Catherine Noone (Fine Gael)
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Welcome to our viewers. I request silence in the Gallery and within the committee when members are speaking. I really hope everyone will respect that request; it is important that no matter what people say or how much disagreement there is, we allow them to speak. We will not be speaking at length on any one matter because we agreed last week that we have had our debate on the substantive issues for the most part.

Obviously there will be some discussion but everyone must be reasonable about repetition, etc.

I shall now deal with the usual matters. The draft minutes for the meeting of 6 December have been circulated. Are they agreed? Agreed. Are there any matters arising? No.

We have received two items of correspondence. Is it agreed that we note them? Agreed.

Rónán Mullen (Independent)
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One of the items of correspondence relates to a letter from Ms Liz McDermott of One Day More. She requested that the same privilege be accorded to her correspondence as was accorded to other witnesses that came before the committee. At our last meeting a letter from the Danish ambassador was read into the record. He took issue with what I believe was Ms McDermott's testimony. She has requested that her clarification of certain issues be put on the record of the committee today.

Catherine Noone (Fine Gael)
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The Senator has made a fair point. The letter from Ms Liz McDermott of One Day More was about the rate of the terminations of pregnancies in Denmark and, therefore, it is not a matter for this committee. We can only deal with issues that relate to Ireland. The issues mentioned in the letter were read aloud by Deputy Mattie McGrath last week. He read the entire contents of her letter so it is on the record. I think that we should move on, if that is okay.

Rónán Mullen (Independent)
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If Deputy McGrath is happy that that be said in his name, I mean everything that was in her letter, then grand. I remind the Chairman of the phrase "what's sauce for the goose is sauce for the gander".

Catherine Noone (Fine Gael)
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Sure.

Rónán Mullen (Independent)
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I believe that every word Ms McDermott sent in should be read out. If it has already been read out, then I accept that point, in total.

Catherine Noone (Fine Gael)
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We will publish it. Does Deputy McGrath want to say something?

Mattie McGrath (Tipperary, Independent)
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I read most of it aloud but it is not the same as it being read by the secretariat.

Rónán Mullen (Independent)
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That is my point.

Catherine Noone (Fine Gael)
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We are not dealing with Denmark and the letter is on the record. I call Deputy Fitzpatrick as he has indicated a wish to speak.

Peter Fitzpatrick (Louth, Fine Gael)
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I have raised concerns about Down's syndrome children from day one of this committee. I think that the email that the committee received from Ms McDermott should be read aloud for the simple reason that the letter from the Danish ambassador was read into the record. Ms McDermott's email also contains a clarification for Deputy Jonathan O'Brien who asked her to clarify a few issues. She clarified everything in her email. It would take approximately two minutes to read her email again.

Catherine Noone (Fine Gael)
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I hear where the Deputy is coming from. I have ruled on the matter and that is just the way it is. In fairness, the letter is on the record and the matter related to Denmark. I remind members that we have a lot of work to do today. The letter is on the record and is available. It forms part of our report because it is on the public record. We need to move on.

Peter Fitzpatrick (Louth, Fine Gael)
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I accept what the Chairman has said.

Catherine Noone (Fine Gael)
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I promise the Deputy that the contents of the letter are on the record.

Peter Fitzpatrick (Louth, Fine Gael)
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I thank the Chairman.

Catherine Noone (Fine Gael)
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Is that agreed? Agreed.

I must take care of the usual housekeeping stuff because we are in public session. As everyone already knows, I ask people to please keep their phones switched off or on aeroplane mode.

Jerry Buttimer (Fine Gael)
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Is there any hope of getting the heat turned down in this room?

Billy Kelleher (Cork North Central, Fianna Fail)
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The powers that be are trying to encourage brevity.

Jerry Buttimer (Fine Gael)
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I agree with brevity.

Catherine Noone (Fine Gael)
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Every week I have had an ongoing battle about the heat in this room. There is a limit to what I can do but I have asked about the heating. I hope somebody will listen to me and turn down the heat.

Jerry Buttimer (Fine Gael)
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The Chairman is a multi-tasker.

Catherine Noone (Fine Gael)
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I thank the Senator. Today, we will make decisions on the report of the Citizens' Assembly. Our decisions will be reflected in a report that is due to be launched next Wednesday. As agreed in our module report, we will go through the report starting with module 1 that deals with the constitutional issues. Module 2 deals with the provisions in legislation and is where one can find the 13 reasons given to us by the assembly. Module 3 deals with the ancillary recommendations.

Since 20 September we have discussed and analysed these issues in great detail. Last week, members had an opportunity to put their overall views on the record. I urge that there be little if any repetition and that we are as business-like as possible.

I will now start with the decision required for module 1. We made a decision on 18 October not to retain Article 40.3.3° in full. I now propose that we follow the procedure used by the assembly and consider whether to repeal Article 40.3.3°. In the context of today's list of amendments, and previous discussions that we have had pertain to that, we shall deal with motionNo. 1. I ask Deputy Jan O'Sullivan to move the motion.

Jan O'Sullivan (Limerick City, Labour)
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I move motion No. 1:

That, having regard to the decision of the Committee not to retain Article 40.3.3° in full, the Committee recommend its repeal simpliciter.

I will not speak at length on my motion as we have a lot of votes to get through. We have had extensive discussion with our legal adviser, and subsequently in public session, on the different options in terms of the types of wording that should be put before the people by way of referendum. It is my view, and I think the view of others on this committee, that repeal simpliciteris the most clear way of dealing with the issue. It is already the responsibility of the Legislature to legislate and, therefore, it is not necessary to replace the wording. The Citizens' Assembly has recommended, that the replacement wording be that the Legislature would legislate and to put that into the Constitution. I think that would be confusing, it is unnecessary and all of the legal advice has suggested the same. Putting any other kind of wording back into the Constitution would simply brings us back to what I view as an inappropriate dealing with the issue by way of the Constitution. I feel that it should be dealt with by legislation. I propose that we recommend repeal simpliciteras the wording to go before the people.

James Browne (Wexford, Fianna Fail)
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I apologise for my absence during the statements here last week. I am the Vice Chairman of the Oireachtas Joint Committee on the Future of Mental Health Care and I had to attend a meeting of the committee.

Having heard and carefully considered the expert evidence before the committee, I shall vote against an inclusion of the words "repeal simpliciter". I call for a referendum to be held, as soon as reasonably practicable, to replace the eighth amendment in the Constitution and allow for terminations in the following cases: the real and substantial physical risk to the life of the woman; the real and substantial risk to the life of the woman by suicide; the serious risk to the physical health of the woman; the mental health of the woman; the health of the woman; pregnancy as a result of rape; and if the unborn child has a fatal foetal abnormality that is likely to result in death before or shortly after birth. Also, the referendum or legislation should include the following caveat - if it was passed at a referendum, any such legislation would be passed within six months by the Dáil so that there are no delays.

Finally, I believe, irrespective of what happens, that there should be decriminalisation of women who obtain a termination whether it is illegal or not.

Catherine Noone (Fine Gael)
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Motion 1 has been tabled by Deputy Jan O'Sullivan and motion 2 was tabled by Deputy Mattie McGrath. Is it agreed that we discuss them together? Agreed.

Hildegarde Naughton (Galway West, Fine Gael)
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I want to clarify that I am in favour of repealing based on legislation published in tandem with the referendum so that citizens clearly know what will replace the eighth amendment in the event of a question being put to the people of whether they wish to repeal or not. It is for that reason that I do not favour repeal simpliciter. I believe that legislation needs to be published in tandem with any referendum that is put to the people.

Kate O'Connell (Dublin Bay South, Fine Gael)
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I only have an issue with the first part of the motion and the words: "having regard to the decision of the Committee not to retain Article 40.3.3°," which we voted on some weeks ago. I suggest that we simplify Deputy Jan O'Sullivan's motion and say that the committee recommends the repeal simpliciteras outlined in the legal advice received by the committee and not refer to our previous Vote here. Perhaps I am being pernickety about the matter. I suggest that we have a stand-alone clear motion that does not refer to anything else that happened previously. Maybe we should state that the term "repeal simpliciter" was used in our legal advice, which would tidy up the motion.

I wish to refer to the point made by my colleague, Deputy Naughton, about having legislation in tandem.

It is my personal view that we heard evidence that showed the difficulties with publishing legislation in tandem, including that it would be subject to amendment in the Houses of the Oireachtas. It is my understanding the recommendations of the committee will go to the Department of Health and that it has the heads of a Bill ready to go, depending on what is included in the report. That is happening, notwithstanding the fact that we heard, according to our legal advice, that there were slight issues with it in that it could be amended. I wanted to make that point.

Rónán Mullen (Independent)
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I would like to speak against Deputy Jan O'Sullivan's motion and in support of Deputy Mattie McGrath's proposal that the committee recommend that Article 40.3.3° be retained in full. Article 40.3.3°, when passed in 1983, established Ireland as a beacon of human rights in this area. It took decisions on this life and death issue away from the political and judicial elites and has led to a situation where Ireland consistently has the best medical practice. Only today, we have news from the Institute of Obstetricians and Gynaecologists which reminds us that Ireland is one of the safest places in the world in which to have a baby. Our figures are even better than those for Britain. We have seen how in country after country, when this issue was given over to politicians, there was a steady liberalisation of the law. Therefore, we are not just talking about a limited abortion regime but about an increasingly liberal one. In repealing the eighth amendment simpliciterthe people would be invited to trust that politicians would not continually liberalise the abortion regime more and more until we had a law similar to that in Britain, where four times as many abortions take place per year, per capita, according to the figures available to us. I strongly urge the committee to reject amendment No. 1 and support amendment No. 2.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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I would like to speak on behalf of my party in favour of repeal simpliciter. It is essential that we make the decision as clear cut as possible. Many of the difficulties, as advised by the people from whom we heard, arose from the fact that this issue was dealt with in the Constitution in the first place. We heard evidence from health professionals that the eighth amendment was an impediment in doing their job and offering a full range of health care services to women. For that reason, while I am not sure if a seconder is required, we will certainly second the amendment in favour of repeal simpliciter. We had discussions about the numbers of Irish women who travelled to England and I came to the conclusion that it was not possible to determine the numbers and that neither was it possible, therefore, to determine the actual rate of abortion for this country. On the basis of the information given to us by health professionals and persons who are very eminent in their field, including legal professionals, the overwhelming evidence is that repeal simpliciteris what we should be recommending as a committee.

Billy Kelleher (Cork North Central, Fianna Fail)
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I am supportive of the amendment in favour of repeal simpliciter. The best way we can reflect our support or opposition is by casting a vote. With reference to Deputy Hildegarde Naughton's proposal that, while she is in favour of repeal simpliciter, there be an addendum to it, it would be better to separate it out. If the committee agrees, in the body of the report there should be a recommendation that legislation or the heads of a Bill be published to reflect the views of the committee in order that, if a referendum is held, the public would have an idea of what the Oireachtas intended to legislate for. However, attaching it to repeal simpliciter would not make repeal simpliciter very simple.

