Ms Caroline Simons:

I thank the committee for the invitation. It is a great privilege and an honour to be allowed to contribute to the committee's discussions on this important matter. Like many others, I have been listening closely on the Internet to the proceedings over the past few days and if anything has become absolutely clear, it is that the Government's argument that suicidality could be addressed by abortion, has been completely demolished. The testimony that we have heard over the past two days has completely demolished any argument that suicidality can be addressed by abortion, even during crisis pregnancy. Professor David Fergusson, in the British Journal of Psychiatry, states, "There is no evidence ... that suggests that abortion reduces the mental health risks of unwanted or mistimed pregnancy." That being the case, why are the legislators even contemplating passing legislation against the medical evidence? The answer is because they believe they have to because of Attorney General v. X and others and they are being told that they must do so because of what the A, B and C v. Ireland decision of the European court has required. I will come back to that in a moment.

What would be the impact of passing this legislation? First, psychiatrists would be asked to propose a procedure for which there is no psychiatric justification, obstetricians would be asked to terminate the lives of healthy babies in physically-healthy women and legislators would have violated the most basic human right for a reason which cannot be justified. Society would perceive that the right to life of the unborn is not that important and we are not really serious about protecting it. After all, it can be violated on an entirely irrational and unjustifiable basis. After a time, this would become received wisdom and that would be the end of the culture of life and the beginning of the culture of abortion. If one surrenders the principle of the right to life of the unborn, that sends a message to society which, in turn, produces a cultural change. Then other cultural questions emerge. What other rights will one overwhelm when their subjects are not very important? Some people refer to this as the slippery slope argument. Whatever one calls it, it is certain that ideas such as these have real consequences.

Why do so many of the doctors who have addressed the committee want legislation? The pro-choice advocates, some of whom frequent this Chamber, understand the possibilities for their agenda and have welcomed the proposed legislation as an important first step and a beginning. However, most of the doctors who have come here want something quite different. They want to know, in the words of the master of the National Maternity Hospital, "that I will not go to jail", and that they are free to make appropriate clinical judgments for their patients. The reasons for this fear are somewhat puzzling. It is not sufficient to hinder the doctors in their practice of medicine as they all have stated that they have never refused an intervention or withheld any treatment because of any fear of the law. The Irish Medical Council has not received any criticism or request for clarification of its guidelines from any doctor or representative body regarding the practice of obstetrics. There have been no prosecutions of doctors. I have no doubt that those fears are sincerely held by some doctors and that we must address this perception, but the real question is whether these fears well founded. Obstetricians are not lawyers. Perhaps they do not appreciate the mental element required to prove a crime. A jury must be convinced beyond reasonable doubt that a doctor has acted deliberately intending to carry out an unlawful abortion. The doctor who acts in good faith, ethically, with due care and in a manner in which another doctor of similar expertise might be expected to act in a similar circumstance, has nothing to fear from the law. Doctors make judgments all the time. They will not always be right, but that is not negligent and it is certainly not criminal.

The European court decision in A, B and C v. Ireland recognised that Ireland may make whatever policy it chooses regarding abortion and the right to life. It does not require us to legislate for Attorney General v. X and others. It gives no direction regarding the content or form of action we take. It requires that we have accessible procedures by which people can know the law and know where they stand. That is entirely reasonable and justice demands it.

Legislating in this area would not be problematic were it not for the decision in Attorney General v. X and others, and here we come to the nub of it. The court heard no medical evidence. There was no psychiatric evidence. There was no duty of care to the unborn. Then Chief Justice, Mr. Justice Finlay, considered that suicidality in pregnancy could only be avoided by abortion against his test and that abortion could not be postponed in order to monitor the woman's condition unlike the case for physical risks to the woman's life. However, on psychiatric intervention, perinatal psychiatrist, Dr. John Sheehan, has told the committee, "It is exactly the opposite to the medical intervention and ... the notion of carrying out an emergency termination is completely obsolete in respect of a person who is ... suicidal." After this week, we know that abortion will never address the suicidal woman's actual needs and it might very well harm her. It is, therefore, unthinkable that we should legislate for abortion to address suicidality.

Ultimately, a referendum will be required to deal with the difficulties posed by Attorney General v. X and others. In the meantime, we propose that the Medical Council should draw up guidelines to deal specifically with the issues surrounding medical interventions for physical complications during pregnancy.

The Government should give a commitment to the Committee of Ministers of the Council of Europe that guidelines will be drawn up by the appropriate bodies of medical expertise within the medical profession based on medical practice, addressing the case of A, B and C v. Ireland and giving the clarity required. The Government should give a commitment that the difficulties associated with the X case will be examined and the options for clarifying identified and that it will keep the committee informed of progress. The Committee of Ministers has acknowledged a significant increase in the number of cases relating to complex and sensitive issues which it needs more time to resolve.

This issue is, indeed, complex and it is certainly sensitive, but this committee's efforts over the last few days have clarified much of what was confused. For this, we owe the committee our thanks. Now that they are clearly identified we may finally address the problems posed by the X case and ensure that every woman in Ireland can be confident of the continued highest standard of maternal and foetal care.