Professor Fionnuala McAuliffe:

I wish to clarify for Senator Colm Burke the point about two obstetricians. Having discussed the matter in detail, we believe that two obstetricians would be involved in making decisions in all cases where it was felt that the termination of a pregnancy or the premature delivery of a baby was required. Whether the threat owes to suicide, heart disease or lung disease, obstetricians should be central. Two obstetricians plus the relevant specialist registered psychiatrist should be involved.

Deputy Mattie McGrath referred to the consultation process. We convened a group of senior institute members on 4 December, discussed the report in detail, devised a draft document, circulated it to the members of the institute's executive and discussed it on 14 December. The executive's members are chosen from and represent their regions. Their role is to communicate with their members within each region. The document was passed unanimously by the executive on 14 December. There was adequate consultation with the institute's members.

Deputy Naughten mentioned emergencies. In emergency medical situations, the usual procedures and policies are often put aside to prioritise the provision of medical treatment. The same would pertain were a woman's life in serious danger. If she needs immediate treatment, one obstetrician should be sufficient. We would not expect the requirement for two obstetricians or the usual paperwork to pertain, as women's lives could be lost. In emergency cases, people often write their notes afterwards. The priority is to deliver first-line medical services.

Regarding the question on fatal foetal anomalies, the institute's remit was to give an opinion on the expert group report, which was confined to a substantial threat to the life of the mother. It was not within our remit to address fatal foetal abnormalities. Our brief is confined to the report.

Deputy Dowds asked about the legal framework. There should be a legal framework in which we can act in these cases. We do not have a register of the cases in question. As a maternal medicine consultant, I am a specialist in this area and I see many such cases. There are a number of cases every year in which there is some legal uncertainty. We refer those patients abroad for treatment. I do not have the exact numbers. It is important for our patients and the public that doctors work within an appropriate legal framework. We request that legislators provide a robust framework.

I was asked about how we deal with cases of immediate risk and so on within the legislation. Medical expertise plays a role in this regard. We have experience of looking after pregnant women and we have knowledge of the literature. If two senior obstetricians believe that there is a substantial risk to the life of the mother - we will not define percentages or timelines, as doing so is impossible - the criteria will be fulfilled. Legislation to this effect would cover all situations in which there is a substantial risk to the life of the mother.