Ciara Conway (Waterford, Labour) | Oireachtas source

I wish to share time with Deputy Anne Ferris.

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

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

It is a national disgrace that we are still arguing over this issue 20 years on from the Supreme Court ruling in the X case. For many Irish women - our sisters, mothers, wives, friends and girlfriends - a pregnancy which puts their life at risk is an agonisingly real fact of life for them and their families. Women still have to travel in secret like fugitives to England to seek life saving treatment. This is simply appalling. Women are increasingly turning to the Internet to endanger their own lives by procuring abortion pills online. This is done without medical supervision and at huge risk to their lives. Doctors have been left with no legal protection in caring for women whose lives are at risk as politicians during the years have run for cover from this difficult issue until now. However, I am proud that following the failure of six successive Governments to legislate for the X case we have finally stopped kicking the proverbial can down the road and, for the first time, legislation on this critical matter relating to women's lives is before the House. Much of the opposition to the Bill is related to head 4 and the risk of loss of life of a pregnant woman due to suicide. The X case judgment explicitly included suicide as one of the grounds where abortion was permissible because of the risk to the life of the mother. Lest we forget, the reality of that case was a 14 year old girl had been raped and impregnated by a neighbour and, when refused access to a termination, became suicidal. In 1992 and again in 2000 the people were asked if they wanted to specifically exclude suicide from the limited provisions in which a pregnancy could be terminated and on both occasions they said, "No." It is incumbent on all of us to listen to them and ensure this legislation is passed.

A number of campaigners and politicians clearly believe, however, that they have more legal insight into the issue than both the Supreme Court and the people. Democracy is a nuisance as far as they are concerned. Law professor Fiona de Londras noted that in the context of what the people had decided in the 1992 and 2000 referendums, prima facie it appeared to be unconstitutional if the legislation was to exclude suicide. Former High Court and Supreme Court judge Mrs. Justice Catherine McGuinness recently told the Oireachtas Joint Committee on Health and Children that a referendum would be needed if the suicide provision was removed from the legislation. Suicide is a real risk to the lives of a small number of women who are pregnant. It is rare, but it happens. Medical professionals who work with pregnant women and do not hypothesise in front of cameras or microphones, including perinatal psychiatrist Dr. Anthony McCarthy and the Master of the National Maternity Hospital, Dr. Rhona Mahony, confirmed this at the committee hearings. One woman or man dying by suicide is one too many. Pregnant women who are suicidal should be believed and supported. They should not have their real and life threatening distress undermined by the insinuation that mental health issues are somehow not real or that psychiatry is hocus pocus medicine. They should be believed because this is as real a threat as a physical issue.

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

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

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

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

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

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

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

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

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