Oireachtas Joint and Select Committees

Tuesday, 8 January 2013

Joint Oireachtas Committee on Health and Children

Implementation of Government Decision Following Expert Group Report into Matters Relating to A, B and C v. Ireland

12:35 pm

Dr. Mary McCaffrey:

On Deputy Kelleher's question about whether lists should be published, I have huge concerns about the publishing of lists. Doctors will manage patients on a case-by-case basis and every case will be different. There is always a risk that if one publishes lists of people who will do A, B and C, one will actually discriminate against people. For example, in the UK one is not allowed to ask at an interview whether someone will perform a termination of pregnancy. It is a different scenario but the important point is that no practitioner will ever allow a woman to die because they will not do something. We are there to save lives and we do it all the time.

Deputy Ó Caoláin asked whether the legislation had ever affected me. No, it has not. The life of the mother has always come first. Pregnancies have ended earlier than anticipated in my practice and in other people's practices because the life of the mother was at risk.

Deputy Conway asked about cancer. While I would feel terrible even talking about cancer with Senator Crown in the room, I have had patients with cancer who have had appropriate surgical treatment in pregnancy, and who have then gone on to have their chemotherapy at a later stage in pregnancy and have their radiotherapy after the pregnancy is completed. Again, each patient is taken on a case-by-case basis. It is about multidisciplinary teamwork and it is about consultation, communication and dealing with the mother's life, which is the most important thing. There may be situations in which a baby will be delivered early because the mother needs further treatment but more and more of the evidence on cancer shows that one can coast to a point in the pregnancy at which the baby is viable. That is obviously what people are always aiming for.

On the suicide issue, we need to become very focused on the fact there are other treatments for suicide. If a male patient pitched up in accident and emergency tonight and said he wanted to kill himself, there would be medical treatments, drugs and therapies, and these would be reviewed in a couple of weeks. That is the first-line treatment, and cases are reviewed after a couple of weeks.

Those were the main questions asked.

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