understanding of the mother's issues. It would, therefore, seem appropriate in a case where there is a risk of self-destruction that there is no gestational limit applied in this situation as this creates a major ethical dilemma for us.
My overriding concern, however, in relation to the whole area of self-destruction and termination of pregnancy to prevent same, relates to the lack of evidence to show that termination is of any assistance in this scenario and that we as obstetricians and gynaecologists must be able to stand over the decisions we make as being based on good medical evidence.
In relation to the infrastructure and resources it is my view, and that of many of my colleagues, that the inclusion of suicidality within the legislation may, and I stress may, in the long term lead to an increased demand for termination in this country. We currently do not have any real understanding of how big that demand may be. Currently in excess of 5,000 women a year go from Ireland to the UK to have termination procedures performed. We cannot be certain how many of these women would decide to use this current legislation as a means of obtaining a termination in this country and even if unsuccessful in obtaining a termination in this country, a huge amount of time and resources will be spent on the assessment of these patients ... In conclusion, I welcome this draft legislation, particularly in the area of real and substantial risk to the life of the mother which pertains to physical illness. I think, however, that there are significant concerns in all areas of the medical profession in relation to this Bill when it comes to suicidality. Our overriding concern relates to the lack of evidence to show that termination of pregnancy is an appropriate treatment for women who are deemed to be at risk of suicide. As obstetricians we are expected to practise evidence-based interventions and first and foremost to do no harm. This legislation should help in providing clarity and reassurance to professionals and patients alike. To enact and underpin the idea that termination of pregnancy is a solution or a treatment for a patient at risk of committing suicide when there is no evidence to support that intervention creates an ethical dilemma for our profession.
To make matters a little more difficult there is no gestational limit mentioned in the draft at which this termination might happen. This opens the possibility for iatrogenic prematurity with all the risks of infant morbidity and mortality. Who will be responsible for these interventions? I also confirm to the committee that we as a profession, and particularly in my hospital, have concerns about the potential for increased demand for termination services in this country as this may be an unintended consequence of this legislation in its current form.
Those remarks were made by Dr. Sam Coulter-Smith, who is the master of the Rotunda Hospital, rather than by Deputy Billy Timmins or any spokesperson for a pro-life group. I hope the Minister can address those concerns. I did not hear them addressed at the close of the hearings.
I have listened to some speakers who have questioned the suggestion that "abortion is not a treatment for suicide" and expressed weariness at its continuous use. Surely this is the issue at stake. By allowing abortion upon a threat of suicide, the Government would be legislating for a treatment that is not evidence-based. It is impossible to predict suicide accurately. Abortion exposes some women to mental health issues. Section 9 of this proposed legislation will potentially put women's lives at risk. If this section was not in the Bill, I would happily support the remainder of the legislation. I will do so if the Minister removes this section on Committee Stage or Report Stage. International experience has shown that the inclusion of such a measure results in a liberal abortion regime. It is difficult to understand the nuances of this issue, particularly when one hears two psychiatrists arguing from different sides. However, there is widespread opposition from psychiatrists to the inclusion of suicide as a ground for abortion. Professor Kevin Malone stated in his submission to the Joint Committee on Health and Children: "By foregrounding a theoretical risk of suicide in women, and enshrining "suicidality" in Irish law, the proposed legislation runs the risk of further invisibilizing, normalizing, and at worst exacerbating the much more real and volatile threat of increased suicide risk in Irish men, and potentially accelerating suicide risk in young women also." Ms Sunniva McDonagh SC said: "I want to mention what was decided in the X case because we cannot leave out of the picture the fact that the Supreme Court formulated the test without the benefit of medical evidence or best psychiatric practice". Dr. John Sheehan, who is a consultant psychiatrist at the Mater Hospital, said "[T]here is no evidence base to indicate that abortion prevents suicide". Professor Malone, who is a consultant psychiatrist at St. Vincent's Hospital, has said "I wonder how [abortion] can overnight become a recommended psychiatric treatment in Ireland".
In their submission to the Oireachtas Joint Committee on Health and Children, three Irish perinatal psychiatrists with over 40 years of combined clinical experience said they had not seen a single case in which termination of pregnancy was the treatment for a mental disorder. However, since 1992, the HSE has assisted six minors who were in State care in travelling abroad for abortions on the grounds of suicide. A psychiatrist was involved on each occasion. How can this conflict be resolved? As many other speakers have said, the judgment of the European Court of Human Rights in the case of A, B and C v. Ireland does not require Ireland to legislate for abortion. It merely requires us to clarify what the law is. Equally, there is no constitutional duty to legislate for the Supreme Court decision. The judgment in the X case, with respect to the permissibility of abortion as a treatment for suicidality, is not a formally binding precedent. It is not binding because the issue was conceded without argument and therefore does not form part of a binding precedent. At the hearings, Mr. Paul Brady, who is a barrister, and Dr. Maria Cahill of the UCC faculty of law quoted Mr. Justice McCarthy and Mr. Justice Brian Walsh in support of this argument. Mr. Brady said:
It is well established that neither a constitutional provision nor even a statutory provision can be construed on the basis of a concession if it were to be binding in rem. It is unfortunate that .... legislators should feel under some strait-jacketed legal obligation to bind themselves to what was a concession in that decision.
I believe the legislation before the House may be unconstitutional. Contrary to what many commentators have said, a commitment to legislate for the X case was not in the programme for Government. I ask them to read what the programme for Government says. I have grave reservations about the whole process. I made reference to this in earlier speeches and at the committee hearings. The media has shown little interest in examining the detail. It was clear from the expert opinion presented at the hearings and the correspondence from medical practitioners that legalisation for the threat of suicide as a ground for abortion does not save women's lives. The hands of the expert group were tied, in contrast to the commitment in the programme for Government, which states:
We acknowledge the recent ruling of the European Court of Human Rights subsequent to the established ruling of the Irish Supreme Court on the X-case. We will establish an expert group to address this issue, drawing on appropriate medical and legal expertise with a view to making recommendations to Government on how this matter should be properly addressed.
Some nominations from professional bodies to the expert group were not chosen. Why was this? How were the eventual members selected? While this is very much a secondary issue, it is important nonetheless.
The laws we enact influence our culture and our behaviour. Ireland does not have a culture of abortion. I believe this legislation will change that. The message I received when I spoke to the members of the Women Hurt group was very clear. It resonated with me more than most of the submissions I receive. They referred to the pain and suffering they experienced after they had had abortions. They described their negative experiences and how they felt afterwards. Women from different countries and cultures have this - the mental health consequences of having had an abortion - in common. As women who have been hurt by abortion, they fear this legislation will give rise to a social acceptance of it. Many friends and colleagues who hold sincere and genuine beliefs will support this Bill, but I cannot do so. I have spent many months meeting groups and individuals and reflecting on their views. I disagree with some of them, but I accept that they are all genuine. If there was an easy solution to this problem, it would have been resolved some time ago. While this legislation may pass, I do not think it will address our problems - instead, it will increase them. I remind the House that Norma McCorvey, who was central to the 1973 Roe v. Wade case in the US, sought a judicial review of the decision in her case many years afterwards.
Voting against this legislation will result in my losing the Fine Gael Whip. I deeply regret this. I and other family members have served Fine Gael at local and national representative level for a total of over 100 years. I have knowledge of what is the Fine Gael ethos. When this law is enacted, it will not sit lightly with it. The way this issue has been presented to the public can best be reflected in the following words:
"How we Learn"
Great truths are dearly bought. The common truth,Such as men give and take from day to day,Comes in the common walk of easy life,Blown by the careless wind across our way.
Great truths are greatly won. Not found by chance,Nor wafted on the breath of summer-dream;But grasped in the great struggle of the soul,Hard-buffeting with adverse wind and stream.
Not in the general mart, 'mid corn and wine;Not in the merchandise of gold and gems;Not in the world's gay hall of midnight mirth:Nor 'mid the blaze of regal diadems;
Wrung from the troubled spirit in hard hoursOf weakness, solitude, perchance of pain,Truth springs, like harvest, from the well-ploughed field,And the soul feels it has not wept in vain.
I will conclude by giving another example of the many concerns that have been raised with me. Dr. Bernard Nathanson, who was one of the foremost pro-abortion activists in the US, admitted in his 1996 autobiography that he had "helped usher in this barbaric age". He described the four steps that are usually followed by those who want to liberalise abortion law. First, they find a hard case, even if it is not fully relevant. Second, they create fear, doubt and confusion and even grossly exaggerate or lie about the facts. Third, they find a convenient pro-life group that is easy to hate and demonise or scapegoat it. Fourth, they legalise abortion on mental health or suicide grounds. Does this sound familiar to the House? I will conclude by reiterating that I would be happy to support this Bill if section 9 were removed. I remind the House that the questions raised by Dr. Sam Coulter-Smith, rather than by me, have not yet been answered.
