Ms Jacinta Fay:

The expert group report offers a number of options regarding the qualifications of doctors involved in the process. Limiting the number of doctors eligible to determine risk to life to those on the specialist register may unnecessarily restrict the number of doctors available to make such determinations and therefore reduce women's access to a termination. Choice Ireland recommends that medical practitioners eligible for specialist registration, but not actually registered, be allowed to make determinations regarding risk to life. This option balances the necessity for doctors to have the necessary expertise to make determinations with ensuring a sufficiently wide pool of practitioners is available to ensure women have access to terminations.

Choice Ireland agrees with the statements of the master of the National Maternity Hospital that a multi-disciplinary approach should be implemented, using the skills of the necessary experts. Choice Ireland recommends that where practical, the determination should be made by doctors who are already involved in a woman's medical care and the number of doctors required as signatories should be limited to two to reduce the potential stress associated with the process. In addition, this option avoids limiting access to terminations for women in areas where a wider pool of experts is unavailable. The expert group report proposes that in cases where a woman's life is in jeopardy due to a threat of suicide three opinions be sought, namely, those of an obstetrician and two psychiatrists. Choice Ireland recommends that in such cases two opinions should be deemed sufficient. This would avoid the risk of stigmatizing women through the differential treatment of physical and psychiatric threats to life.

To avoid delays occurring in cases where there is an immediate threat to a woman's life and it is not possible to secure medical opinions following normal procedure, emergency provisions should be clearly laid down to allow doctors treat women in these situations.

The expert group recommends that, "to defend and vindicate the right to life of the unborn, terminations at the fringes of viability, even when survival is not anticipated, should take place in medical facilities which have neonatal intensive care units, and carried out at such a time and in a manner as to maximise the foetal chances of survival, without compromising the right to life of the woman". It is important that this provision does not reduce women's access to terminations, particularly in cases where a woman is being cared for in a facility which does not include a neonatal intensive care unit and compelling her to travel to access a termination would pose additional risks to her health.

Choice Ireland recommends that in cases where a woman is denied access to a termination in the first instance any appeal is carried out by a medical rather than a quasi-judicial review panel to reduce the stress placed by the process on her. Women seeking a termination should be provided with access to independent legal support in addition to access to a detailed explanation of the grounds under which her initial application was refused. This would ensure that in cases where a woman feels her request for termination was refused following a failure to follow due procedure that recourse is available to highlight this concern. We would also be cautious that any appeal process should be specifically established for the woman concerned and not for a third party. The expert group notes that while legislation does not undermine a woman's existing right to appeal any decision through the courts, a number of options exist regarding how this could be affected. To ensure a decision is made promptly it would be desirable to put in place specific rights to appeal to achieve a timely resolution.

Practitioners have a right to conscientious objection and the expert group report notes that doctors who hold such an objection have a "duty to refer to another doctor who is not a conscientious objector". In an emergency situation however, conscientious objection should not delay or prevent a woman from receiving treatment in cases where another doctor cannot be found to carry out the procedure.

The expert group report suggests that statistics are required to inform policy, as well as to ensure the principles and requirements of the system are upheld. These statistics should be freely available to the public and civil society.

Due to the stigma surrounding abortion in Ireland and in order to prevent any potential pressure being brought to bear on physicians who carry out such illegal abortions, care should be taken to protect the privacy of women who request terminations and the treating physicians.

Our final recommendation is on whether there is a need for new legislation as opposed to an amendment of the 1861 Act. The European Court of Human Rights judgment in A, B and C v. Ireland noted that the Offences Against the Person Act 1861 represented a significant chill factor for physicians. We recommend a repeal of sections 58 and 59 of that Act so that women in crisis pregnancies and physicians carrying out their duties in good faith do not face possible penal servitude.

Everyone wants to see a reduction in the number of abortions, as no one should ever be faced with that decision, but the criminalisation of women who wish to obtain abortions is not the answer. The only effective and compassionate means of reducing the overall demand for abortion is by providing free and easily accessible contraception and fully comprehensive sex education alongside a strong social system that supports the women and men of Ireland in caring for their children with dignity and respect.