Clare Daly (Dublin Fingal, Independent)
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I do not think there is a contradiction in that repeal simpliciteris not an alternative to repeal and replace with alternative legislation. We know from testimony that legislation is being prepared and that, in order for it to be facilitated, Article 40.3.3° has to be removed from the Constitution. I echo the points made. We need to make the position clear and give some space for those who are in favour of legislation.

Catherine Murphy (Kildare North, Social Democrats)
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I do not think everyone understands the process, in particular those who have not been part of it and those who do not understand Dáil and legal procedures. Essentially, the legislation will not be put to the people unless the referendum is carried. That will be down to the public. The legislation would just be to give an indication of what might follow. We should include in the report that if that is what is done, that it be done without delay afterwards. There is a concern that there would be a time gap. I will be supporting the amendment in favour of repeal simpliciter.

Jerry Buttimer (Fine Gael)
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Ar an gcéad dul síos, ba mhaith liom fíorbhuíochas a ghabháil le Cathaoirleach an choiste as ucht an obair atá déanta aici sa phost sin. I congratulate the Chairman on bringing us to this important day. For those watching at home, this is an example of the Oireachtas doing its work properly. I commend all members of the committee for their diligence.

I support the motion tabled by Deputy Jan O'Sullivan. Like Deputies Lisa Chambers, Billy Kelleher and Hildegarde Naughton, I believe it is important that the heads of a Bill be published in tandem to indicate the intent of the Government because it is about ensuring there will be information available and a wide and sensible debate, if possible.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I reiterate what has been said. However, if we insist on the publication of legislation simultaneously in putting the referendum, we will be in danger of delaying it. I asked the Taoiseach in the House today if he could give us a guarantee about the holding of an early referendum. His reply was that he wanted to have a referendum held in May and that he would be asking all Members of the Oireachtas to co-operate in making sure that would happen. Therefore, as we are up against time, repeal simpliciteris the best way to ensure that will happen. We know from evidence that the heads of a Bill are being published.

Catherine Noone (Fine Gael)
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I want to tell members, as I was not aware of it, that if we are to vote, we will have to ring the bells, if everybody is not present. If we are coming close to the calling of a vote at any stage, although I am not trying to imprison members and those who may have to leave the room, they should be mindful of the fact that we will have to ring the bells if everyone is not present.

Peter Fitzpatrick (Louth, Fine Gael)
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A press release yesterday, 12 December, from the Institute of Obstetricians and Gynaecologists welcomed new figures that showed that Ireland was one of the safest places in the world in which to have a baby. A maternal death rate of 6.5 per 100,000, or one in every 15,301, is extremely low compared with a rate of 8.8 per 100,000 in the United Kingdom and 26.7 per 100,000 in the United States. Figures published by Maternal Death Enquiry Ireland show that maternal deaths in Ireland are extremely rare and that the rate is marginally ahead of rates in the United Kingdom. The data also show that 66% of maternal deaths were due to a pre-existing health condition, with heart disease being the leading cause of death. Dr. Peter Boylan, chairperson of the Institute of Obstetricians and Gynaecologists, who came before the committee, stated:

These figures should offer reassurance about the high level of maternal care and the safety of the Irish maternity services for women and babies. A maternal death rate of 6.5 per 100,000 or 1 in every 15,301 is extremely low and compares with a rate of 8.8 per 100,000 in the UK and a rate of 26.7 per 100,000 in the US.

As I have said all along, Ireland is one of the safest countries in the world in which to have a baby, as confirmed by Dr. Boylan. I will not support anything that will not retain Article 40.3.3°. I will be supporting Deputy Mattie McGrath's proposal that the committee recommend that the article be retained.

Kate O'Connell (Dublin Bay South, Fine Gael)
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Although I have already spoken, I would like to make the point that if the metric we are going to use to measure women's health is how many we let die, we are in a bad situation.

Catherine Noone (Fine Gael)
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Thank you, Deputy. I will move on to Deputies Durkan and Mattie McGrath. I apologise to Deputy Durkan for not seeing him indicate.

Bernard Durkan (Kildare North, Fine Gael)
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I am not quite invisible. We should recognise the important issues involved in this debate and the evidence adduced during the hearings.

Catherine Noone (Fine Gael)
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Can we have one voice in the room, please?

Bernard Durkan (Kildare North, Fine Gael)
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Over the past ten years, both sides of the debate have called for a referendum. In accordance with those expressed wishes, it follows that we should go along with the recommendation to put before the people a question on which they can decide. I think we should proceed in that context.

Catherine Noone (Fine Gael)
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Thank you, Deputy. I do not think we should overstate our power at the end of the day.

Bernard Durkan (Kildare North, Fine Gael)
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Our power is not the ultimate power at all.

Catherine Noone (Fine Gael)
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It is up to the Irish people.

Mattie McGrath (Tipperary, Independent)
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Do the amendments have to be moved, formally proposed and seconded?

Catherine Noone (Fine Gael)
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No.

Mattie McGrath (Tipperary, Independent)
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They do not. Obviously, I am opposed to this. The deletion of Article 40.3.3° of the Constitution is not required to protect the life of the mother. It is possible to provide any additional clarity that may be required by medical professionals by way of ordinary legislation, or amended medical practice guidelines, or both.

Catherine Noone (Fine Gael)
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Thank you, Deputy. I call Senator Ned O'Sullivan.

Ned O'Sullivan (Fianna Fail)
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I am ad idemwith my two colleagues, Deputies Lisa Chambers and Billy Kelleher. I do not propose to speak about each vote we will be taking. My understanding of the procedure is that we are now in a voting situation.

Catherine Noone (Fine Gael)
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Exactly.

Ned O'Sullivan (Fianna Fail)
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We have all spoken at length for the past three months.

Catherine Noone (Fine Gael)
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Thank you for making that point, Senator.

Ned O'Sullivan (Fianna Fail)
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I think we should proceed to the individual votes, maybe with a proposer and a seconder.

Catherine Noone (Fine Gael)
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As he has indicated, I will let Deputy Jonathan O'Brien in.

Jonathan O'Brien (Cork North Central, Sinn Fein)
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I was going to propose what Senator O'Sullivan has just proposed.

Catherine Noone (Fine Gael)
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Two sensible men.

Billy Kelleher (Cork North Central, Fianna Fail)
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I had already made the same proposal

Catherine Noone (Fine Gael)
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Yes. It is all very sensible. I call Deputy Rabbitte.

Anne Rabbitte (Galway East, Fianna Fail)
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While I am very much in favour of a referendum, I am not in favour of repeal simpliciter. I am in the same position as Deputy Browne. I support what he has said for all the same reasons.

Catherine Noone (Fine Gael)
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Thank you, Deputy. The clerk will now ask members, in alphabetical order, to vote "Tá" or "Níl" on motion 1, repeal simpliciter. I will go last. I will be abstaining, unfortunately, as I believe it is the most appropriate thing for me to do as Chairman of the committee.

Catherine Noone (Fine Gael)
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In line with the conversation we had earlier, after each motion we will put another question to the committee regarding the position of the Citizens' Assembly. We will now move on to motion 3, in the name of Deputy O'Connell. She has proposed a substitute motion 3, which encompasses the original motions 3, 4 and 5. As no new issue is being raised in substitute motion 3, I am accepting it for consideration. It will now be discussed with motions 4, 5, 7 to 9, inclusive and 10 to 17, inclusive, all of which deal with the risk to the life or health of the woman. I should advise that if substitute motion 3 is accepted, motions 4, 5, 7 to 9, inclusive and 10 to 17, inclusive, cannot be moved. Part of motion 9 is an exception to this. I will deal with that later.

Jerry Buttimer (Fine Gael)
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On a point of clarification, the original grouping list we received referred to motions 11 to 17, inclusive. Is the Chair correct in referring now to motions 10 to 17, inclusive?

Jan O'Sullivan (Limerick City, Labour)
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Some of us have a different grouping.

Catherine Noone (Fine Gael)
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This change has been made a result of the late substitution

Jerry Buttimer (Fine Gael)
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All right. Okay.

Catherine Noone (Fine Gael)
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It has been clarified.

Jerry Buttimer (Fine Gael)
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That is fine. Go raibh maith agat.

Catherine Noone (Fine Gael)
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I call Deputy O'Connell to move-----

Jan O'Sullivan (Limerick City, Labour)
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Will the Chair circulate the new grouping list?

Catherine Noone (Fine Gael)
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There is no new grouping list.

Hildegarde Naughton (Galway West, Fine Gael)
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Will the Chair call out the groupings again?

Catherine Noone (Fine Gael)
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I will. Motions 3, 5, 7, 8 and 11 to 17, inclusive are being taken along with motions 4, 9 and 10 because they are encompassed by motion 4. I ask Deputy O'Connell to move motion 3. I will take short contributions on the motion before we make a decision on it.

Kate O'Connell (Dublin Bay South, Fine Gael)
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I move motion 3:

That the Committee recommend that termination of pregnancy be lawful where the life or health of the woman is at risk and that a distinction should not be drawn between the physical and mental health of the woman. Provision for gestational time limits for the termination of pregnancies be guided by the best available medical evidence and be provided for in legislation – any assessment in relation to the termination of pregnancy where the life or the health of the woman is at risk be made by no fewer than two specialist physicians.

I would like to explain the genesis of this motion. As a committee, we were tasked with looking at the recommendations of the Citizens' Assembly. Some 72% of members of the assembly voted to recommend that "a distinction should not be drawn between the physical and mental health of the woman". That is why this motion mentions physical and mental health. I understand that termination of pregnancy where the life of the woman is at risk was dealt with in the Protection of Life During Pregnancy Act 2013. This motion seeks to bring everything together. I realise that members have concerns about health risks. We heard extensively at this committee about individual cases in which the level of risk can be very low in the morning, but the woman's life can be in danger by the evening. In order to deal with that, this motion provides that where the life or the health of the woman is at risk, this determination shall be made by no fewer than two specialist physicians. The 2013 Act provides for a determination to be made by two or three physicians. This committee has not heard of any case that has happened up to now in which a second or third physician has not been available to sign off on it.

I promise I will not go on all day. It is important for members to understand what we mean by risk to the health of the woman. Severe hypertension - blood pressure - can be difficult to control in the case of a pregnant woman. It is often the case that when high blood pressure kicks in around the 20th or 22nd week, it gets to a point where the only way to rectify the problem is to deliver the child. Severe hypertension, which is difficult to control, is often associated with kidney disease in the woman that is likely to deteriorate in pregnancy. The outcome for the woman in such circumstances is often a stroke.

I would like members to think of a woman who has one, two or three children at home - I have three at home - and is going to have a fourth child, but who has hypertension at 23 weeks and faces the possibility of being rendered disabled and unable to communicate for the rest of her young life. Often, diabetes can be more difficult to control during pregnancy. There are also clotting disorders. On its own, a clot in a leg is not a major problem, but if it becomes a pulmonary embolism, that is, a clot in the lung, it can pose a serious risk of stroke during the pregnancy if the pregnancy is not terminated.