I would like to share time with Deputy Catherine Murphy.
Is that agreed? Agreed.
I am pleased to speak on this legislation. In 1992, the Supreme Court found that the Constitution guaranteed a woman the right to terminate a pregnancy lawfully and within the State where there is a real and substantial risk to her life, including where that risk is the threat of suicide. Two referendums and a European Court of Human Rights judgment have copper-fastened this established constitutional right. The report of the expert group on the judgment in the case of A, B and C v. Ireland was published last November. It found that legislation and regulations in accordance with the X case would give constitutional, legal and procedurally sound effect to the European Court of Human Rights judgment. This approach, far from being a prescription for so-called abortion on demand, will underpin the extremely restrictive nature of the 1992 ruling in the X case to include suicide. Some people have sought and will continue to seek to undermine the need to include suicide. I have found many of the arguments they have put forward in this regard to be disrespectful to women. In some instances, they have been deeply hurtful. Many people have chosen to forget, or to omit to mention, that the Supreme Court ruled in 1992 that where the threat of suicide posed a real and substantial risk to the life of the woman, and where no other intervention could save her life, then a termination of the pregnancy is lawful. That was the case in 1992 and that is the case today.
It is worth remembering the precise circumstances of the X case, where a 14 year old child was raped and brutalised. That 14 year old child was pregnant and suicidal and the courts vindicated her right to terminate that pregnancy and not carry it to term. If we want to speak frankly in respect of people's position on this legislation, we have to go back to the specifics of the X case. I view it as a barbaric notion that a raped, brutalised, pregnant and suicidal child would be forced by the State to carry that pregnancy to term. That, for me, does not add up ethically or morally, and it does not add up legally, as we know given the Supreme Court has so judged.
I recognise that, for many, this debate is by definition a difficult one. There is a diversity of views which have been thoroughly aired in recent months and, indeed, years. That is legitimate and healthy. However, for over 21 years the Oireachtas failed in a basic duty to deliver legislation that provides clarity for medical practitioners and the necessary protections for pregnant women whose lives are at risk. Therefore, I welcome the introduction of the Bill. Successive Governments have failed our women on this issue and the body politic, in its entirety, has failed them. I commend Labour and Fine Gael on introducing this legislation and on ensuring adequate time for debate in advance of a final vote before the summer recess.
It is clear the vast majority of citizens want this legislation, although that does not mean they are, to use the term, "pro-abortion" or in favour of abortion. It is a simple recognition of the fact that in real-life situations where a woman's life is at risk, there is an expectation that interventions will be made to save that woman where all else has failed. I know it is difficult for some Members of the Oireachtas to hear the fact that the majority of people support this legislation. There is a minority view which is strongly and sincerely held, and I respect that, but we are, after all, a democracy. After a delay of 21 years and all of the heat and sometimes rancour that has surrounded this debate, I believe the democratic will of the people should be reflected in their democratic institutions.
Quite frankly, I fail to see any parallel between this legislation and the bank guarantee. In fact, I cannot imagine a more stark contrast. In the case of the bank guarantee, as instanced by Deputy Timmins, far-reaching and devastating decisions were made under a cloak of secrecy and in a rushed and pressurised manner. One could hardly say this is the case with this legislation. Far from it. In fact, it has been marked by delay and, I believe, cowardice of a monumental scale on behalf of the political establishment.
Many bodies, individuals and institutions outside of the world of politics have strong views on these matters. I am thinking in particular of religious institutions and the churches. I believe in a pluralist society. I believe in space for healthy debate and I absolutely respect the right, indeed the responsibility, of people from the churches to state their position and to lead a discussion among their congregations. However, I have to say that some of the remarks made by the Roman Catholic bishops have been factually inaccurate and most unhelpful. As an individual and as a practising Roman Catholic and regular mass-goer, I believe any threat to excommunicate members of the Roman Catholic Church on the basis of their stance on this legislation to be utterly indefensible and oppressive.
The bishops say, and we hear some echoes of this argument in this Chamber, that the Government is under no obligation to legislate for the X case. That is simply wrong. We are legislators. We are elected to legislate not just for ourselves or on the basis of our personal dogma or ethos; we are elected to legislate on behalf of the people. We also have an ethical and moral responsibility to deliver legislation that supports and protects the constitutional rights of our people. This legislation is quite simply about recognising and setting up the constitutional right of a pregnant woman to have her life saved where her life is in jeopardy. It is as simple as that.
That is what is in train in the Oireachtas. We are legislating for the constitutional right of a woman to a termination where her life is at risk. The legislation reflects the restrictive nature of the Supreme Court judgment and subsequent referendums. It will not lead to a more permissive regime - that is simply not the case. Deeply questionable arguments and tactics have been employed in the course of this debate by some, and I am uncomfortable with that. It is simply untrue to say that the Government, or indeed any of us who want to see this legislation on the Statute Book, are not listening to those who oppose this Bill. I have listened very carefully and respectfully to the argument from the other side. Every hue of opinion and expertise has been given a full opportunity to come before the Oireachtas and its Members to argue their case, share their views and give professional opinions.
This is a democratic State. We are a democratic people. Our laws are shaped by our Constitution - the people's Constitution. The religious institutions, churches, interest groups and lobbies all have a crucial and valuable place in our society but, in the final analysis, it is we who are elected to the Oireachtas who are responsible for bringing forward our laws. As decided by the people, the courts interpret our Constitution, the Oireachtas delivers our legislation and the people elect us as legislators.
I welcome this legislation. Sinn Féin will be bringing forward some amendments but I believe this is a really positive day and a positive period for us in that, at last, we are simply doing what needs to be done to doubly ensure the lives of the small number of pregnant women who will sadly find themselves in a position where that precious life is imperilled.
First, I want to state that I am in favour of legislating for the X case. Not only do I think we should legislate, I believe that, as democrats, we have a duty to legislate. The only question for me is whether the legislation goes far enough.
In 1992 and 2002 proposals were put to the people in a referendum to restrict further the right of Irish women to abortion by removing the right to abortion on grounds of suicide. The people of Ireland rejected these proposals on both occasions. The Supreme Court found it inexcusable that the Oireachtas had not legislated - it is the job of the courts, after all, to interpret laws whereas it is our job to make them. We have had our instructions from the people and we have a responsibility to stand up and take responsibility. I cannot think of another case of a constitutional amendment where the people gave their instructions and those instructions were ignored not for years but for decades.
The legislation is the bare minimum, in my opinion. The tragic case of Savita Halappanavar could unfortunately happen again even after this legislation is passed.
The Savita Halappanavar case demonstrated in a way that was readily understood the kind of risk a pregnant woman can be exposed to, even in very limited circumstances. That was readily understood and many people were very scared as a consequence of that case. We are expecting people to abandon their anonymity, as her family and Deirdre Conroy did, so that people can understand and that understanding can help us make laws. Deirdre Conroy went through four years of legal wrangling in the European Court of Human Rights although the issue could have been considered by our courts.
It is inexcusable not to include the heartbreaking issue of fatal foetal abnormalities. There are Deputies on the Government side who also believe that. To force a woman to continue with a pregnancy to term when there is no prospect of giving birth to a baby that is compatible with life is barbarous. For most women and couples who find themselves in this unfortunate situation it will have followed the great joy of being told there was a pregnancy. They will have looked forward with great hope to the birth of a live, healthy baby. They will have considered names, shared the news with family and friends and been asked if it is a boy or a girl. They will be looking forward with great hope. They will then have received the devastating news that there will be a pregnancy but no baby at the end of it. To force any woman to continue with such a pregnancy to almost full term is horrific. There is a compassion in Irish people that finds that unacceptable. Irish people would not want to put a woman or a couple - very often it is deeply felt by both - through that. Instead of fulfilling a duty of care to that woman, which is where the focus should be, we force so many of them to seek that compassion and care in hospitals in Liverpool, Manchester or London. That is shameful.
Pregnancy may be a natural occurrence but it is not without risk. Only yesterday I met a young woman who was so damaged by such a pregnancy that she cannot physically have a baby and will have life-long adverse health consequences. Yesterday I also met a GP who talked about the experience of his daughter Ruth. Her baby was diagnosed with fatal anencephaly at 13 weeks and she travelled to England for a termination. He said:
If she had continued with the pregnancy, she would have effectively been a life support machine. Every day in hospitals, doctors and families have to make decisions to switch off machines. Is this not a similar position?
