Rónán Mullen (Independent) | Oireachtas source

Non-members are being subjected to a regrettable inconvenience in this regard. We are all putting in the full ten hours here.

I thank our expert witnesses, who have been given the difficult shift. How dramatic do they believe the change to obstetric practice in Ireland will be as a result of this legislation, particularly in respect of head 4? Dr. Mary McCaffrey talked about the need for training. She will correct me if I am wrong but I assume she is referring to a need arising out of head 4. I do not imagine that extra training would arise in regard to interventions under heads 2 and 3.

Do the witnesses have concerns regarding - to use the word employed by the Chief Medical Officer this morning - the subjective nature of the psychiatric assessment of suicidality? We heard from the obstetricians in the Dublin hospitals earlier that the figure of one in 500,000 refers to the number of suicides that actually take place in pregnancy. In other words, it is extremely rare.

Dr. Boylan and Dr. Mahony, I think, appear to suggest that this might be connected with the fact that Britain has a liberal regime. The sub-text seemed to be that if abortion were not available more would happen. Do they think that there is a cohort who will access it, if it is legal on this ground, or provided for because it is already constitutionally legal? Do they think that there is any reality in the view that a psychiatrist will be able to say this as a matter of probability and to certify that the person is likely to commit suicide? Does a psychiatrist have any tool, absent of course an underlying mental illness, that enables him or her to say that this is so as a matter of probability? I think the concern that many people have is that psychiatry and mental health have become the means in other jurisdictions in the western world by which the line is fudged between what is medical and what is, for want of a better word, a matter of choice and that medicine has been co-opted and indeed corrupted. Do they have any concerns that this could happen here? The obstetrician does have a certifying role in these cases, not just to carry out the procedure. On what basis will the obstetrician make up his or her mind? Will he or she not simply defer to the two psychiatrists? If that is the case is it meaningless for the legislation to say that an obstetrician must also be involved at certification stage?

We have talked a great deal about the conscientious objections of those who might not want to carry out or certify terminations. If there is a subjective element to a psychiatric determination in this case do any of the experts believe it might arise that a person who, as a matter of his or her personal philosophy, is pro-choice, might take the precautionary approach when a person presents, given that it would appear that he or she lacks an objective basis on which to certify? Is it possible that a person with that philosophical mind-set might be more likely to certify that the abortion is necessary as a matter of precaution?