Members may have concerns regarding gestational time limits. The motion reads: "Provision for gestational time limits for the termination of pregnancies be guided by the best available medical evidence and be provided for in legislation". I cannot understand how anyone could have any issue with that, given that the Royal College of Obstetricians and Gynaecologists comprises the experts in this field.

Generally, the issue of gestational age limits only applies to late diagnoses of foetal abnormality, for example, anencephaly, due to scanning being unavailable, which we have addressed in the ancillary recommendations. If viability is reached, it is not regarded as an abortion, but a pre-term delivery. Doctors always make every effort to save the baby's life. Viability now sits at approximately 23 weeks. Although survival rates are low at that gestational level and disability rates in survivors are high, we have maintained the lives of people born at 23 weeks.

I wish to reassure members that the health risk to the mother would be defined by two doctors and the gestational limits would be set by the doctors' governing or ethical bodies.

Ned O'Sullivan (Fianna Fail)
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I second that.

Catherine Murphy (Kildare North, Social Democrats)
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I understand that motion 9 is in this grouping. It is not terribly different from the composite motion proposed by Deputy O'Connell. The only difference is that not just legislation would be required, but also regulation through the Medical Council and An Bord Altranais.

If this composite motion is accepted, we should also recognise that there cannot be a delay in receiving medical opinion where there is a serious risk to health. That matter could be included.

Paul Gavan (Sinn Fein)
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To speak in support of the motion, it is a well-worded composite based on motions proposed by a number of parties. I respectfully disagree with Deputy Chambers, in that the evidence has been clear - we cannot grade risk. That has been a consistent message from the medical experts who have presented to us. For that reason, we should support the substitute motion 3.

Catherine Noone (Fine Gael)
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I will interject to say that we discussed the possibility of voting on motions and then clarifying by voting on the Citizens' Assembly's recommendations. That covers us, but I will continue to take comments from members.

Bernard Durkan (Kildare North, Fine Gael)
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This is an important distinction. From the evidence presented during the hearings and having regard to the rapidity with which a woman's health can deteriorate in a situation such as has been set out, what may well not be a serious risk at a particular time may be a progressive risk, with its progress rapid, so that by the time the risk is determined as being serious and action is taken - if it is presumed that the seriousness of the risk will determine at all times what happens - it may be too late to save either mother or baby.

We have had this debate and I respect the point made by my colleague, but it is important that we remember something. If we recall the evidence that we heard, cases were referred to in which there was a rapid decline in the health of the mother. Either that rapid decline was not spotted in time or, if it was, it was impossible to do anything about it because it happened so quickly that no difference could be made.

In the interests of the health and safety of the woman and, for that matter, the child, it is better that action be taken earlier rather than later. That is the evidence that was adduced in the Citizens' Assembly's hearings and at this committee. That is the best medical evidence. In order to ensure that we do not have equivocation, we need to attach to the motion the most serious element that can happen in a particular case.

We should be conscious of the points raised by Deputy O'Connell regarding medical conditions and the degree to which a woman's condition and, consequently, that of the baby yet to be born can deteriorate.

Catherine Noone (Fine Gael)
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It is important to point out that the first part of Deputy Chambers's proposal is the Citizens' Assembly's first recommendation.

Catherine Noone (Fine Gael)
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And we will vote on that.

Catherine Noone (Fine Gael)
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A few other members have indicated. I will allow them to contribute, after which I will make a comment. We will then need to move on.

Rónán Mullen (Independent)
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The elephant in the room is that, in Britain, abortion on the grounds of mental health issues in particular has been the ground on which the widespread availability of abortion - effectively abortion on demand - has occurred. This is despite the fact that the ground has shifted in this area. When we heard evidence about mental health, we were reminded that there was no evidence associating abortion with improvements in mental health for women and that there was some evidence of a low to moderate increased risk to women's mental health in certain cases. That has led to calls for a change to the approach in Britain, even among those who support abortion as a right generally, so as not to link abortion with mental health as a ground. That was not challenged before this committee.

Linking mental health with physical health, in effect, seeks to bring in abortion on demand under the pretext of a therapeutic intervention.

On the question of physical health, we have heard no evidence at this committee that the health of any woman was compromised by the requirements of the settled law of Ireland. That is a fact. We have heard no evidence that any doctor was ever pursued by the criminal law for having made an appropriate therapeutic intervention that resulted in the loss of the life of an unborn child. The reason for that is as follows. Under the settled law of Ireland the threat to a woman's life does not have to be imminent. Several times Deputy Durkan has mentioned cases where people have died. I would like to hear what he is talking about because the settled law of Ireland has not compromised anybody's life.

Catherine Noone (Fine Gael)
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I urge the Senator to direct all his comments through the Chair.

Rónán Mullen (Independent)
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I will make two final points about the two specialist physicians requirement. First, it is known that the requirement in Britain to have the signatures of two doctors has been widely flouted on occasion. There is evidence, and needless to say this committee did not seek the evidence, of pre-signed letters of authorisation from doctors. That is a chilling reminder of how this law can easily be abused.

Second, references to best available medical evidence is a euphemism. The people, who this committee considers vectors of the best available medical evidence, spoke in terms of requiring abortion on request. In fact, their evidence always operated to reject distinctions between health grounds and a more general dealing with abortion on the grounds of a request. In one particularly chilling case we heard doctors speak in a very blasé fashion about late term abortions and that we should not be distracted by late term abortions of children even for a trivial reason like a cleft palate.

Catherine Noone (Fine Gael)
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Please stick to the point.

Rónán Mullen (Independent)
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I urge the rejection of these amendments.

Catherine Noone (Fine Gael)
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I thank the Senator and call Deputy Jan O'Sullivan.

Jan O'Sullivan (Limerick City, Labour)
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I reject the two statements about mental health being a ground for abortion on demand and that no woman's life has been at risk because of the current law. I disagree with both statements.

I support the composite motion put forward by Deputy O'Connell. There is merit in Deputy Catherine Murphy's motion to draw up guidelines in consultation with the Medical Council and An Bord Altranais. Perhaps guidelines would be drawn up anyway. Maybe we can include the provision in the wording in some other way but it is a useful point.

Catherine Noone (Fine Gael)
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We can put it in.

Hildegarde Naughton (Galway West, Fine Gael)
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I have a procedural question on the motions put forward by Deputies O'Connell and Lisa Chambers. Will we vote on the Citizens' Assembly recommendation in terms of a real and substantial physical-----

Catherine Noone (Fine Gael)
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That is the plan. It does obviate the necessity, in fact, to vote. I mean some aspects of the motion, as I said before.

Hildegarde Naughton (Galway West, Fine Gael)
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I refer to the ground of where there is a real and substantial risk to the life of the woman, which currently exists already. Will we vote on the matter?

Catherine Noone (Fine Gael)
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Yes, we absolutely will.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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I am a bit confused now. I support Deputy O'Connell's motion. There may have been a little disagreement over the requirement for two specialist positions but one would not die in a ditch for it. Her motion brings together several of the grounds which, if accepted, would not allow for us to subsequently vote on the reasons because the reasons would then be accepted. One of the recommendations is to link physical and mental health. I support what Senator Gavan said about the gradation of risks. All of the medical evidence suggests that one cannot grade risk as it is a fluid and moving thing. I think we should be guided by the doctors and nurses on this matter.

On a point of clarification, An Bord Altranais was abolished and the Nursing and Midwifery Board of Ireland was created.

Catherine Noone (Fine Gael)
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That is true.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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I suggest we refer to the board when we speak about the organisation.

Catherine Noone (Fine Gael)
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I call Deputy Buttimer. I mean Senator. I seem to have promoted him to Deputy.

Jerry Buttimer (Fine Gael)
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The Chairman is following a good pattern.

Catherine Noone (Fine Gael)
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I call Senator Buttimer.

Jerry Buttimer (Fine Gael)
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The settled law of this country has been shown to us on this committee as acting as an impediment to doctors, obstetricians and professionals doing their job.

I am happy to support the composite motion as it brings together different strands and, in particular, embraces the evidence that we have heard. I would like Deputy Catherine Murphy's motion on the Nursing and Midwifery Board of Ireland and Medical Council to be encompassed in this motion as well.

Catherine Noone (Fine Gael)
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There is no difficulty there and we will get to that. Senator Ruane indicated a while ago and I must allow her to comment.

Lynn Ruane (Independent)
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I have no issue with Deputy O'Connell's motion. I have an issue with the way the motions are grouped because my two motions are excluded even though they seek to include socio-economic as a health ground. We have heard lots of evidence about how some countries and jurisdictions, that have access to abortion on health grounds, also include socio-economic but do not name it as a ground.

I fear at this point that people do not understand how class, being in a minority group or being disadvantaged and suffering deprivation can have an impact. Sometimes these matters only come to light after the 12-week period. I hope the up to 12-week provision captures most of the women who might find themselves in this situation because of their socio-economic status. However, it does not mean that their socio-economic status will not affect them in their 14th or 15th week of pregnancy. They may find themselves on the street at any stage of their pregnancy. Their parents may have put them out of the family home because of the pregnancy. Perhaps the pregnant woman is unable to access supports or the father of her unborn child may have abandoned her. Loads of socio-economic stuff can come up after the 12th week of pregnancy. I hope that we could incorporate socio-economic under the health ground like other jurisdictions do. A vote on Deputy O'Connell's motion will totally rule out our consideration of socio-economic as a health ground. Can we address the matter?

I know that the socio-economic reason is recognised as a ground later on. I feel people are a little fearful to name socio-economic as a ground. I thought that people would be more susceptible to encompassing it as a health ground instead.

Catherine Noone (Fine Gael)
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Has any one else indicated? Deputy Lisa Chambers has indicated her wish to comment. I remind members that we need to move on.

Catherine Noone (Fine Gael)
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On the recommendation.

Catherine Noone (Fine Gael)
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Can we move on?

Bernard Durkan (Kildare North, Fine Gael)
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Madam Chairperson, Senator Mullen asked me to clarify a matter and I think that I should do so.

Catherine Noone (Fine Gael)
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Yes.

Bernard Durkan (Kildare North, Fine Gael)
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I did not make my remarks lightly. I made them having dealt with individual cases and not just sparsely but in recent times. All of the medical attention was available but it was not enough to help people determine when was the right time to intervene. It is critical, regardless of whatever intervention taken place, that recognition is given to the fact that both the mother and the baby are at risk at the same time. I mean an intervention, not necessarily to terminate the life of either. The time it takes to provide the medical assistance that is required can range between half an hour and two hours. It is important for me to emphasise that lives can be lost in that period.

Catherine Noone (Fine Gael)
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I would like to just hear the voice of Deputy Durkan and I do not want to ask again today.

