Dr. Peter Boylan:

With regard to Senator Bacik's points, the issue of head 1 being broadened has been dealt with adequately. I support everything that was said. As to whether a perinatal psychiatrist should be involved, we do not have three. We have one and a half. As Dr. Mahony said, these are whole-time equivalents, so we have 1.5 perinatal psychiatrists for 75,000 pregnant women per year. It is approximately 100,000 if one includes miscarriage. That is questionable.

Regarding the time for the medical review procedures, seven days is too long to initiate the process, with another seven days for the review team to give an opinion. These women are at risk of death and a fortnight is probably too long to wait in those circumstances. The circumstances will vary from one woman to another. We need to be able to individualise. My personal opinion is that seven days is too long.

On head 19, I have difficulty with the proposal that a pregnant woman who undergoes a termination will potentially face 14 years in prison. If a woman is subject to medical opinion and if that opinion, even if erroneously, concludes that termination is necessary to save her life, it is entirely unreasonable to expect her to second-guess a doctor's opinion in this respect. It would appear somewhat bizarre and contradictory to propose that a woman be sentenced to 14 years imprisonment on foot of accepting medical advice in this State, whereas should she travel to the UK and have a termination there, she is protected under the constitutional amendments of 1992. That does not seem to make sense.

There were several other questions relating to the Marie Stopes clinic and private institutions. The end of the sentence was omitted by Senator Walsh, that is, in emergencies. Women in emergencies will not be attending the Marie Stopes clinic and I doubt very much that the Minister would approve that the Marie Stopes clinic terminate pregnancies.

Head 6 is a matter for comment by the psychiatrist. In my practice I have not come across an instance where a woman has died because we have not terminated her pregnancy. I have come across it in other circumstances in the recent past.

Should women who have had an abortion be heard? Absolutely. Women who have had all experiences should be heard. However, the climate in which women have terminations in this country, albeit they have them abroad, is quite hostile. We should, perhaps, carry out some research on the influence of hostility, antagonism, guilt and so forth that these women experience and the inability, in particular for women who have foetal abnormalities and who go abroad for a termination, to grieve for the loss of that child. They grieve for them; these are very much wanted children.

Very often women who have terminations for apparent social reasons or mental distress very much want the child but cannot cope with the prospect. We need to listen to these women. It is not within the remit of this Bill. Of course we need to listen to women; that is what we are about.

Very premature babies have a risk of brain damage. Their brains are very fragile, they are exposed to lack of oxygen, they can have bleeds on the brain and, in effect, strokes, and end up with cerebral palsy, blindness, brain damage, etc. However, if the mother dies, the baby dies too. We have to make balanced decisions based on the best evidence of the woman in front of us, taking all things into account. We do not want to have two deaths on our hands. I think one should respect the professional opinion of professionals who are making these decisions.

There was a question about evidence-based medicine in the context of suicide. I will leave that to the psychiatrists. I am not an expert in that area.

The Californian experience was referred to. It might be useful - and I am sure the committee has done so already - to look at the experience in Northern Ireland where, as I understand it, termination is allowed for foetal abnormality incompatible with life and not just a threat to the life of a woman. There are about 40 terminations a year in Northern Ireland out of 25,000 births. If one extrapolates from that, there will probably be about 60 for 75,000 births in Ireland. That is a guesstimate, but it is certainly not thousands upon thousands. It is a small number. I thank Senator Crown.