Professor Veronica O?Keane:

I thank Deputy Terence Flanagan for drawing my attention to a point that has not previously been raised, which is that death during pregnancy is rare. However, suicide is an important cause of death during pregnancy even where abortion is available. In the confidential inquiry into maternal deaths in the United Kingdom, which assessed three years of deaths, it was found that maternal suicide was more common than previously thought and, overall, was a leading cause of maternal mortality. I thank the Deputy for drawing my attention to that point.

As for the question about abortion after 30 weeks, obviously every effort would be made by obstetric colleagues and by the medical profession in general to save a baby's life if it is viable and that is a given. As for Deputy Ó Ríordáin's comments, I fully agree with him. I also came before the joint committee thinking the subject matter of this hearing was about enacting legislation in respect of suicidal ideation. In response to Deputy Durkan's question, the answer is that in the absence of legislation, it is almost impossible to manage these highly complex cases. Unfortunately, we have seen this with the death of Savita Halappanavar towards the conclusion of the writing-up of the report. As for the last point made by Senator Brennan, the assessment of suicide is something about which doctors are trained. Indeed, we are taught about it in our undergraduate career and it continues through. In highly complex cases, we combine the expertise from various disciplines, as well as from medically aligned disciplines, and are used to such complex case management conferences.