I ask that today on behalf of him and Ruth.
I understand that neither rape nor incest can be included in this legislation because it would be unconstitutional. That would require a further referendum, which we should commit to and which I would support. We occasionally meet people who have experienced incest or rape recently or in the past. People who have experienced incest will often talk about the guilt they still feel, even though they were only children. The only role people such as myself can play is to encourage them to go for counselling. So many rapes go unreported, often because the victims have no expectation that the courts will dispense justice or they want to be sure they can remain anonymous. Instead, they seek support from organisations such as the rape crisis centres. In many cases it takes great courage to walk up that street, up those steps and through that door. On many occasions women feel they have themselves been put on trial when their cases go to court. They know the rape crisis centres will deal with them in a confidential, compassionate and sensitive way. This morning, some woman may well visit rape crisis centres. Whether the rape is recent or historic, it has taken great courage for her to get there. This morning, disgracefully, a van belonging to the Pro Life Campaign pulled up outside the door of the Dublin Rape Crisis Centre in Leeson Street. The photograph is there. There is no traffic around the van. It is sitting outside the centre with a sign that reads, "The abortion bill won’t make women safer." The confidentiality that women looked for was breached this morning by this. It is completely unacceptable that this should have happened. It screams at them that women would be safer if this Bill were not passed. It interferes with the confidentiality they thought they were going to have in visiting the Dublin Rape Crisis Centre. It shows the lengths to which this organisation will go. The Pro Life Campaign is trying to dismiss the incident by saying the van got stuck in traffic. The photograph shows there is not a car, bike or bus anywhere near it. It was deliberate. It is disgraceful. These women were violated by a rape, they often feel violated by the fact that they cannot get justice, and now they are being violated again by this. It is outrageous.
I thank the Minister of State. This legislation is the bare minimum. When Deputy Clare Daly put forward her Bill some of the Government Deputies, including those in the Labour Party, made speeches saying they would wait for this legislation. The impression they had, in good faith, was that this legislation would be a little bit beyond what is presented. I accept there is a limit on what can happen because of the Eighth Amendment, which I would favour removing, but it does not go far enough. I question whether it will meet the needs of the European Court of Human Rights, and we could be back here sooner than we think. Instead of being instructed to do things from outside, I hope we can grow up and start recognising that Irish people have moved on and that women in this country can be trusted. That should come across in this discussion. We should take the responsibility of saying this is what we need to do in a modern country that has a duty of care to women, particularly when they experience rape, incest or fatal foetal abnormality. From that point of view, although the proposals in this Bill are an improvement, it does not go far enough.
I agree with much of what Deputy Catherine Murphy said, especially her condemnation of the antics of the group that parked its van outside the Dublin Rape Crisis Centre.
It is a tragedy when an expectant mother forms the belief that she cannot carry a pregnancy through to fruition to give birth to a life. The right to life is the most basic of human rights that this and every State must vindicate. Equally, only a State with a blatant disregard for human rights, such as some kind of warped theocracy, would seek to hold expectant mothers as prisoners of their pregnancies. The fact that for 20 years since the X case judgment this Legislature has refused to address the reality that thousands of Irish women have decided to terminate their pregnancies and have travelled to the UK and other jurisdictions to have this procedure, and continue to do so to this day, is an indictment of this House and our entire body politic.
Eighty-three women who received abortions in England and Wales in 2011 gave home addresses in County Clare. It is reasonable to assume that many women from Clare did not give their real addresses and that many others received abortions in jurisdictions other than England and Wales.
In the first of three referenda on this issue in 1983, Article 40.3.3° of the Irish Constitution was inserted by the Eighth Amendment of the Constitution:
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.
Subsequent referenda established the right to travel for the purposes of a termination and the right to receive information about such services abroad and crucially, for the purposes of this legislation, rejected a Bill which removed as a ground for the termination of pregnancy a real and substantial risk to the life of the mother by self-destruction. Such had been the finding of the Supreme Court in the X case. In that case, Mr. Justice McCarthy noted:
[T]he right of the girl here is a right to a life in being; the right of the unborn is to a life contingent; contingent on survival in the womb until successful delivery. [He concluded that] On the facts of the case, which are not in contest, I am wholly satisfied that a real and substantial risk that the girl might take her own life was established; it follows that she should not be prevented from having a medical termination of pregnancy.
Those are the parameters within which this House must legislate. Both Government parties agreed to examine the decision of the European Court of Human Rights in the A, B and C v. Ireland case, in advance of the last election. Indeed, Ireland like every other state which is a party to the convention on human rights, undertakes to abide by the final judgment of the court in any case to which it is a party. In the A, B and C v. Ireland case, it was affirmed:
[T]he Court does not consider that the prohibition in Ireland of abortion for health and well-being reasons ... exceeds the margin of appreciation accorded in that respect to the Irish State
However, the court concluded that the Irish authorities had failed to respect the private life of the third applicant by reason of the absence of any implementing legislative or regulatory regime providing an accessible and effective procedure by which the third applicant could have established whether she qualified for a lawful abortion in Ireland in accordance with the Irish Constitution. In seeking to provide that clarity, I am concerned that the Protection of Life during Pregnancy Bill, as it currently stands, may not adhere to adhere to the Constitution. When sections 7, 8 and 9 are read in conjunction with section 22, there appears to be no duty of care to preserve the life of the unborn as far as is practicable when carrying out necessary medical procedures in respect of a pregnant woman and, as a result, the Bill may be found to be unconstitutional.
I am aware that in carrying out a medical procedure referred to in sections 7, 8 or 9, a reasonable opinion must be formed and that opinion must be formed having regard to the need to preserve human life as far as practicable, that the risk to the life of the mother can only be averted by carrying out the medical procedure. However, while carrying out that medical procedure, it would appear that the Bill as currently drafted would permit the intentional killing of the foetus even if it might otherwise survive the procedure. I do not believe that to be the intention of the Bill, nor do I believe that it would be constitutional to legislate in that manner and I look forward to clarification from the Minister on this crucial matter before the Bill passes through these Houses. The last thing we need, 21 years after the X case, is for this Bill to be referred to the Supreme Court and found to be unconstitutional. It is a virtual certainty that the constitutionality of this Bill will be tested, either through a referral from the President, or otherwise.
The second matter I wish to raise is the Taoiseach’s suggestion to the Dáil that it is not permissible under the Constitution to include in this legislation a provision for abortion in cases of fatal foetal abnormality. However, in the case of D v Ireland, another European Court of Human Rights case, decided in June 2006, the Government of Ireland presented a very different story to the Court. In that case D, the mother of two children, became pregnant with twins. She was informed by her obstetrician that one foetus had stopped developing at eight weeks gestation. In the 17th week of pregnancy it was confirmed that the second foetus had a lethal genetic condition. She felt unable to tolerate the physical and mental toll of a further five months of pregnancy with one foetus dead and with the other dying. She did not consider any legal proceedings in Ireland at that point, but rather made arrangements to travel to the United Kingdom for an abortion, which she underwent. She chose the medical induction option, leading to 24 hours labour, as she felt it was the option most respectful of the second foetus. She felt that there was a culture of concern in this hospital which she found reassuring. She did not have time to remain in the UK to have counselling on the genetic implications for future pregnancies, although she was given some statistical information about the recurrence of this abnormality. She transported the foetus to Ireland for a discreet burial by a sympathetic minister.
The Government’s submission to the Court stated:
[T]he foetus was viable in the X case whereas in the present case there might be an issue as to the extent to which the State was required to guarantee the right to life of a foetus which suffered from a lethal genetic abnormality. The meaning of “unborn” in Article 40.3.3° had attracted some public and academic comment. However, there had been little judicial examination of the meaning of “unborn” and certainly no case comparable to the present. Accordingly, although it was true that Article 40.3.3° had to be understood as excluding a liberal abortion regime, the courts were nonetheless unlikely to interpret the provision with remorseless logic particularly when the facts were exceptional. If, therefore, it had been established that there was no realistic prospect of the foetus being born alive, then there was “at least a tenable” argument which would be seriously considered by the domestic courts to the effect that the foetus was not an “unborn” for the purposes of Article 40.3.3° or that, even if it was an “unborn”, its right to life was not actually engaged as it had no prospect of life outside the womb. In the absence of a domestic decision, it was impossible to foresee that Article 40.3.3° clearly excluded an abortion in the applicant’s situation in Ireland.