Bernard Durkan (Kildare North, Fine Gael)
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The medical practitioners have experienced such situations and can confirm what I have said. In all of the cases that I have dealt with, of which there have been a few, the patient was the first person to indicate that she was unwell and that she did not have the confidence to continue. We must keep all of that in mind.

Catherine Noone (Fine Gael)
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The question is on the composite motion 3.

Rónán Mullen (Independent)
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Votáil.

Mattie McGrath (Tipperary, Independent)
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Votáil.

Catherine Noone (Fine Gael)
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We are all present so we can vote.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I want to ask a question. It is up to Senator Ruane to do the following. Can her motions on the ground of socio-economic be extracted and voted on separately?

Catherine Noone (Fine Gael)
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We will come to that.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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Will we?

Catherine Noone (Fine Gael)
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Yes.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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Because it says it is included in this.

Catherine Noone (Fine Gael)
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It is okay. We will deal with it. The vote has been called and I will ask the Clerk to the Committee to read out the names.

Jerry Buttimer (Fine Gael)
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Is this on the composite motion?

Catherine Noone (Fine Gael)
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Yes, on the composite motion.

Rónán Mullen (Independent)
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A Chathaoirligh,-----

Catherine Noone (Fine Gael)
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There is no further comment; we are voting.

Rónán Mullen (Independent)
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On a point of order-----

Catherine Noone (Fine Gael)
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One cannot make a point of order once the vote has been called.

Rónán Mullen (Independent)
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I only want to ask that what we are voting on would be read out. That is a reasonable request. Members are talking about composite motions.

Catherine Noone (Fine Gael)
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The actual motion, that is fair enough.

Rónán Mullen (Independent)
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Please. Each time we vote, we should have it read out.

Catherine Noone (Fine Gael)
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Yes, that is fair enough. The motion states:

That the Committee recommend that termination of pregnancy be lawful where the life or health of the woman is at risk and that a distinction should not be drawn between the physical and mental health of the woman. Provision for gestational time limits for the termination of pregnancies be guided by the best available medical evidence and be provided for in legislation – any assessment in relation to the termination of pregnancy where the life or the health of the woman is at risk be made by no fewer than two specialist physicians.

Catherine Noone (Fine Gael)
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Can we have quiet in the room, please? I am sorry to be so bossy but we will never get through our work unless we listen to one another.

We will now put the first Citizens' Assembly recommendation now: "That the Committee recommends that a termination of pregnancy be lawful where there is a real and substantial physical risk to the life of the woman."

Rónán Mullen (Independent)
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On a point of order, "real and substantial risk to the life of the woman" is not a motion in itself. What are the prior words that govern that from the Citizens' Assembly recommendations?

Catherine Noone (Fine Gael)
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We are voting on the position of the Citizens' Assembly, basically, the first recommendation.

Rónán Mullen (Independent)
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What was the full wording of that recommendation?

Catherine Noone (Fine Gael)
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A "real and substantial".

Clare Daly (Dublin Fingal, Independent)
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That the termination of a pregnancy would be lawful, obviously, in circumstances where there is a real and substantial physical risk to the life of the woman.

Rónán Mullen (Independent)
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Were those the words, "the termination of a pregnancy would be lawful"?

Billy Kelleher (Cork North Central, Fianna Fail)
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A real and substantial physical risk to the life.

Catherine Noone (Fine Gael)
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Sorry, one second. What I have in front of me here-----

Rónán Mullen (Independent)
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I do not have it in front of me. I would appreciate the assistance of the secretariat on that.

Catherine Noone (Fine Gael)
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The "real and substantial physical risk to the life of the woman" is the crux of the issue. It is basically, "That the Committee recommends that a termination of pregnancy be lawful where there is a real and substantial physical risk to the life of the woman." Is that agreed? Agreed.

Now we will move on to reason 2. There is an amendment in the name of Deputy Mattie McGrath, motion 6. I will allow Deputy McGrath to move the motion.

Mattie McGrath (Tipperary, Independent)
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I move motion 6:

That the Committee reject risk to the life of the woman by suicide as a ground for the lawful termination of pregnancy.

I sat through the 2013 Oireachtas hearings. The evidence adduced at the 2013 Oireachtas hearings on the Protection of Life During Pregnancy Bill 2013 re suicidality and mental health remains relevant. Abortion is not a viable treatment for suicidality. We heard that. That is my amendment.

Rónán Mullen (Independent)
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This is the only recommendation, as far as I can see, governing the possibility of subtracting from the grounds for abortion that are currently legal under the law of the country. It is fair to say that there was substantial evidence before the health committee in 2013, including from suicide prevention experts who recommended against suicide as a grounds. There have been substantial and evidence-based claims that this is not an evidence-based ground for abortion. Certainly, there was evidence from psychiatric experts before this committee which appears to distance the majority of the psychiatric medical profession from this whole business of providing for abortion on the grounds of a threat of suicide.

While I accept that the committee's apparent will to see abortion legalised as a matter of right on demand will make the issue moot anyway, I support Deputy Mattie McGrath's proposal that we reject this use of suicide as a ground.

I should note in passing as well that a small, but significant, number of children have died as a result of this invocation of a threat to life. It does not make sense in terms of evidence-based medicine. It never did. It certainly is a major injustice to the children involved.

It certainly does not make sense in terms of suicide prevention. If one thinks of any other situation where a threat of suicide would lead to a particular fulfilment of a demand, it is easy to see why this was bad law to begin with.

Catherine Noone (Fine Gael)
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We will now vote on the Citizens' Assembly recommendation.

Question, "That the Committee recommends the termination of pregnancy be lawful where there is a real and substantial risk to the life of the woman by suicide." put. Is that agreed? Agreed.

Mattie McGrath (Tipperary, Independent)
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No.

Rónán Mullen (Independent)
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Chairman, is it not the case that when the Chair puts the recommendation, that all in favour say, Tá; and all against say, Níl. That is a voice vote and it is only then, members say Vótáil. Is that how it works?

Catherine Noone (Fine Gael)
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Yes. That is how it works. Does Senator Mullen wish to call a vote?

Rónán Mullen (Independent)
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No, not in the sense of calling for a vótáil.

Catherine Noone (Fine Gael)
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I should have been clearer.

Catherine Murphy (Kildare North, Social Democrats)
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Is the point I made on the Nursing and Midwifery Board of Ireland and the Medical Council noted and articulated in the report?

Clerk to the Committee:

Yes.

Catherine Murphy (Kildare North, Social Democrats)
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I do not think there is a need to do anything more than that.

Catherine Noone (Fine Gael)
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Is that agreed? Agreed.

Catherine Noone (Fine Gael)
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No 7. has already been discussed. We are moving on to reason 3.

Question,"That the Committee recommends the termination of pregnancy be lawful where there is a serious risk to the physical health of the woman." put and declared carried.

Catherine Noone (Fine Gael)
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We now proceed to reason 4, the issue of a serious risk to the mental health of the woman.

Question, "That the Committee recommends the termination of pregnancy be lawful where there is a serious risk to the mental health of the woman." put.

Clerk to the Committee:

That is the substantive motion.

Catherine Noone (Fine Gael)
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We cannot move motion No. 8, and that may be leading to some confusion. We are voting on the Citizens' Assembly's recommendation.

Catherine Noone (Fine Gael)
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I ask members to bear with me. At the outset we changed how we would do our voting. It just takes a little longer to organise it.

Jan O'Sullivan (Limerick City, Labour)
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Before we proceed, could the Chair state the matter on which we are voting?

Catherine Noone (Fine Gael)
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The question is "That the Committee recommends that termination of pregnancy be lawful where there is a serious risk to the mental health of the woman."

The clerk will now ask members, in alphabetical order, to vote "Tá" or "Níl" on the recommendation of the Citizens' Assembly.

Catherine Noone (Fine Gael)
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We will now proceed to reason 5, a serious risk to the health of the woman. We have already dealt with motions 9 and 10 and we will clarify the issue raised by Deputy Catherine Murphy on the Medical Council and the An Bord Altranais. We will put the question on the substantive recommendation of the Citizens' Assembly.

Rónán Mullen (Independent)
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On a point of clarification, is this a vote on a serious risk to the health of a woman, without distinction as to physical or mental health?

Catherine Noone (Fine Gael)
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Exactly. I will read out what we are voting on.

Question, "That the committee recommends that termination of pregnancy be lawful where there is a serious risk to the health of the woman." put and declared carried.

Catherine Noone (Fine Gael)
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We will now proceed to reason 6, risk to the physical health of the woman.

Jan O'Sullivan (Limerick City, Labour)
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On a point of clarification, in the context of the previous composite motion do the provisions around gestational limits and so on hold?

Clerk to the Committee:

That still holds.

Catherine Noone (Fine Gael)
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That still holds.

Clerk to the Committee:

Senator Ruane has an issue and wishes to include "socio-economic considerations."

Catherine Noone (Fine Gael)
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Senator Ruane raised an issue that is relevant to this. I propose that we vote on the issue and we can take note of any issues such as the issue that Senator Ruane has raised in the report.

Lynn Ruane (Independent)
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Rather than vote on the two motions separately, we can just remove the word "physical" because there would be no distinction between physical and mental health, as per the previous vote. So rather than vote twice on my two motions, I suggest that we have one vote but we remove the word "physical".

Catherine Noone (Fine Gael)
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Is that agreed? Agreed.

Ned O'Sullivan (Fianna Fail)
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Will the Chair outline what we are voting on?

Catherine Noone (Fine Gael)
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I will be delighted to clarify what we are voting on, when I know myself.

The question is "That the Committee recommends the termination of pregnancy be lawful where there is a risk to the health of the woman and that socio-economic considerations be taken into consideration in this regard."

Mattie McGrath (Tipperary, Independent)
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Vótáil.

Catherine Noone (Fine Gael)
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As all members are present, we can vote on motion 12. The clerk will now ask members, in alphabetical order, to vote "Tá" or "Níl" on motion 12.

Catherine Noone (Fine Gael)
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We will now move on to reason 7.

Jonathan O'Brien (Cork North Central, Sinn Fein)
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Chairman, it is my understanding that we are putting the question on reason 6.

Catherine Noone (Fine Gael)
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Yes, reason 6 refers to the risk to the physical health of the woman.

Hildegarde Naughton (Galway West, Fine Gael)
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Is it possible to have a break?

Catherine Noone (Fine Gael)
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We will take a ten minute break now.

Catherine Noone (Fine Gael)
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We are now back in public session and will move on to reason 7, risk to the mental health of the woman.

Catherine Noone (Fine Gael)
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We will move on to reason 8.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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Is it the case that motions 14 and 15 fall?

Catherine Noone (Fine Gael)
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Yes, exactly.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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My apologies. I just wanted to be clear on that.

Catherine Noone (Fine Gael)
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That is fine. I will put the question again. Everyone is present. However, I remind members our work will be delayed if they leave and do not come back. I am not trying to keep them prisoner but, as I said, we will get through our work more quickly if everyone remains.

