Dr. Sam Coulter-Smith:

My comments on the first question would echo those of Dr. Boylan. Senator Norris asked about babies being left to die or deliberately killed. There is absolutely no question of that happening in this country. He also asked if termination of pregnancy was the equivalent of the death of a child. It is not, because it depends on the gestation at which it occurs. We dealt with that earlier. He asked about the different clinical scenarios. Where there is a threat to the life of the mother based on a physical illness, in all likelihood the evidence will be much clearer. Where there is a risk of suicide, the evidence is a little less clear and it makes that situation much more challenging and difficult to deal with. That is where the expertise of our psychiatric colleagues is required. Senator Norris is absolutely correct that whether the intervention occurs because a woman has a physical illness or because she is suicidal, the outcome of that situation will be the same at a particular gestation.

However, I argue that the evidence behind the decision-making is different.

Reference was made to the incidence of suicide in pregnancy. Dr. Boylan has alluded to UK figures. The situation in relation to the UK laws is different. Dr. Boylan has mentioned that where a coroner in Ireland may not record a case of suicide and may record an open verdict, it presents a greater challenge in trying to have an understanding of the actual figures. We can agree, however, that it is extraordinarily rare and unpredictable. Members may ask the psychiatrists when they talk to them next week, but they will tell members it is an unpredictable and rare event.

On the question as to whether I was consulted on the heads of the Bill, the answer is "No". With regard to efforts to achieve maturity, it is enshrined in the Bill that all doctors are duty bound to ensure they make every effort to get the baby to maturity where it will survive, if that is at all possible, and the only reason one would intervene to terminate a pregnancy is if all other avenues have been explored and there is no other option.

With regard to the large number of women who go to the United Kingdom, I agree absolutely that we do not understand the issues they have. I was not suggesting that if termination of pregnancy was required for any of these women, it would not be performed because of a lack of resources, but that if what was described occurred and there were to be a greater demand for the type of service in question in this country, our current resources could deal with it.

On head 4 and intervening in a case of suicidality, no obstetrician would have an issue with intervening and performing a termination of pregnancy if it were to save the life of the mother and if every other avenue had been explored and there were no others.