On the basis of these submissions, the court found that if the question of whether Article 40.3.3° excluded an abortion in the case of a fatal foetal abnormality was novel, it was, nevertheless, an arguable one with sufficient chances of success to allow the initial burden on the Government to be considered satisfied. Accordingly, the European Court found that a legal constitutional remedy was, in principle, available to the applicant in Ireland to obtain declaratory and mandatory orders with a view to obtaining a lawful abortion in Ireland. This obviously begs the question - was the Government wrong in what it told the European Court of Human Rights on 6 September 2005, or was the Taoiseach wrong in what he told the Dáil yesterday?
Deputy Seamus Healy is sharing his 20 minutes with Deputy Gerry Adams.
I welcome and support this legislation which is limited and restrictive. This is a sensitive issue which is very difficult for some people to deal with - indeed for many people. The expert report expressed this well when it stated that abortion is a difficult, painful issue in this country and elsewhere. It also observed that the reasons are not hard to understand: intense ethical, religious, social, political and intimate personal issues coincide. That is quite correct. The issue must be dealt with in a compassionate and understanding way. However, it has to be dealt with urgently. We cannot continue a situation where women's lives are at risk or where the medical profession is unclear about the legal position. As legislators, 21 years' later, we must accept our responsibilities in this area.
In my view there is an overwhelming middle ground, a very significant majority of the public, who are in favour of the provisions in this Bill. That overwhelming middle ground would be prepared to go further to include in the Bill provisions to deal with fatal foetal abnormality, inevitable miscarriage, pregnancy arising from rape and incest. Many polls in the recent past and earlier have shown that this is the view of a significant majority.
The history includes the 1983 referendum, the X case in 1992, the two referenda of 1992 and 2002 and the European Court judgment in the A, B, C v. Ireland and D v. Ireland cases in 2010. It is clear that the Supreme Court found that a termination is lawful in Ireland where it is a matter of probability that a woman faces a real and substantial risk to her life and where that risk can only be averted by a termination.
The late Mr. Justice Niall McCarthy said at the time that the delay which had taken place at that stage was not only unfortunate, it was inexcusable. Remember, we are now 21 years further down the road. It is inexcusable now. We have had both court cases and the people have spoken on the issue on two occasions in 1992 and 2002, respectively. They supported the contention that suicide as a real and substantial risk to the life of the mother should be included. It is now necessary for the Oireachtas to legislate based on the X case judgment and the judgment of the European Court of Human Rights.
Some people have indicated that the legislation is very liberal. We must remember that it is governed by the Constitution, the 1983 amendment thereto and the X case judgment, in which the court referred to a real and substantial risk to the life of a woman which could only be averted by a termination. To say the legislation is liberal and to refer to the situation in Britain is, at best, misleading. The British legislation refers to the health of a woman, whereas the Bill refers to a real and substantial risk to her life.
A number of issues in the legislation which should be dealt with have been referred to in other contributions. One to which I want to come back is the question of fatal foetal abnormality, which issue has been put clearly on the agenda by the group, Termination for Medical Reasons. It has spoken to Members in a briefing in the AV room in Leinster House. This is a sad, tragic issue which many families find themselves confronted by. There are almost 1,500 cases of fatal foetal abnormality in Ireland annually. These are real people with real stories of the injustice of having to travel to seek a medical termination and treatment. These families feel the denial of treatment in Ireland and the requirement to go abroad is very unfair and unjust. A number of eminent legal people have argued that termination in a case of fatal foetal abnormality is constitutional. This view is supported by the Government's submissions in the D v. Ireland case before the ECHR. The judgment in the D v. Ireland case states:
Accordingly, although it was true that Article 40.3.3° had to be understood as excluding a liberal abortion regime, the courts were nonetheless unlikely to interpret the provision with remorseless logic particularly when the facts were exceptional. If therefore it had been established that there was no realistic prospect of the foetus being born alive, then there was "at least a tenable" argument which would be seriously considered by the domestic courts to the effect that the foetus was not an "unborn" for the purposes of Article 40.3.3° or that, even if it was an "unborn", its right to life was not actually engaged as it had no prospect of life outside the womb. In the absence of a domestic decision, it was impossible to foresee that Article 40.3.3° clearly excluded an abortion in the applicant's situation in Ireland.
The Government argued that the D case could have been dealt with in the Irish courts and that such terminations could be found to be constitutional. That issue must be revisited in the legislation to provide that fatal foetal abnormality is covered.
Section 22 of the Bill also falls to be addressed. The provisions of the section criminalise a pregnant woman. There is a legal precedent whereby a pregnant woman affected in a situation such as that under discussion may be excluded from committing an offence and facing a 14 year sentence of imprisonment. There is a widespread view that this is an unusual situation and that the legislation should be amended. There is a view across the House that this is, in fact, a provision which should not be contemplated.
The time limits in the legislation also fall to be addressed. The time limits in respect of reviews must be shortened from three days to one and seven days to three, respectively.
Another matter which must be addressed is the omission of provisions on the duty of care owed by institutions to persons availing of the services provided for in the Bill. We must also include a provision to protect women and doctors from harassment.
I have tabled amendments on fatal foetal abnormality, time limits, the duty of care and protection from harassment which will I hope be discussed on Committee Stage. I hope we can enact legislation which covers these areas. I welcome and support the Bill. It is limited and restrictive in scope.
Personally, I am not in favour of abortion. That is my strongly held view, but I am not here to legislate for me, especially not on this issue. Like other Members of the Oireachtas, I have a duty and responsibility to legislate for citizens, in this case pregnant women whose lives are at risk. Therefore, I and Sinn Féin will support the Protection of Life During Pregnancy Bill.
Sinn Féin believes that Irish society has a responsibility to not only address the issue of abortion but also address the fact that thousands of Irish women travel to Britain each year for abortions. We also believe that all possible means of education and support services should be put in place to prevent crisis pregnancies. We believe that the way to tackle the issue of abortion is by way of comprehensive education, full access to child care and comprehensive support services, including financial support for single mothers, and that full information and non-directive pregnancy counselling should be freely available.
Personally, I am strongly opposed to any attempt to criminalise or be judgmental of women who have had abortions. Who here in this Chamber - or, indeed, outside this Chamber - has the right to judge these women? I am concerned that this Bill could potentially lead to a woman, in whatever circumstances, being sentenced to up to 14 years in prison.
The fact is that the lives of some women are placed at a real and substantial risk due to their pregnancy. In these cases only a termination of the pregnancy, as distinct from the termination of the life of the unborn, although that can be a consequence of the intervention, will save their lives. That is already accepted practice in this State. It is also the current legal position, as is an intervention where the woman's life is at real and substantial risk due to the threat of suicide. If passed into law, this Bill will legalise a termination only where there is a real and substantial risk to the life of the mother, including a risk of suicide.
This legislation has been a long time coming and the issue that gives rise to it has been at the centre of considerable debate and controversy for many years. The tragic death last year of Ms Savita Halappanavar, and the evidence emerging out of the inquest, refocused attention. It also underlined the urgent need for legal clarity for doctors and protection for pregnant women. The HSE report on Ms Halappanavar's death was published in the past few weeks and on the same day as this Bill, and because of its direct relevance to the legislation, I wish to comment on it. I take the opportunity again to extend my deepest sympathy to Mr. Praveen Halappanavar and all the relatives and friends of Savita. Like the outcome of the inquest, the report has far-reaching implications. It is extremely serious and distressing that the report found that Ms Halappanavar's death had resulted from inadequate assessment and monitoring of her condition and a failure to offer all options to her. University College Hospital Galway's non-adherence to clinical guidelines relating to the prompt and effective management of sepsis, severe sepsis and septic shock from the time of first diagnosis contributed significantly to her death. We may never be able to state definitively that this Bill, if it had been in force at the time of Ms Halappanavar's hospitalisation, would have saved her life. However, there are good grounds, based on expert evidence, for believing that this would have been the case, as a termination would have been regarded as a life-saving option to which Ms Halappanavar should have had timely access.
The background to this debate goes back further, however, to 1992, when a 14-year-old girl became pregnant as a result of rape and was suicidal. The then Attorney General sought an injunction preventing the girl from travelling with her parents to have an abortion abroad. The case, known as the X case, went to court and the Supreme Court ruled that a termination of pregnancy was lawful if it could be shown that there was a real and substantial risk to the life, as distinct from the health, of the mother. In 2010, the European Court of Human Rights ruled that the State violates the rights of pregnant women by refusing to allow them to receive lawful terminations in the event that a pregnancy could threaten their lives. The decision by the European Court of Human Rights made it clear that there is an onus on the State to legislate under the terms of the Constitution and the decision in the X case. Regrettably, previous Governments failed to face up to this issue. It has taken 21 years for this legislation to be produced.
