Dr. Tony Holohan:

I will try to answer those questions as quickly as I can. If I could describe how I think the panel might work in practice it might help in answering Deputy Kelleher's second question. The likelihood, and by no means the only scenario that could arise, is whereby a GP, for example, who is visited by a pregnant woman who is expressing suicidal ideation, and who has concerns, may make a referral to a consultant psychiatrist for his or her expert assessment. That psychiatrist may well then form a reasonable view that there is a genuine risk to her life, if he or she believes that to be the case. The psychiatrist would then seek the opinion or involvement of a second psychiatrist to essentially corroborate that view. If the view further extends to a potential requirement for an intervention such as a termination, they would then have to consult with or engage an obstetrician. That would be the likely mechanism through which one would end up with three different doctors coming together to assess. It is not a panel remote from the individual.

This is very much about treating a woman whose life is at risk or where there is a belief that there is a real and substantial risk to her life. We are placing a framework around the care the doctors who are caring for her will provide. This is a medical service the woman is receiving, not a remote panel. This is very much the group of doctors who are involved in caring for and looking after that woman in that situation. The requirement for reporting will give rise to an ability on our part to produce some form of annualised reporting of numbers, potential indications and so on. It will be open and available to us to have the information upon which we can make reports that people can use to assess the impact of the legislation.

On Deputy Kelleher's first question, arising from the Constitution there is a clear duty upon doctors to make every effort to save the life of an unborn child where that is reasonable, feasible and practicable. That is enshrined in current Medical Council guidelines. While I would not in any sense seek to direct the council in the guidelines it would set out, I would expect that the council will, when any new legislation is prepared in this area, seek to update and change its guidance to set out that form of expectation. There may well be room then for colleges, for example, to set out what that means in practice. Without my saying this is what will happen, this will be very much open to obstetricians. It might well be set out that there would be a requirement for a certain form of imaging to take place as part of the foetal assessment process. That brings detail to what would be required to make an assessment of and take steps to vindicate the right to life of the unborn child.

To answer Deputy Ó Caoláin's first question, yes, we believe they fulfil the conditions set out in the expert group report. My answer to Deputy Kelleher's question may help to answer Deputy Ó Caoláin's question on head 4. I would see the initial psychiatrist as the person who would be primarily looking after that individual person, but I would like to think, as I said in my opening statement, that the colleges would begin to set out guidance on the detail of medical practice that will arise to give effect to the services that will be governed by this broad framework of legislation.

Deputy Ó Caoláin raised the question of conscientious objection. That is provided for in Medical Council guidelines. Am I not answering his question there?