Bernard Durkan (Kildare North, Fine Gael)
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With regard to the last vote, did the Chairman say at the end that someone was missing?

Catherine Noone (Fine Gael)
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No, there was no vote. We have not had it yet. The question is whether the committee recommends that termination of pregnancy would be lawful where there is a risk to the health of the woman.

Catherine Noone (Fine Gael)
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We now move on to reason No. 9 which is where the pregnancy is a result of rape. There is a motion in the name of Deputies Kelleher, Chambers-----

Rónán Mullen (Independent)
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I am sorry about this but I would like to get some clarification if I may. It may assist others because, as the Chairman will understand, a lot is happening.

Catherine Noone (Fine Gael)
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It is hard to follow.

Rónán Mullen (Independent)
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Is it the case that reason No. 6, which is on risk to the physical health, reason No. 7, which is on risk to the mental health, and reason No. 8 have been voted through?

Catherine Noone (Fine Gael)
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Yes.

Rónán Mullen (Independent)
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I apologise for holding up proceedings.

Catherine Noone (Fine Gael)
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That is no problem.

The motion is that the committee would recommend, in view of the complexities of legislating for the termination of pregnancy for reasons of rape and incest, that it would be more appropriate to deal with the issue by making the termination of pregnancy lawful with no restriction as to reason up to a gestation limit of up to 12 weeks through a GP-led service.

Billy Kelleher (Cork North Central, Fianna Fail)
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I move motion 18:

That the committee recommend, in view of the complexities of legislating for the termination of pregnancy for reasons of rape and incest, that it be more appropriate to deal with the issue by making the termination of pregnancy lawful, with no restriction as to reason, up to a gestational limit of up to 12 weeks, through a GP-led service.

The purpose to this is to allow for termination of pregnancy up to 12 weeks without reason. In particular, this would also facilitate the issue around rape. We have heard substantial evidence that suggests it would not be possible to legislate directly for terminations in the context of rape. There are varying views in the committee but I think the overwhelming evidence and legal advice is that it would be impractical to legislate for that purpose. A further factor would be the time constraints surrounding the necessary proofs if rape was provided for as a standalone ground in legislation. Overall, this would facilitate many of the issues surrounding that complexity-----

Catherine Noone (Fine Gael)
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Can we just have Deputy Kelleher's voice, please?

Billy Kelleher (Cork North Central, Fianna Fail)
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I thank the Chairman. This would address the complexity involved in defining that particular issue which was identified during the committee hearings. Further, this would be without restriction, so no reason would be required up to 12 weeks. We also provide that this would be a GP-led service. We heard evidence that many women and young girls are taking abortive pills that are purchased online through the Internet. They are delivered by An Post to this country and consumed to carry out a termination. This happens without any health or GP oversight.

Having listened to the evidence of the Irish College of General Practitioners and others I think it is important that there would be some medical oversight that would ensure there was quality control in other words and that where women or girls procure a termination by abortive pills it would be donein their best interests. That is the purpose of the amendment and I hope it gets broad support.

Catherine Noone (Fine Gael)
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I thank Deputy Kelleher. I will call members but a lot of people indicated at the same time. Members should let me know if they wish to speak. I noted Deputy O'Connell, Deputy Louise O'Reilly, Deputy Catherine Murphy and Deputy Naughton.

Kate O'Connell (Dublin Bay South, Fine Gael)
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Motion 28 is in my name. I am fully supportive of the motion tabled by Deputies Kelleher and Lisa Chambers and Senator Ned O'Sullivan but I have a couple of issues with it on a technical level. The intention is to have a GP-led service. What about a case where somebody in a rural area does not want the local GP to know and presents at a Dublin maternity hospital? Could we amend the motion to say a GP or hospital doctor could deal with it? Perhaps I am wrong but I do not see any mention of termination tablets or oral medication.

Billy Kelleher (Cork North Central, Fianna Fail)
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That would be a matter for the medical advice to the person. It would be decided by the clinician. Whether it would be surgical or medical would not be a call I would feel competent in making.

Kate O'Connell (Dublin Bay South, Fine Gael)
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I just want to make sure there is no ambiguity here. I was going to table an amendment to the motion but we can discuss it here. A person could be contraindicated to use termination tablets even at five weeks. The motion covers both surgical and medical.

Billy Kelleher (Cork North Central, Fianna Fail)
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It leaves it entirely in a clinical-led situation.

Kate O'Connell (Dublin Bay South, Fine Gael)
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It leaves it to the doctor.

Billy Kelleher (Cork North Central, Fianna Fail)
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Yes.

Kate O'Connell (Dublin Bay South, Fine Gael)
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The other issue I have is that my understanding – I have checked this with consultants – is that currently termination tablets are licensed up to ten weeks in the domestic, non-clinical setting and thereafter can be used depending on the doctor. The reason I changed my original motion to 12 weeks was to allow for variations in menstrual cycle length but also to encompass a change in the drug licensing laws. The morning after pill in this country was licensed for 72 hours and now we have a version available for five days. That changed in recent times. I just do not want the motion to be in any way restrictive if something developed. We could include medical doctor rather than GP to cover cases where somebody presents at a hospital. I accept what Deputy Kelleher said about the doctor making the decision and that is fine, but also that it would be determined by licensing practice.

Billy Kelleher (Cork North Central, Fianna Fail)
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This is an indicative motion and it will be underpinned by legislation which would have to provide more clarity.

Catherine Noone (Fine Gael)
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I thank Deputy Kelleher for the clarification. I will move on to the next person who indicated.

Catherine Noone (Fine Gael)
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I think Deputy Lisa Chambers should perhaps come in at this point.

Catherine Noone (Fine Gael)
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I know a lot of people have indicated but I will make a suggestion that might work. We could say, "The committee recommends in view of the complexities of legislating for a termination of pregnancy for reasons of rape and incest that it would be more appropriate to deal with this issue by making the termination of pregnancy lawful, with no restriction as to reason up to a gestation limit of up to 12 weeks through a GP-led service or delivered in a clinical context and determined by law and licensing practice in Ireland." Is that agreeable to members? I will come back to those who have indicated.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I think we are conflating two things here, that is, allowing 12 weeks for the use of the abortion pill with putting a limit on the request for an abortion because of rape and incest. I think it is a very sensitive issue and we need to be careful. If we put a 12-week limit on a request for an abortion in the case of rape or incest we may well be excluding a whole cohort of women. We are going through a period now where Women’s Aid have 16 days of drawing our attention to the question of domestic violence and we are seeing programmes on the television in the home. The Rape Crisis Centre gave a presentation recently in Dublin City Council. There is a whole cohort of women who live in abusive relationships who are scared to come forward to look after their own health while they are caught in that abuse and while they are caught in that trap. It may take more than 12 weeks for them to get out of that space. It could be 16 weeks or 18 weeks. If we limit access to 12 weeks then we are doing some of the most vulnerable, done down, badly treated women in society a huge disservice. That includes women who are victims of incest who get pregnant as a result. Again, we are looking at an extremely difficult situation to get out of both mentally, physically and financially and it may be that they are the ones who are in need of the late abortions more than anything else. We are conflating two things about the use of the abortion pill up to 12 weeks and the very serious nature of rape and incest.

Catherine Noone (Fine Gael)
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We have already agreed that a provision for gestational time limits for termination of pregnancy would be guided by the best available medical evidence and provided for in legislation.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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Yes, except we are dealing with the rape section now.

Clare Daly (Dublin Fingal, Independent)
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We are voting on the recommendations of the Citizens' Assembly also, so they are not mutually exclusive. We will be voting on the two.

Hildegarde Naughton (Galway West, Fine Gael)
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I wish to speak on the motion tabled by Deputies Kelleher and Lisa Chambers and Senator Ned O'Sullivan. I agree with you, Chair. I would like to cover rape and incest. We heard from Tom O'Malley of the difficulties around proving rape and all that entails such as court cases and delays. It is also important to address the fact that abortion pills are widely available and unregulated with no medical oversight. The incorporation of the line suggested by Deputy O'Connell into the motion, to the effect that it would be done in a clinical context determined by law and licensing practices, could perhaps cover the medical abortion pill. I think that would cover it all. My understanding is that it is safe to take the abortion pill up to ten or 12 weeks.

Bernard Durkan (Kildare North, Fine Gael)
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Agreed.

Catherine Noone (Fine Gael)
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I will read the question when the remaining members have spoken, namely, Deputies Louise O'Reilly and Catherine Murphy and Senator Mullen.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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On behalf of Sinn Féin we will not be voting against the motion but neither are we in a position to support it. We will be considering further the recommendations of the Citizens' Assembly. It is a long-standing policy of Sinn Féin that we accept the need for the availability of abortion in the case of rape, incest and sexual violence but in order to best reflect party policy we will be supporting reason 9 because we think it is important that that is supported. We had understood a different sequencing in terms of how things were going to happen. That point has already been articulated. We are not in a position to support the motion but neither will we vote against it this afternoon.

Catherine Murphy (Kildare North, Social Democrats)
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Science does not stand still. If the licensing period is ten weeks, we have got to future-proof to some degree, even if there is a doubt about that.

We are conflating issues. I had a motion, 27, stating termination of pregnancy should be lawful with no restriction as to reason, up to a gestational limit of 12 weeks. That was to capture quite a lot of factors. I had another amendment on circumstances where there is a surgical abortion rather than a medical one and on decriminalisation. Several factors can get rolled in together.

Catherine Noone (Fine Gael)
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We are going to deal with the decriminalisation aspect.

Catherine Murphy (Kildare North, Social Democrats)
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I know but I am not sure that putting the various aspects together is the best way to achieve our objective.

The clinical approach is a better one. There will be primary care centres that may well have nurses prescribing who are educated to degree level. We have got to capture that and not overly restrict what can be done. I take the point that is being made. The witnesses from Holland were quite useful in this regard. In their jurisdiction, they have a 12-week limit but they drew attention, in particular, to the fact that those who tend to present later, where there has been rape or incest, for example, tend to be younger. The delegates from Holland outlined how they dealt with a combination of factors, as in a rape accompanied by distress and mental health issues or, perhaps, a physical health issue where somebody very young is involved. One can proceed by separating the two factors but I am concerned that we are trying to capture everything in one measure. I am not opposed to it but I would rather see us dealing with each separately. The amendment on the clinical aspect is a good additional one.

Rónán Mullen (Independent)
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I cannot understand how members who might have voted against the provision of abortion on grounds of health simpliciter- on the basis, presumably, that it imports too wide a set of grounds and invokes the undemonstrated and, in fact, contra-indicated use of mental health as a ground - could vote for or support abortion on demand up to 12 weeks, which is effectively what this is about.

Rónán Mullen (Independent)
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I do not need to note that was not a point of order; it is simply an interruption of another speaker who did not interrupt the Senator.