It is a fact that there are sharply divided opinions on this issue and that was clearly evident during the recent Joint Committee on Health and Children hearings. Most of the focus in those hearings was on the issue of suicide, with a number of medical people and politicians giving evidence that abortion is not a treatment for suicide. Nobody contends that it is. They also claimed that this could open up the possibility of large numbers of women using the threat of suicide to secure a legal abortion. I believe that these arguments are disrespectful to women and impossible in the light of the proposed legislation. I share the view of the former Supreme Court judge Mrs. Justice Catherine McGuinness that the proposals are "sufficiently rigorous" to ensure that very few cases will be dealt with in respect of the threat of suicide.
For our part, Sinn Féin has set out its clear position on abortion. Our policy, which is not in favour of abortion, has been settled policy for us for some time. In the Northern Ireland Assembly, we opposed and voted against the proposed extension of the 1967 British Act to the North. We believe, as I stated earlier, that all possible means of education and support services for women should be put in place.
The legislation being proposed by the Government aims to address the issue of a pregnant woman whose life is at risk and who requires a medical termination, and the need for legal clarity for doctors involved in such a procedure. It does this in the context of existing constitutional law as interpreted by the Supreme Court in the X case. Sinn Féin has stated consistently that legislation is required in line with the X case judgment and in compliance with the A, B and C v. Ireland judgment and the expert group recommendations. In fact, it is long overdue. I commend the Minister, Deputy Reilly, on his introduction of this legislation.
There is now a widely held view - according to recent opinion polls, a clear majority view - in Irish society that legislation along the lines originally set out in the heads of the Bill, and now in this legislation, is necessary. It is not perfect legislation. Notwithstanding this, judged in the round, and taking into account the pressing need for long overdue legislative certainty and clarity, Sinn Féin will support this legislation.
This is certainly the most difficult and contentious piece of social legislation I have discussed in my years in the Oireachtas, and it has consumed a great deal of time for all Members, including myself, over the past number of months, particularly since the report of the expert group and the chain of consultative arrangements that were put in place subsequently.
One of the points I want to make at the outset is that lobbying is part and parcel of the democratic process. Personally, I very much regret the attempt to demonise one side of the debate based on the actions of a small minority. It is true to state that this has been, by and large, a dialogue of the deaf. There has been very little willingness to have real and open engagement, particularly on the extremes of both sides of the argument, and I suppose one must bear in mind also that the vast majority of people have not spoken at all on the issue. It is unfortunate that the actions of a small minority have been elevated to such importance as to provide a justification in some respects for the demonisation of one side of the argument. I have been the subject of quite a good deal of representation - it was ongoing up to this very day - on the matter. I would say that 99% of it has been respectful and conveyed in an appropriate manner. While in most cases we have had to agree to differ on the issue, those involved behaved in an exemplary manner. In that sense, I want to put on the record some correspondence I received from the Carrigrohane Union of Parishes, which is the Church of Ireland parish in my constituency. It wrote to me recently in respect of this legislation, stating:
We, as members of Carrigrohane Union of Parishes,
Thank you for the time you have taken to listen and are ashamed of the abuse you may have received in the name of the Church and Christ.
Are concerned about possible lax interpretation of the legislation and ask that as a public representative you are vigilant in the application of the Act.
Request that in the legislation requiring the annual reporting of notifications of terminations to the Health Minister before 30th June each year, that this is reinforced by requiring the Health Minister to present it to the Dáil for consideration, so that the government is seen to be accountable.
We offer you our prayerful support in your difficult role as a public representatives, and pray for healing and forgiveness so that we can know the blessing of God is in our nation.
They go on to say, "You have listened... you have faced formidable pressures... we may not agree about everything, but you have our respect. Thank you." That summarises, by and large, the tenor of many of the representations I have received. That is from the Church of Ireland but I have also engaged directly with members and clergymen from most of the Christian churches, including the Catholic Church, and I encountered the same tenor. Lobbying is part of the process and we must be cognisant of that.
There is a view that we do not need to legislate and that we could continue to ignore what is an established constitutional right since 1992. I accept there is no legal imperative to legislate. Neither the Supreme Court ruling nor the judgment from the European court in the A, B and C v. Ireland case specifically obliges us to legislate. The European court ruling obliges us to clarify. I sat through the health committee hearings in January after the publication of the expert group report and the hearings in May after the publication of the heads of the Bill. I listened to constitutional experts, obstetricians, gynaecologists, psychiatrists, perinatal psychiatrists and representatives of all the churches. It became abundantly clear that this is enormously complex. While clarity is necessary, it is difficult to see how the appropriate clarity can be provided outside the legislative process.
Some people have suggested guidelines as an appropriate instrument. In that respect I will refer to the current Medical Council guidelines that relate to abortion. The guideline states: "Abortion is illegal in Ireland except where there is a real and substantial risk to the life (as distinct from the health) of the mother. Under current legal precedent, this exception includes where there is a clear and substantial risk to the life of the mother arising from a threat of suicide. You should undertake a full assessment of any such risk in light of the clinical research on this issue." For me and most reasonable people, those guidelines are quite vague relative to what is contained in the legislation, where there is an onus of consultation with a number of medical practitioners before an entitlement to a termination can be vindicated. I quote the guidelines merely to show that the current Medical Council guidelines are unsatisfactory. The legislation is an improvement in the sense that the woman seeking a termination under the suicide provision will be obliged to go before a panel of three medical people, two of whom shall be psychiatrists. This is not provided for in Medical Council guidelines. Guidelines are not the be-all and end-all in respect of clarity and in that sense do not serve to advance the euphemistic pro-life interest, as I see it.
Another point must be made in respect of what is already an established constitutional right since 1992. It emerged in a response to a parliamentary question tabled recently by my colleague, Deputy Timmins. He asked the Minister for Children and Youth Affairs in respect of the C case to provide information on the number of girls in the care of the State "that were taken to Britain or elsewhere for an abortion following a court decision, following testimony from a psychiatrist for the State that she was suicidal for each year from 1998 to date in 2013; the psychiatrist involved on each occasion; and if she will make a statement on the matter." The Minister replied as follows:
I am advised by the HSE that six minors who were in State care were assisted in travelling abroad for abortions since 1992. The circumstances in each case are complex and unique to the individual involved. In the interests of confidentiality and given the very low numbers involved the HSE is constrained from providing details of the individual cases. The HSE has confirmed that it acted within the legislation and in the best interests of the children involved in all cases. In each of the six cases a psychiatrist was involved in providing an assessment of the mental health needs of the child. In four of the six cases a court hearing was convened."
Under the constitutional right established since 1992, six children in the care of the State who were pregnant have had that right vindicated. It is not as if this legislation is establishing a new legal right. It is providing the clarity required for how that legal right may be interpreted and in many respects, in the context of how it was accessed or vindicated up to now, it is making it more restrictive in terms of the obligation to consult more widely.
In respect of the suggestion that we are not required to legislate, the reason I quote that reply and the Medical Council guidelines is that the right already exists, but how the right is vindicated is shrouded is uncertainty. Some have already vindicated it. Guidelines are wholly inadequate in my view in the context of the guidelines that already exist under the Medical Council. Others say we can deal with this by regulation. However, regulations must be underpinned by some form of primary legislation, so it is a circuitous argument. Given the complexity of the issue, I believe the only way to provide the required clarity is to proceed by way of legislation.
There are a number of issues I wish to raise with the Minister. Framing this legislation has been something of a high-wire act in trying to move within the parameters of the X case judgment in 1992, the A, B and C v. Ireland judgment, the constitutional provisions of Article 40.3.3° and the expert group report. That is the space within which the legislation is framed. I have raised a matter previously with the Minister, so he might address it in detail in his reply to the debate. It has been raised in the public domain most recently by the former Director of Public Prosecutions, DPP, Mr. Eamonn Barnes. He argued, perhaps more cogently in a legal way than I could when I raised the issue in the health committee hearings on the heads of the Bill, that whether we like it or not there is an Article 40.3.3° in the Constitution. It states that the State recognises the equal right to life of the unborn and in so far as practicable shall by its laws seek to vindicate that right. As a father, husband, brother and son in respect of my relationships with the women in my life, I find it difficult to grasp that equal right to life. In my family circumstances I would certainly elevate the right to life of the mother. I believe most people would, notwithstanding the difficulty of the situation.
However, in the legislation are we not legally elevating one right above the other beyond what was envisaged in the 1982 amendment to the Constitution by granting, in section 13, a right of appeal to one party above the other in respect of entitlement to a medical procedure to terminate a pregnancy? That is the point both I and the former DPP have raised. Would it not be appropriate that an authorised medical officer - I am not anxious that this matter would become bogged down in a legal sense - appointed under this legislation would be empowered to act if it sees fit and bearing witness to all the medical evidence, to represent the interest of the unborn in any proceedings that might be undertaken under sections 7, 9 or 13? The latter two are the sections dealing with an entitlement to a termination under the suicide provision or entitlement to an appeal where a decision has been refused by the appropriate panel. In the interests of ensuring the constitutionality of the Bill, this is something that raises fundamental issues about what we have provided for in the context of an appeal.
I say this because it is against the background of Article 40.3.3° that this legislation will undoubtedly be adjudicated upon, either by referral by the President after consultation with the Council of State or by way of subsequent challenge by some third party. There is a danger that the constitutionality of the legislation might be undermined by that failure or the elevation of one party’s entitlement above another. I say this cognisant of the flaws in the provision that was inserted in the Constitution and how it has since been interpreted. In many respects, the referendum outcome has been a bitter harvest for those who, in 1982, advocated for a referendum. They certainly did not envisage the outcome although wiser counsel in many quarters did in 1982 predict it as a possibility. I would like to see the comprehensive, legal Government response to this issue.
I thank the Minister for his engagement with me and others on the Bill to date. Reference has been made to Lord Steel’s legislation in the United Kingdom and to the French and Californian experiences. I am conscious of these. It is important, in framing our legislation and given its complexity and the fact that there was very little meeting of minds among all the experts we heard, that we put in place an effective review mechanism. Its genesis, but certainly not the finished article, is encompassed in the legislative provisions for notifications. I wish to raise with the Minister some of the weaknesses I noted, and I hope he will be in a position to improve upon these on Committee Stage. There is a requirement under section 20 to report to the Minister where a medical procedure referred to in section 7(1), 8(1) or 9(1) is carried out. The glaring omission is that there is no reporting or review mechanism concerning decisions made under the appeal system. That should be addressed. Section 20(3) states:
The following information is specified for the purposes of subsections (1)(a) and (2)(a):
(a) the Medical Council registration number attached to the registration of the medical practitioner who carried out the medical procedure referred to in section 7(1), 8(1) or 9(1), as the case may be, in respect of the pregnant woman concerned;
While I can understand the reason for this requirement, it clearly highlights the glaring omission of an equally or more important requirement to provide to the Minister the Medical Council registration numbers of the three medical practitioners who, under the legislation, jointly certify that an entitlement exists. This is because the three medical practitioners are effectively the gatekeepers. It is stated that perhaps one pregnant woman in 500,000 is genuinely suicidal and that nobody wants the death of that woman on his or her hands, but it is surely as important to know the identity of the three medical petitioners who certify an entitlement as the identity of the medical practitioner who carries out the medical procedure. Could the Minister commit to addressing this omission?
Section 20 states the Minister shall publish all the information he is furnished with by the appropriate institutions. A simple additional requirement would be the placing of the publication before the Houses of the Oireachtas by the Minister. I hope the Minister can accede to this based on conversations we have had on this matter.
It is ludicrous to talk about Oireachtas reform if the Executive continues to assume it knows best and that it is the only authority that may be dealt with. It is important that we review the impact of this legislation, particularly given the international experience and the facts that we are fallible and may get it wrong. Most people want to deal with emergency circumstances in which a woman's life is in danger owing to a physical condition or, perhaps more contentiously, a threat of suicide. We need to know annually how the legislation is working. In the process of reviewing the legislation before Committee Stage, could the Minister examine the two issues I have drawn attention to in regard to notification?
Section 15 requires the HSE to submit to the Minister a report on the operation of the chapter in question. I refer to the certification of identity on review. The purpose is to ascertain whether there are doctors who will automatically provide certification without due regard to best medical practice. The Minister stated he will not hesitate to use the powers afforded to him under the legislation, as drafted, to suspend a service in that instance. We will only know the answer by having an effective reporting mechanism. I would like the Minister to assure us that this matter will be dealt with.
I am prepared to support the legislation on Second Stage. It is the culmination of a very extensive consultation process. It does not involve an easy decision; it is difficult. I have gone to extremes to listen to and engage with all sides. I found the engagement process to be constructive in 99% of cases. There is an established constitutional right to be borne in mind. We would not trespass lightly on any other established constitutional right. I have heard the view that the judgment is flawed. I could imagine the hullabaloo that would have arisen if the Government had decided, in respect of the most recent ruling on its inappropriate handling of the children's rights referendum, that it was only a Supreme Court ruling and did not have to be taken very seriously. We have waited a long time to bring the required clarity to this issue. Doing so challenges all of us and forces us to deal with enormously complex issues. As lay people charged with legislating, we must take account of eminent persons in all the appropriate fields, who have failed to agree. The legislation is a measured step. In the context of suicide, which is the most contentious aspect, it is balanced in the sense that the entitlement to a termination on grounds of suicide must be in the context of those certifying entitlement in this regard being satisfied that no other form of treatment would effectively protect the life of the mother.
I welcome this opportunity to speak on the Government's Bill. I have said from the start that Fianna Fáil will not treat this issue as a political football as it is very complex, sensitive and personal. All sections of this Bill were thoroughly debated at the Oireachtas committee hearings and there was substantial input from legal, medical and psychiatric experts. Abortion has provoked debate throughout the country since the referendum in 1983 when the eighth amendment, inserting Article 40.3.3°, was made.
I am using the word "abortion" as it was explained by the experts that every pregnancy is terminated and that the vast majority of pregnancies terminate after a normal delivery in maternity units. In the 30 years since 1983, there have been many changes, and at least we are now allowed to have a rational and respectful debate in the Oireachtas.
This Bill was discussed at two lengthy hearings of the Joint Committee on Health and Children, in January and April this year.
It is only right that respect was shown to all Deputies and Senators and that the varying views and, most importantly, the legal, medical and psychiatric experts who are at the coalface were listened to at length.
Various forms of contraception are widely available and regulations were introduced years ago to allow for the availability of the morning after pill without prescription to prevent unwanted pregnancies. Sex education is provided in schools, as well as in the home, and Ireland has become a more open society. It is no longer dominated by the teachings of the Catholic Church and has become more pluralistic. There is no doubt that there was a considerable shift in public opinion following the unfortunate death of Savita Halappanavar. Rightly or wrongly, the media attention her death received both at home and abroad was a turning point in people's attitudes. People believe there should be legislation to allow doctors to intervene to save the life of a mother when it is in danger, while making every attempt to save the life of the unborn. All churches have the right to their opinion, but even though 84% of Irish people in the latest census declared themselves to be Catholic, it appears they are no longer dominated by the teachings of the Catholic Church because in the most recent MRBI poll more than 75% of people agreed that the Bill was acceptable. The churches have an obligation to inform their members about the Bill, but it is also important that this information be based on fact and truthfulness.
There are concerns about the issue of suicide and section 9 deals with the issue comprehensively, more so than the current law. The Bill requires a review panel to be set up to offer every woman the assistance she requires, something which is not in place currently.
Some Members have found it extremely difficult on a personal level to even consider voting for termination in any circumstance and there are those who believe the legislation is a reasonable response to a sensitive issue. I have examined the heads of the Bill closely, but I also informed myself on the choices for legislators. I base my comments on legal and medical facts, which is why I support the Bill, as I firmly believe it is the right thing to do as a legislator but also as a husband and a father. I genuinely do not believe there is an alternative to this legislation which the Government has published as a result of the ECHR judgment in the A, B and C v. Ireland case. The judgment acknowledged that only the Irish people could decide on Ireland's position on the termination of pregnancy but stated there was an obligation on the Government to provide a legislative pathway. In other words, legislation is required to provide for what is contained in the Constitution. Article 40.3.3° of Bunreacht na hÉireann provides: "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". There has been constitutional protection for the unborn for the past 30 years and there still will be after the Bill is passed. We need to be clear with the people and reiterate this fact as much as possible.
This legislation will provide doctors with legal protection when they are acting to save lives in emergencies and will ensure terminations are rare and only necessary when the life of the mother is in danger. At the joint committee hearings Dr. Gerard Burke described it as "reflecting common sense and reflecting the manner in which obstetricians currently practise and the Bill will make little, if any, change to the way patients are treated." This is important as groups with their own agendas are misconstruing the legislation and making exaggerated claims of floodgates being opened and our maternity hospitals suddenly turning into "abortion clinics". Nothing could be further from the truth. The Bill is more restrictive than the current law. There is no constitutional protection in the United Kingdom or America and, therefore, the floodgates will not open as a result of the legislation. Abortion will only take place in exceptional circumstances. The Bill provides that it will be an offence to intentionally destroy human life and a person who is found guilty of this offence will be imprisoned for up to 14 years.