Catherine Noone (Fine Gael)
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It happens a good bit in here.

Rónán Mullen (Independent)
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Yes. I do not interrupt, actually.

Catherine Noone (Fine Gael)
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The Senator does.

Rónán Mullen (Independent)
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I just want to put that on the record. I do not believe I have ever done it.

To me, this is a very distressing proposal. Motion 18 does not state "in view of the difficulties with regulating the online purchase of abortion pills". The substance is "because it is difficult to legislate for termination of pregnancy for reasons of rape or incest". I get why many good people are conflicted about those cases. They are very heart-rending and difficult but there is something reminiscent of the judgment of Solomon about proposing that, since they are so complex to deal with, we should therefore propose that a much wider category of unborn children may be legally killed. If one examines the law in Britain, one notes that the vast majority of Britain's staggering number of abortions per year, which is nearly 200,000, take place in the period up to 12 weeks, as I understand it.

At meetings of this committee, we never examined the size of an unborn child at 12 weeks, or just under. As far as I know, we never looked at any images of an abortion. I believe Deputy Mattie McGrath invited people to inform themselves at some level but the committee did not do so. I do not even know whether the people proposing this could tell us or discuss in detail the size or developmental stage of the little creature whose legal right to exist is proposed to be dismissed here. There is no difference between a surgical abortion and a medical abortion considering the impact on the unborn baby. We have what I would regard as a really distressing proposal. It is harder to imagine a better example of how politicians can lose sight of the humanity of unborn children through this whole process. As I have said before, if one asks people the situations in which one can take away the right of unborn children, the answer seems to be, "more and more, actually."

This is a very disturbing proposal. It is for abortion on demand. Having no restriction as to reason effectively means that if a person asks for an abortion, she gets it. I am not clear from the wording whether it is intended that the general practitioner would prescribe the pills or whether they would have to be taken in a general practitioner's surgery but I do know there is no child under 12 weeks in the womb who would have the right to the protection of the law if the Irish people were to take this on board. It is a staggering proposal and I urge people to reconsider it.

Clare Daly (Dublin Fingal, Independent)
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We are in danger of straying and staying here until Christmas, the way we are going. I have just a couple of points. People are confused about why we are here. We are not drafting legislation; we are issuing guidance to the Oireachtas to draft legislation. The idea that some people raised, namely, that our vote on this would be misinterpreted as a statement that there should be terminations in cases of rape only up to 12 weeks, does not reflect what anybody is saying. A way of dealing with this is to take the vote on the Citizens' Assembly recommendation first. I would imagine that it will be carried on its own. It does not imply a restriction regarding any limit in cases of rape. We should then consider the motion on the period of 12 weeks without any restrictions as to reason. For some, a termination will be because of rape. For others, there will be other reasons. So be it; that is the motion. That will deal with the matter so we will not just be cutting off access to terminations in cases of rape at 12 weeks.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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I have outlined our position and the rationale that underpins it but I want to be very clear that this will not hinder us from supporting the final report. We fully accept that this is a process from which a report will emerge. Not everyone will agree with it but we fully intend to support the report.

Catherine Noone (Fine Gael)
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Unless somebody has something different to say-----

Jan O'Sullivan (Limerick City, Labour)
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I have a procedural point. We need to have consistent language in the various recommendations. In the decriminalisation section, there is probably better language in respect of clinical and medical guidelines and so on. In writing the report, we should use the same language in each section.

Catherine Noone (Fine Gael)
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That is a good suggestion.

Bernard Durkan (Kildare North, Fine Gael)
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We need to acknowledge the widespread use of the medical pill that is now available for termination. It is already being used, and it is also used in the United Kingdom and many other countries. In tandem, we have to recognise that there are no legal or medical supervision requirements attached to the use of the product. To fail to address that issue could possibly leave the State liable in terms of its duty of care. We need to bear that in mind.

Rónán Mullen (Independent)
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Is there a restriction on the second intervention? Deputy O'Connell intervened for a second time earlier.

Catherine Noone (Fine Gael)
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It was a clarification. Does the Senator want to clarify a point?

Rónán Mullen (Independent)
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If there is a certain amount of this is going on, one could have a public education campaign. One could do as I suggested earlier-----

Catherine Noone (Fine Gael)
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We will get to that-----

Rónán Mullen (Independent)
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-----and guarantee that a person could seek medical care. To legalise something bad because it is already occurring, however, is really to say we should not have any law in the land prohibiting anything.

Bernard Durkan (Kildare North, Fine Gael)
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The other way-----

Catherine Noone (Fine Gael)
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I am not going to allow a conversation on this. I want to put the question.

Bernard Durkan (Kildare North, Fine Gael)
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I know but we need to answer. The other answer is that we ignore it altogether and pretend it is not happening, in which case criminalisation remains in place, leaving it open to somebody to take an action against somebody who is already availing of a particular route to deal with a situation such as rape. If it is intended that we should oppose that and restrict the ability of a woman who has been raped and needs to avail herself of the facility in question, I do not believe we should isolate her at all.

Peter Fitzpatrick (Louth, Fine Gael)
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I was not going to say anything. After 21 days, an unborn child has a heartbeat.

I think that-----

Catherine Noone (Fine Gael)
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The Deputy has the floor. If members want to briefly clarify something afterwards, indicate and I will allow it. Deputy Fitzpatrick, please continue.

Peter Fitzpatrick (Louth, Fine Gael)
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This is a very important day. I would say to Deputy O'Connell that it is very bad form to butt in when people are speaking. In the three months of this committee, I have never once interrupted her. I have shown her some respect. People should not be afraid to speak up here.

Catherine Noone (Fine Gael)
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I am trying to make sure that Deputy Fitzpatrick can speak uninterrupted.

Peter Fitzpatrick (Louth, Fine Gael)
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This is a very serious issue, and in fairness I think Senator Mullen is correct. If we go ahead and approve this it is going to allow abortion on demand, as far as I am concerned. I think it is totally and utterly wrong. I said it from day one. The child's heart beats after three weeks, and I think it is very important that the people out there realise that if we pass this, it will be abortion on demand.

Catherine Noone (Fine Gael)
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I am going to allow Deputy Naughton a brief comment. Deputy O'Connell wants to clarify something. Deputy McGrath also wishes to comment.

Hildegarde Naughton (Galway West, Fine Gael)
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I will be very brief. For me, this amendment is really the only way to deal with rape and incest according to the legal experts we had before us. I do not know if the Fianna Fáil group would be willing to accept some form of amendment to this to include abortion pills. I would like to explain within this amendment that this is because of the widespread availability of unregulated abortion pills, about which we need to do something.

Catherine Noone (Fine Gael)
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That can be done in the report too, Deputy.

Hildegarde Naughton (Galway West, Fine Gael)
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I would like to have it included in some way. It may be that "licensing laws" or "determined by law and licensing practices" covered that-----

Catherine Noone (Fine Gael)
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Would it be acceptable to Deputy Naughton to have that included in the report?

Billy Kelleher (Cork North Central, Fianna Fail)
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The difficulty in only including medical termination could arise if there are complications in the pregnancy of a very young girl, for example, who may need a surgical intervention for the termination to be completely carried out. Again, we are only being indicative here. The legislation will be published by the Government and brought to the floor of the Dáil. I do not think we need to be overly prescriptive. I understand the points people are making. This is proposing 12 weeks as outlined. If we get overly prescriptive on whether it is a medical or surgical procedure we potentially tie the hands of the experts, that is, the GPs or clinicians.

Catherine Noone (Fine Gael)
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It is fair to say that abortion pills were an issue that Ms Justice Laffoy indicated that we should cover. We have covered it, and we discovered a lot of information about it.

Billy Kelleher (Cork North Central, Fianna Fail)
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This covers it.

Catherine Noone (Fine Gael)
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This covers it, and our report needs to cover it. Would that be satisfactory from the Deputy's perspective?

Hildegarde Naughton (Galway West, Fine Gael)
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I would be in agreement with that, and if we could put in "determined by law and licensing practice" as well, I do not think it takes-----

Catherine Noone (Fine Gael)
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I am going to read out that question. Can I put the question? Sorry, Deputy McGrath.

Mattie McGrath (Tipperary, Independent)
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This is why I said during the committee that we should have opened the debate up more and had a broader discussion. I am totally opposed to this, and I want to put that on record. I will be voting against it.

Catherine Noone (Fine Gael)
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Thank you.

Kate O'Connell (Dublin Bay South, Fine Gael)
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On a point of clarification, I do accept that Deputy Fitzpatrick does not interrupt people at the committee. However, there is no heartbeat at three weeks. Obviously, from the moment the sperm and the egg fuse the genetic material is there for all of us to have existed, but there is no heartbeat. At seven weeks there is a pulsating tube, from the evidence I have read. It is unfair to suggest that occurs at three weeks.

Catherine Noone (Fine Gael)
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I am putting the question now on the motion, as amended.

Catherine Noone (Fine Gael)
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We will now proceed to the Citizens' Assembly's recommendation.

Catherine Noone (Fine Gael)
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We now move on to reason 10. This brings us to another motion in the name of Deputies Kelleher and Chambers and Senator O'Sullivan.

Catherine Noone (Fine Gael)
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Before Deputy Chambers begins, I have to mention that there is also a motion 21 which is linked to this one. We will discuss these together. My apologies for the interruption.

Catherine Noone (Fine Gael)
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Thank you.

Kate O'Connell (Dublin Bay South, Fine Gael)
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I welcome this motion. If Deputy Kelleher, Deputy Chambers and Senator O'Sullivan were up for this, we could insert a wording based on the evidence we heard from Dr. Peter Thompson on the issues around the diagnosis of fatal foetal abnormality. He spoke of two doctors acting in good faith. I wonder if we could put something like that in here. If a woman's baby is diagnosed with a severe fatal foetal abnormality, she would definitely want a second opinion, I would imagine. We have already spoken about two doctors in a previous motion. If we could mention two doctors acting in good faith, I think it covers the issues around fatal foetal abnormality not being a defined medical term.

Any time there is a medical intervention as such, it is important the phrase "in good faith" is used. It is a matter for the committee.

Billy Kelleher (Cork North Central, Fianna Fail)
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I have no difficulty with the concept. However, I think we are becoming overly prescriptive in an area where legislation will be required thereafter. We are tying the hands of the Legislature. This is requesting a compassionate way of dealing with a diagnosis of fatal foetal abnormality. To do anything beyond that would make it difficult for legislators to address.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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We will support the amendment. I think, however, where there might be any conflict or difficulty, the actual reason above is simple and does not tie legislators down. There may be some dispute over what does and does not constitute a medical diagnosis.

It was unfortunate that many of those who sit around this table and call themselves pro-life did not stay to hear the testimony of Mr. Gerry Edwards and Ms Claire Cullen-Delsol from Terminations for Medical Reasons Ireland.

Reason 10 covers this. I am not sure we need the motion. Reason 10 is much clearer and simpler in its language.