The floodgates have not opened since 1992 when Article 40.3.3° was interpreted by the Supreme Court in X v. Ireland. The court concluded that a termination of pregnancy was permissible only when it was established as a matter of probability that there was a real and substantial risk to the life of the mother if such a termination was not effected. Basically, since 1992 abortion has been legal and, in an article in November 2000, Professor William Binchy accepted this by saying, "As a result of the holding in X, abortion is lawful." At the time he and others were calling for a referendum to allow medical intervention for mothers during an emergency but ensuring abortion would be illegal in Ireland. An all-party Oireachtas committee, chaired by the late Brian Lenihan, completed a report in response to the X case. It included evidence from experts in the legal and medical professions and a referendum was held in 2002. The report included a Bill - the Protection of Human Life in Pregnancy Bill 2002 - which provided for medical intervention when the life of the mother was in danger, as well as repealing sections 58 and 59 of the 1861 Act. The referendum fell by less than 10,000 votes. Two referendums seeking to reverse the decision of the Supreme Court in the X case were held and both attempts failed. It is the law since 1992 and it still is the law that women have the right to seek a termination on grounds of self-destruction.
Under this legislation, there will be a review panel comprising an obstetrician and two psychiatrists who will assess the woman and offer assistance and treatment. The woman may appeal any decision and this has to be held within seven days. The legislation will repeal sections 58 and 59 of the Offences against the Persons Act 1861 and provide a legal framework for doctors who work in maternity hospitals every day to save the lives of both babies and mothers. As the evidence from the masters of the maternity hospitals and obstetricians from hospitals outside Dublin showed, every effort is made at all stages of pregnancy to save the lives of both, even when there is a medical emergency that endangers the life of the mother and, with medical advances, the number of weeks after which the unborn is viable is decreasing every decade. In the 1990s survival was only possible after 26 weeks gestation, but, thankfully, this is now much lower at 23 weeks gestation. The Medical Council, the Institute of Obstetricians and Gynaecologists and the College of Psychiatrists of Ireland have welcomed the Bill. They believe it will strengthen the council's guidelines which have covered this issue for many years without legislative backup. A number of doctors who gave evidence to the committee believe the Bill is too restrictive and needs to do more than clarify existing law. I do not agree with expanding the Bill to allow a more liberal approach to abortion. Let us not forget that the people will ultimately decide if there is to be any change to Article 40.3.3°.
There should be strict monitoring of the number of interventions that result in abortions in order that any spike can be investigated. It is welcome that the Bill requires such interventions to be notifiable to the Minister for Health. This will prevent the floodgates from opening, as perceived, and will also be in keeping with the intentions of the legislation. The Bill is a reasonable, conservative and restrictive legislative response to the findings of the ECHR judgment, which is why I support it.
It is refreshing and welcome that we have had such a respectful debate on this issue. Everybody has been lobbied, but more and more we need respectful debate in the House. We need political leadership which we did not see, for example, this week from the Taoiseach on the Anglo Irish Bank tapes. He acted with a presidential decree like President George W. Bush and showed no respect for the House. A great deal of respect has been shown in other debates, but we did not witness respect this week for the House, politicians and the profession of politics. Unfortunately, instead of uniting the body politic against the cabal of bankers in the former Anglo Irish Bank who blatantly lied to the regulator and civil servants and going after them, we were engaged in a political blame game which besmirched politics.
It was disgusting to see the Taoiseach engage in that. I was particularly disgusted by his reference to an "axis of collusion", which serves only to let the clique at Anglo Irish Bank off the hook. It is not good enough. It was a sick smear and the Taoiseach should not have done it. Paul Williams confirmed on "Morning Ireland"-----
The Deputy must speak to the motion.
I am speaking to the motion. I am making a comparison between the respectful debate we have had on the Bill and what was said in this House earlier in the week. It was not good enough for the Taoiseach to behave like that. Paul Williams has confirmed that the tapes do not include any recordings of politicians, yet the Taoiseach chose to besmirch Members of this House instead of seeking unity among the body politic. The Taoiseach knows the truth of what happened, his party knows the truth, and the Irish people know the truth. He should not be making those types of allegations against Members of this House. He came in here and tried, in a sleveen fashion, to smear all politicians.
Will the Deputy speak to the motion?
What the Deputy is saying has nothing to do with the motion. He is taking advantage of the debate on a serious social issue to seek to absolve Fianna Fáil of its role in past events.
The Taoiseach cannot come in here and talk about an axis of collusion.
I ask the Deputy to return to the motion.
I am returning to the motion. There is nothing in the tapes to support the slur against the body politic by the Taoiseach this week. There is nothing to support what he said regarding the absence of files in his Department and the Department of Finance. That is all on the public record. Why is he going about the place digging a hole? He should do the decent thing and withdraw his remarks regarding an axis of collusion. If he is so concerned about tapes, why have we not had an inquiry into the Lowry tapes?
I have asked the Deputy to speak to the motion.
I am speaking to the motion. My point relates to respect for politics, something for which the Taoiseach showed no regard. He is acting like a political thug and boot boy. In behaving in such a party political fashion he is showing no respect for his office.
That is unacceptable, Acting Chairman.
I have repeatedly advised the Deputy that his remarks must relate to the Bill that is before us.
My comments are relevant. We must take stock of debates in this House. It simply is not good enough to have the Taoiseach and members of his Government acting as they did this week. They want to let the bankers off the hook and dump the whole issue onto a political kangaroo court.
I ask again that the Acting Chairman intervene. I am shocked that the Deputy would take advantage in this way.
I will have to suspend the sitting for five minutes if the Deputy does not speak to the motion.
I am making these points in the context of the respectful debate we have had on the Bill before us today. We did not, unfortunately, see the same respect for the body politic from the Taoiseach this week. His remarks should be withdrawn for the sake of the profession of politics. They were sickening to hear. I am entitled to make these points.
Not in the course of this debate.
I will conduct the proceedings, Minister. Is Deputy Collins ready to conclude?
I will conclude in two minutes. Do I have time remaining, Acting Chairman?
Yes, five minutes, but I ask the Deputy to confine his remarks to the Bill we are discussing.
Article 40.3.3° of the Constitution protects the life of the unborn. I would not support any watering down or attempted removal of that Article under any circumstances. I understand such removal is a policy goal of the Labour Party. It is not a position shared by me or by my party. When Fianna Fáil in government brought forward a referendum proposal in 2002 to address this issue, Fine Gael opposed it in a very cynical manner. Throughout this debate, members of that party have maintained that nothing was done for 20 years. This is another example of politics being besmirched. We had a referendum in 2002, before the Minister, Deputy James Reilly, was ever in politics.
It seems that any comments which offend Fianna Fáil sensitivities are deemed to be a besmirching of politics.
This Government will not acknowledge the lies that were told to its predecessor by Anglo Irish Bank. If Fine Gael had been in government at the time, it would have been lied to in exactly the same fashion.
We would at least have left some notes in the Taoiseach's office.
It is the same in the debate on the termination of pregnancies, the Fine Gael Party can never stick to the facts.
There were no notes in the Taoiseach's office about any of this.
The Deputy, without interruption. I remind the Deputy again to confine himself to the motion that is before the House.
The Fianna Fáil Party submitted a freedom of information request on this matter and we received volumes of files, most of them redacted. For members of this Government to come in here and claim there are no files is a complete lie.
The Deputy must speak to the motion.
They should show some respect instead of going around like political thugs and boot boys with their sleveen type accusations.
The Deputy is describing himself.
They should have some respect for Members of this House. The body politic was lied to by the bankers. Members of the Government have plenty of experience in banking themselves. If they were in government they would have been lied to in the same way.
What does any of this have to do with the Bill we are discussing?
I am responding to what the Minister said. He and his colleagues should stop going around in a dictatorial fashion declaring that what happened is the fault of everybody else. They have tried to establish a political kangaroo hanging shop, but it will not work.
The Deputy has two minutes remaining.
I advise the Government to learn from the manner in which the debate on this Bill has been conducted and show some respect for people. The arrogance on the benches opposite is out of control.
We have a long way to go to reach the level of arrogance displayed by the Deputy's party in government.
The Minister is not here long enough to speak about that. He came here in 2007, just as I did. He is not around the place long enough to talk about the arrogance of others.
I experienced four years of the previous Government's arrogance.
Arrogance is coming in here and seeking to establish a political kangaroo court. Arrogance is coming in here and misleading the country with claims of there being no files or records in regard to what happened with Anglo Irish Bank.
The Deputy will have to speak to the motion.
I have concluded.
Without wishing to digress further from the debate, it seems Deputy Niall Collins has identified the new Fianna Fáil party line, namely, that its leaders were not knaves but merely fools. I assure him that I never considered Brian Cowen or Brian Lenihan to be knaves, but their capacity to believe everything they were told by the banking sector shows they were very much fools. When anybody who comes to my office looking for anything, I do due diligence and think twice before giving them what they want.
The Minister should confine his remarks to the Bill that is before the House.
That is something one learns very quickly in politics.
I welcome the opportunity to contribute to this debate and articulate my support for the Bill. This legislation is not about suicide, which I will address in detail in due course. Rather, it is about protecting women whose lives are threatened during pregnancy and assuring doctors that they can do their job without fear of prosecution. If I were asked two years ago whether I believed legislation on this issue was necessary, I would have offered my considered view that it was not and that the current legal position was safe. I might have pointed to the very low pregnancy mortality rates in this country - in many years the lowest in Europe - and that abortions only occurred in Ireland where they were medically necessary. In short, I would have made the case that if the system is not broken we should not seek to fix it.
Various events in the past two years have changed my view on the question of the necessity or otherwise of legislation. The first issue is our discovery that guidelines, circulars and other legal instruments which are not underpinned by legislation will often come unstuck. This occurred most recently in respect of the motorised transport grant and the mobility allowance scheme, where a decision issued by way of circular did not have a legislative underpinning. Likewise, in the case of the Children First guidelines, we have seen the necessity of providing a legislative basis. Going back further, we all know what happened with nursing home charges when they were not underpinned by legislation. The message has gone out again and again that Governments cannot rely on guidelines, circulars or policy documents in the absence of a legislative framework. It seems clear in the case of the issue we are discussing that guidelines or anything of that sort are not an alternative to legislation.
Another factor in changing my position on the need for legislation was the judgment of the European Court of Human Rights. "C" was a real woman who was recovering from cancer when she became pregnant and sought advice as to whether a termination was in her best interest. She could not get an answer to that question from the medical profession in Ireland. It went back and forth between ethics committees but nobody would give her an answer.
Subsequently she had to go to the United Kingdom and have a surgical abortion at a later stage when she could perhaps have been told either that she did not need one at all or that she could have had it done as a medical abortion earlier on. That was not done because of the absence of a proper procedure to determine whether somebody's life was at risk and needed a termination. That is one of the reasons we have to change this situation. We also know from the testimony given by the Masters of the various maternity hospitals that 20 or 30 terminations occur in Ireland every year on medical grounds because they are necessary to save the life of the mother.
The Savita case changed things a lot for people in this country. The case was not handled well. There was a catalogue of errors and many things went wrong. This woman died of multi-organ failure secondary to septicaemia, secondary to a septic miscarriage. Everyone knows in medicine that when somebody is ill from an infection, the things one tries to do are, first, to treat with antibiotics but always to try to remove the source of the infection. The doctors in that case should have done so and should have done so early or, at the very least, should have had that conversation with the patient, but they did not. The patient and her husband requested a termination and were probably right in their diagnosis that a termination was necessary to save her life. Under this legislation what would happen at the very least? Under this legislation, if somebody requests a termination, a second obstetrician will be brought in to give an opinion and, at the very least, that second obstetrician might make the case go differently. Had this law been in effect at the time Savita Halappanavar might well have survived. The truth is that terminations are sometimes required to save the lives of pregnant women in cases of sepsis, cancer, PET, malignant hypertension and others and we need to ensure our laws provide for and facilitate this and to ensure there is no delay in performing such a procedure, where it is necessary.
Some people try to say this is not an abortion. They talk about it being "indirect" or "dual effect", the kind of things I have never seen in my medical textbooks. The reality is that the procedure is the exact same as it would be if it was a social abortion. It is interesting that many of the people who argued vociferously, with conviction and all the arguments behind them to support the view that these were not real abortions, no longer make that argument because it is not valid. I may not have been able to attend all of the hearings, as other Members did, but I am a qualified medical doctor; I have a degree and higher diploma in obstetrics and did study psychiatry at least as part of my degree. Therefore, I do know something about these areas, even though some may think they know better.
That is not where the concern arises in connection with the Bill. It arises, in particular, in connection with the provision on suicide. Many Members of the House are concerned that the provision might be misused, that psychiatrists and obstetricians might certify abortions where they are not necessary to save the life of a mother and that they may be afraid not to do so because if a case does arise where they do not sign off or certify a termination and the woman goes on to kill herself, they may be blamed. That is the other chilling effect. We have talked a lot in recent weeks about the chilling effect. Members are concerned that we may introduce a whole new form of chilling effect, whereby psychiatrists and obstetricians may sign off on a termination inappropriately for fear that they might get it wrong. That is the reality where medicine combines with the law.
I can certainly understand the genuine concerns of many Members about the suicide provision in the legislation. That, however, ignores the fact of where we are now and the current legal position, as a result of the deeply flawed 1983 amendment to the Constitution and the Supreme Court's interpretation thereof in the X case. The current law in Ireland is that even a psychologist, someone who is not a psychiatrist, who is not even a doctor, can certify that a termination is necessary to save the life of a suicidal woman in the State. Thankfully, that does not happen or, at least, we do not think it happens. That is the current legal position in Ireland. The Bill is much stricter. It is much stricter than the current situation. It requires two psychiatrists and an obstetrician to certify that an abortion is necessary. They certainly cannot do it on the basis of suicidal ideation or tendencies. It has to be suicidal intent. They can only do it if they are convinced that this is the only means by which the woman's life can be saved. If the woman's life is not saved, it is a certainty that the life of the unborn will go too.
This is not pro-life legislation. I am not going to pretend that it is, but it is certainly more pro-life than the existing legal position. There are Members in this House who are legitimately concerned that this provision will be misused. This provision and this legislation are much tighter than the status quo. If the status quo is not being abused, why do these Members believe a law that is much tighter and stricter than the current legal position will be abused? Any law can be abused, but this law contains more safeguards than other laws and the existing legal position and on that basis it is much safer to legislate as we are doing than to allow the situation to continue as it is.
We must also consider the alternatives. This legislation will be tested in the courts which will decide on it either on the referral of the President or through a challenge to its constitutionality. Those who would not like to address the issue of suicide in the Bill must understand that can only be done by a third referendum on deleting self-destruction as a ground for abortion in the State. We have had two referendums on that issue. As is always the case in referendums, people vote all sorts of ways for all sorts of extraneous reasons, but they did vote "No" on two occasions in these referendums. I do not think it would be possible to ask people to vote a third time on that issue without asking other questions also, such as their view on allowing terminations on the grounds of rape, or alleged rape, or incest or the health of the mother or a foetus not compatible with life. People within and outside the House who are pro-life and who are calling for referendums should be careful what they wish for because they do not know, for example, exactly how big a Pandora's box they would open if this went back to a referendum. Public opinion has changed a lot and changed dramatically, even in the short number of years I have been in this House and that needs to be reflected in the strategies people put forward.
It is important to mention, too, that there are many very good colleagues in the Fine Gael Party who have deep concerns about this legislation. I would certainly not like to see my party lose anyone from its ranks over legislation that I do not believe will substantially change what is happening about abortion in Ireland. I do not believe this will open new floodgates or that huge numbers of terminations will occur on Irish soil that are not occurring already. I would really hate to lose colleagues on the basis of legislation that will be shown in two or three years time, when we face the next election, to have been safe and not to have been grounds to depart from a party which we all love. I appeal to people thinking of doing so to reflect on this and consider whether they really want to take a stand on legislation which will have been shown to be safe long before the next election takes place. We will know it is safe because for the first time we will have a reporting mechanism. We do not have this now. We know how many people have transmissible diseases, how many cases there are of certain infectious diseases because a doctor has to report them and fill in a form to do so. A good innovation and an advance the Minister has inserted in this legislation is a proper reporting procedure which I believe is very important as it will allow us to monitor where terminations are occurring and why. He has said he is willing to act should there be any unusual pattern or good reason to believe the legislation is being misused in any way. That is extremely important, too.
This is an emotive issue that is difficult for many people, but we need to reflect on it and be very careful not to repeat the mistakes made in the past, the biggest one being the 1983 amendment which was so flawed that it managed to offer a life to the unborn without defining "unborn" and to offer protections to pregnant women and the unborn but not to men or women who were not pregnant. In addition, it did not deal with the obvious conflict that was certain to arise when one gave an equal right to the unborn as to the pregnant woman because, as we all know, the unborn cannot survive without the mother.