Hildegarde Naughton (Galway West, Fine Gael)
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I agree with the amendment in the case of fatal foetal abnormality and that we ensure we cater for it. I agree with Deputy O'Connell as I do not see it tying the hands of the Oireachtas. I am open to this and will support her amendment. Any parents would welcome having two specialists giving them expert advice.

Catherine Noone (Fine Gael)
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I think we are all in agreement on this. It is just about getting the wording right.

Kate O'Connell (Dublin Bay South, Fine Gael)
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There could be a compromise if we could put "...of foetal fatal abnormality so that a medical diagnosis made in good faith...".

Catherine Noone (Fine Gael)
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That sounds reasonable.

Kate O'Connell (Dublin Bay South, Fine Gael)
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It just covers a doctor.

Billy Kelleher (Cork North Central, Fianna Fail)
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Every medical decision is based in good faith. If not, it is a criminal offence.

Catherine Noone (Fine Gael)
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Of course. It is perhaps being overly cautious but it is probably no harm.

Catherine Noone (Fine Gael)
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I call on Deputy Mattie McGrath.

Mattie McGrath (Tipperary, Independent)
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I did not indicate.

Catherine Noone (Fine Gael)
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Sorry, it was Senator Mullen.

Rónán Mullen (Independent)
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Two issues struck me from the evidence we heard from medical people and from the various families. It became increasingly obvious that what people were looking for was not just the permission for the termination of pregnancy where a child's condition could be said to be fatal such that they would not live long after birth. We also heard medical people saying there should not be a closed list. This seemed to me to veer quickly into very much a case of severe disability grounds.

Second, this is one of these areas where, almost by definition, one is talking about the termination of the life of an unborn child late in pregnancy. We heard from different people.

I was here for the group Deputy Louise O'Reilly referred to. Even if I was not, I do not think anybody's motivations in being here or absent should be second-guessed by any colleague on the committee.

Catherine Noone (Fine Gael)
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We have had this conversation before. I note the Senator's comments.

Rónán Mullen (Independent)
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It was open to you, a Chathaoirligh, to interrupt Deputy Louise O'Reilly when she said that earlier.

Catherine Noone (Fine Gael)
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I should have.

Rónán Mullen (Independent)
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From where I am sitting, it seems to be too predictable that when I would defend myself-----

Catherine Noone (Fine Gael)
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No, in fairness it is just because it will bounce back and over. I did not raise it earlier because I did not want us to have a row about it.

Rónán Mullen (Independent)
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With even more justification, I am sure you would understand.

I want to it on the record. I had to drive to the North the night in question. I made it my business to speak to those guests outside and even passed them a note explaining why I could not stay on after they had made their presentations, which I listened to.

It would not impede your neutrality, Chair, were you to make the comment that in your view that is an unfair charge to be levelling by definition.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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It was not unfair.

Catherine Noone (Fine Gael)
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Sorry Senator, I do not want to waste our time. We decided we would be business-like in our approach today. I actually defended you, Senator, on this point in your absence and on the last occasion it was brought up. I will defend you again. You were here for the contribution in question.

Rónán Mullen (Independent)
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I would ask for a greater defence than that. I would ask you to rule, as the Chair, that such comments are not fair or appropriate anyway. That is the difference. Whether I was here or not is not the point.

Catherine Noone (Fine Gael)
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If I were to rule on all the comments that were not appropriate or fair in this committee, I do not think we would ever get through the work. I want to move on.

Rónán Mullen (Independent)
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I am disappointed that you care so little for the reputations of members of the committee who have acted in good faith and who did not deserve to be so personally attacked by colleagues.

Catherine Noone (Fine Gael)
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This is the last thing I am going to say on the matter. I have shown that I allow everyone to speak here. I care for everyone's reputation and they need to care for their own. I am moving on. Deputy Catherine Murphy has indicated.

Rónán Mullen (Independent)
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I have not finished my substantive points.

Catherine Noone (Fine Gael)
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Well, you should have.

Rónán Mullen (Independent)
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I was interrupted by the Chair, as you may recall.

Catherine Noone (Fine Gael)
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No, you did not get interrupted. The Chair does not interrupt. I chair.

Rónán Mullen (Independent)
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You may recall from your chairing that you intervened.

Catherine Noone (Fine Gael)
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Please make your substantive point.

Rónán Mullen (Independent)
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The substantive point is that people such as Ms Liz McDermott and the organisation she represents have pointed out obvious things. For example, in a world where we are supposed to be defending, in terms of human rights, the rights of people with disabilities, it is inappropriate to have a separate category of abortion precisely for people with disabilities simply because they are severe.

Catherine Noone (Fine Gael)
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Sorry, we are not talking about disabilities. We are talking about fatal foetal abnormality.

Rónán Mullen (Independent)
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People with these conditions - I do not use the term foetal abnormalities of the kind you describe but use the term "life-limiting conditions" - qualify as a category of persons with disabilities.

Second, there is the reality that in some cases a diagnosis can be faulty. There are people, such as Martin and Sinéad McBreen, who some of us would have liked the committee to have heard, who received a different story to what the reality turned out to be. There are also the fears of people that there is a culture in this world where doctors, instead of saying they will help and support people, as well as providing perinatal hospice facilities, abandon people to the cold logic of choice. In turn, it creates a world where more and more people will feel that such babies are not to be accorded a legal and social welcome. It is difficult and harrowing. We can offer people something much better by saying we will accompany them and give them every love and support but that we will also honour the very sick child until their natural end.

Catherine Murphy (Kildare North, Social Democrats)
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First, often the abnormalities in question will present late in a pregnancy and involve small numbers. These are extreme situations in which people find themselves and are very unexpected. On most occasions, it is even more distressing because it involves a baby who was wanted and all the positive things that go with that.

The Citizens' Assembly was straightforward. I do not have an issue with the one as it is presented. It is covered one way or the other. It cannot be diagnosed earlier. That is the reality.

Catherine Noone (Fine Gael)
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The reality is that many women do not get scans until beyond 20 weeks.

Catherine Murphy (Kildare North, Social Democrats)
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Some do not get them at all.

Mattie McGrath (Tipperary, Independent)
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I move to reject this because I believe this to be in contravention of, among others, the UN Convention on the Rights of Persons with Disabilities and the UN Convention on the Rights of the Child. I am disappointed with the use of the term "fatal foetal abnormality" because the HSE has issued guidelines around this. We had that debate with some of our invited guests here. I believe it is a crude term.

I have met many people and families who have had that diagnosis and had full gestation with a baby born that lived for a considerable time. One girl I know in Cavan is up to 11 years of age. I have met numbers of them. It is crude language to put in for that reason. I am totally opposed to it.

Catherine Noone (Fine Gael)
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Thank you. Unfortunately, we are not all here because there is a vote in the Seanad. Your arrival is nicely timed, Senator Buttimer. I know you have a lot going on in the Seanad today.

Catherine Noone (Fine Gael)
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The next question is on the Citizens' Assembly.

Rónán Mullen (Independent)
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Not agreed.

Clerk to the committee:

Does the Senator want to call a vote?

Rónán Mullen (Independent)
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Does the Chairman not go through the process of calling those in favour to say "Tá" and so on?

Catherine Noone (Fine Gael)
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We move on to reason 11. This relates to when the unborn child has a significant foetal abnormality that is not likely to result in death before or shortly after birth. We have two proposals, one of which counters the other. We will dispose of motion 22 first. The question is: "That the committee recommends that the termination of pregnancy should be lawful without gestational limits in cases of significant foetal abnormality." The motion is in the names of Deputy Smith and Senator Ruane.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I take the point that other Deputies have made to the effect that we are not being prescriptive about legislation. We are not drafting legislation here. These are simply recommendations. I take the point that the Citizens' Assembly recommendation deals with the matter. However, I have been approached by parents who have asked me to try to get this through without gestational limits. This is why the recommendation was put forward. The idea is to show compassion to people who have been through the experience. They want to know that the gestational limits will not apply to them.

Having listened to the evidence of all witnesses I believe those provisions that put the woman and family at the centre of a case of desperation or a crisis pregnancy are absolutely the way to go. The choice that a person might make in such a circumstance will be difficult. It would not be easy and it would not be done without consulting many medical experts. I assume we all understand that in the context of the motion.

I wish we lived in a society that really cared for those who suffer disadvantage and disability and those who are most vulnerable, but we do not. We have not even ratified the United Nations Convention on the Rights of Persons with Disabilities yet.

Recently, we watched the terrible tragedy of carers and the situation that they are left in for years. Often this abides for their entire lives. They are neglected by the State and not given proper respite care. There is extraordinary disadvantage for people in society. I only wish those who care passionately about the unborn cared even a fraction as much about those who are born.

Lynn Ruane (Independent)
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I echo pretty much what Deputy Smith has said. We have not set gestational periods on any other recommendation relating to health and fatal foetal abnormalities, apart from the limit of up to 12 weeks.

Earlier, Senator Mullen spoke about a category of people. He said people with disabilities are a category of people and that we are looking to introduce abortion because they are a category of people. What he says is true: people with disabilities are a category of people. They also want access to bodily autonomy. People with disability need access.

We look at all the different situations. We have heard so many times that there are as many situations as there are pregnancies that end up in a given situation. Perhaps a woman is in a family where there are already children with disability. Perhaps she has several children or none. Perhaps she has no support or resources. Bringing a child that has a severe anomaly into the world can bring a major pressure on the family and a person's health. I believe that we need to remove the gestational limits in respect of severe or significant foetal abnormalities, as we have done with all the other health grounds.

Rónán Mullen (Independent)
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I have to go to help with a quorum. I indicated my wish to speak in case there was a list. I though other people may have indicated.

Catherine Noone (Fine Gael)
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Thank you. Please go ahead.

Rónán Mullen (Independent)
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I would like to think that anyone who wants to protect unborn children cares about life at all stages, including vulnerable life. I would like to think that my career demonstrates a consistent vision of seeking to protect human dignity and seeking a society that goes the extra mile in terms of dispersal of public funds and so on. This means reaching out and supporting people with disability in particular. If Deputy Smith's comments were in any way directed at me, I would like to show her my record sometime.

I wish to comment on the business of the recommendation on a child with a significant abnormality. We spoke a good deal about children with Down's syndrome. Of course, they are only one category of children with disability or abnormality, but they are children who are particularly well-known and loved in Ireland. We did not hear evidence on it, but eventually we got evidence about how in Britain over 90% of children who are scanned and found to have Down's syndrome are aborted. I believe the figure is the same in Netherlands. The corresponding figure is up to 97% or 98% in Denmark, with only four children being born. From my perspective, any child with a foetal abnormality deserves extra love, care and protection from society. The test of a civilised society is how it treats its most vulnerable members. It is a really tragic development if there is a whole category of human beings who, because they are more vulnerable than the rest of us, are singled out to ensure they have fewer rights at any stage of pregnancy.

That is the journey that has been taken in the western world. We heard Dr. Thompson invite us to disregard the fact that in certain cases children with something as minor as a cleft palate might be aborted up to birth, which is the law in Britain. It was chilling testimony. However, it does not matter if it is severe or not so severe because what the child needs is protection and what the family needs is support. I, therefore, oppose this sincerely.

Catherine Noone (Fine Gael)
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The next matter to be considered is whether the committee recommends that termination of pregnancy be lawful where the unborn child has a significant foetal abnormality that is not likely to result in death before or shortly after birth.

Catherine Noone (Fine Gael)
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We now move on to reason 12. There are two motions, which counter one another. Motion 24 is that the committee would recommend that the termination of pregnancy should be lawful on socio-economic grounds, with a gestational limit determined by the woman in consultation with a doctor. This is in the name of Senator Ruane.

Lynn Ruane (Independent)
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I move motion No. 24:

That the committee would recommend that the termination of pregnancy should be lawful on socio-economic grounds, with a gestational limit determined by the woman in consultation with a doctor

Although this is now a standalone ground, it is hard to speak to it without acknowledging how the majority of the committee voted on the woman's health ground. I struggle to understand how people can separate a woman's health from her socio-economic status or her living conditions, whether poverty, domestic violence, homelessness, prostitution or otherwise. Her socio-economic circumstances are one of the main reasons a woman will seek to access abortion and 70% of the Citizens' Assembly voted in favour of allowing it. If termination is not permitted on socio-economic grounds, this would highlight to me that access to abortion remains a class issue. Although we will cater for many women up to 12 weeks, many women will not be able to access a doctor or perhaps not even know they are pregnant until that time has elapsed. I worked with hundreds of people in addiction for years. Some of the women did not have periods for years due to the damage to their body. However, they became pregnant and nearly six months had elapsed before they realised it. Given how a woman's social situation impacts on her health, this should be allowed as a ground to access abortion. Women from more affluent areas who do not not meet the requirements or do not get to the doctor or find out that they are pregnant before the 12 weeks have elapsed will still be able to travel. If we deny women the right to an abortion on socio-economic grounds, we are saying that we do not care about women who are in less favourable conditions.

Catherine Noone (Fine Gael)
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Thank you.

Lynn Ruane (Independent)
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I have one more point. Many people have spoken to me about the socio-economic ground as if it is only a financial issue. The suggestions is that these women just do not have enough money for an extra child. People do not really understand the impact of class on a woman's situation. It is not always about finances. There is a multitude of factors. I hoped this would pass as an indicator under the health ground, but it did not. However, I hope people will reconsider their position on the socio-economic ground when voting on this recommendation.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I would first like to note that the Citizens' Assembly spontaneously raised this matter. It did not arise from the guidance of the chairperson, Ms Justice Laffoy. It came from the body of the floor at the Citizens' Assembly where 72% were in favour of it. This recognises and reiterates the consistent evidence we heard over the past three months from various witnesses, the latest being those from the Netherlands. When I asked what weight they would give to what we call socio-economic grounds - I think they called them social reasons - they kind of looked at me as if I was nuts because, to them, of course it was a big reason. It was obviously a clear reason to them. I am not interpreting anything from their looks but the attitude was almost why would one not consider a person's social and economic background. Senator Ruane touches on something really important here. If we recognise that abortion is a reality for women already in Ireland, except we export it, we also have to recognise that so many more women did not have access to it because of their class situation. This is a class issue. Some 92% of terminations happen in the first 12 weeks. The pill can deal with it, which is a great step forward. In future laws, perhaps we can recognise it. However, it would be great if the committee would take on board the evidence and the recommendation from the Citizens' Assembly and have that as a reason to be put to the Oireachtas.

Rónán Mullen (Independent)
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What this issue has in common with the previous one about abortion for children with significant foetal abnormalities is that the committee will not recommend them here today. However, we need to be careful about how it is presented. In reality, these things are, by definition, being recommended by the committee up to 12 weeks in the earlier motion passed, which is in effect abortion on demand up to 12 weeks. In not voting for these today, the committee is not recommending allowing abortion on socio-economic grounds or for significant foetal abnormality after 12 weeks. However, even there, the committee is just saying, "not for now" because it has already voted to propose the repeal of the eighth amendment. The committee is saying that is does not recommend to our legislators to propose this now, but the public needs to know that it is certainly on the agenda for later. I oppose this.

Clare Daly (Dublin Fingal, Independent)
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I think it is important to state that we are approaching this slightly differently than the Citizens' Assembly and that is absolutely fine. It voted on the criteria and it then looked at gestational limits. We have already agreed to provide access to terminations without restriction as to reason up to 12 weeks, and that is going to cater for the overwhelming majority of Irish women who need to access a termination. In that sense, it is important to make that point. However, I agree with the speakers putting forward the motion. We are talking about small numbers here but the issues of class and economics are very important considerations. I think the gestational limits should be extended to incorporate those people and that we would not restrict it in that way.

Catherine Murphy (Kildare North, Social Democrats)
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I supported the previous proposal, "That the committee recommends that a termination of pregnancy be lawful where there is a serious risk to the mental health of the woman", whereas this proposal also states "that socio-economic considerations be taken into consideration in this regard". I am comfortable with the previous one but I have a difficulty with this one in that I think it is moving from medical to surgical abortion. I feel more comfortable making the distinction and having a gestational limit. I will not support it from that point of view.

Catherine Noone (Fine Gael)
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Thank you. I remind members that, while anyone can speak, they should keep contributions as-----

Lynn Ruane (Independent)
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Can I make an amendment that, if people are concerned about that, if they look back-----

Catherine Noone (Fine Gael)
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Concerned about what, exactly?

Lynn Ruane (Independent)
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If they are concerned about the fact there is no gestational period. That does not meant there are no medical guidelines or best practice. If that needs to be put in at the end, so be it. Deputy O'Connell's first motion, which we voted on, stated "Provision for gestational time limits for the termination of pregnancies be guided by the best available medical evidence and be provided for in legislation".

Kate O'Connell (Dublin Bay South, Fine Gael)
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Essentially, apart from the point made by Senator Ruane, my issue is around viability and having no gestational limit. I would be far more comfortable if that was decided by somebody. As somebody who is very much a believer in choice, the choice of the woman, I have a difficulty with this, from a viability point of view. I understand these are women on the margins of society with whom some of us, through our other jobs, have come into contact with. Deputy Ruane is correct that people are sometimes six months pregnant before they realise it. However, I think that if something can go in to include a gestational limit, I could at least not vote against it.

Catherine Noone (Fine Gael)
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Perhaps we could agree that. Will the Senator suggest a wording?

Lynn Ruane (Independent)
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While it would be fair enough to elaborate on the amendment, I do not think any doctor is ever going to carry out an abortion on someone who is eight months pregnant. That is just not the same thing that I would intend here. If there is a line that can better suit the intention-----

Clare Daly (Dublin Fingal, Independent)
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Does the next motion take it up to 22 weeks?

Lynn Ruane (Independent)
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That might not pass and it might be separate.

Catherine Noone (Fine Gael)
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Is there an amendment the Senator would like to suggest to her own motion?

Lynn Ruane (Independent)
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We could add in that "the provision for gestational time limits for the termination of pregnancies be guided by the best available medical evidence and be provided for in legislation".

Catherine Noone (Fine Gael)
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What about taking out "without gestational limits"?

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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It might read "determined by the woman in consultation with her doctor in accordance with best practice".

Catherine Noone (Fine Gael)
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The question is, "That the committee recommends that a termination of pregnancy should be lawful on socio-economic grounds determined by the woman in consultation with her doctor in accordance with best practice."

Catherine Noone (Fine Gael)
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That is fine.

Jan O'Sullivan (Limerick City, Labour)
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I have a difficulty in this regard.

Catherine Noone (Fine Gael)
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Your difficulty can be reflected in your vote.

Catherine Noone (Fine Gael)
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We will now put the question on the Citizens' Assembly recommendation itself.

Catherine Noone (Fine Gael)
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We will now move on to reason 13, which deals with the issue of no restriction as to reason. We have several motions on this, most of which we have discussed.

Clare Daly (Dublin Fingal, Independent)
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We have already dealt with the ones up to 12 weeks on the basis that the abortion pill is mentioned in the report and also the GP-led process, which was to address the issue of the HSE, costs and all of that.

Once such matters are reflected in the reports then the 12 weeks provision can go and we will just have the 22 week provision.

Catherine Noone (Fine Gael)
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Is the Deputy withdrawing her motion?

Clare Daly (Dublin Fingal, Independent)
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Yes.

Catherine Noone (Fine Gael)
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Does Deputy Murphy wish to withdraw her motion?

Catherine Murphy (Kildare North, Social Democrats)
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Yes. Mine is covered with the other one and I am happy with that.

Catherine Noone (Fine Gael)
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Does Deputy O'Connell wish to withdraw her motion?

Kate O'Connell (Dublin Bay South, Fine Gael)
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I withdraw my motion as the matter has been dealt with.

Catherine Noone (Fine Gael)
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Is Senator Ruane pressing her motion?

Lynn Ruane (Independent)
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Yes. When I came to this meeting I had decided to withdraw my motion because I hoped that members would support my other two motions. I am afraid that the provision of access up to 12 weeks will rule out a lot of women who will need to access an abortion at 13, 14 and 15 weeks. They will not be catered for in any shape or form.

Catherine Noone (Fine Gael)
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As a result of that decision motion 30 falls and now I will put the question on the Citizens' Assembly recommendations.

Rónán Mullen (Independent)
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On a point of clarification, does motion 30 fall or is it negatived if reason 13 is accepted?

Catherine Noone (Fine Gael)
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It is negatived.

Rónán Mullen (Independent)
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Rather than take motion 30, we are moving to the reason. Is that the proposal?

Catherine Noone (Fine Gael)
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That is the point, I suppose. Yes.

Kate O'Connell (Dublin Bay South, Fine Gael)
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We are voting on the substantive issue.

Catherine Noone (Fine Gael)
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Yes. We are going to vote on the substantive. Senator Mullen is right.

Rónán Mullen (Independent)
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I propose that we take a short break after this vote and before we start discussing the ancillary recommendations, particularly given that there is a natural break between the two.

Catherine Noone (Fine Gael)
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We will get through these matters very quickly.

Rónán Mullen (Independent)
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All right.

Catherine Noone (Fine Gael)
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Yes, the Citizens' Assembly recommendations.

Billy Kelleher (Cork North Central, Fianna Fail)
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It is the substantive issue of the Citizens' Assembly recommendations.

Catherine Noone (Fine Gael)
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We have done that with every vote.

Kate O'Connell (Dublin Bay South, Fine Gael)
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We have done it.

Catherine Noone (Fine Gael)
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Yes, it is important to clarify the matter.

Billy Kelleher (Cork North Central, Fianna Fail)
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I wish to be associated with what the Deputy has said.