Dr. Peadar O'Grady:

I concur with Deputy Mathews that it would have been useful to hear representative groups of women explain the negative and positive experiences they have had in order that all of us can draw conclusions about how to make this experience better for everyone, allow women to make the best decision for themselves and ensure they are not coerced into having an abortion or stigmatised afterwards. These are the two major causes of distress. We should get rid of this fear, as Deputy Mathews outlined. The voices of these women can be heard at a later date.

As to whether conscientious objection would disrupt access, that could be the case, and the issue will have to be monitored. It has been noted in ethical papers that there is a conscientious objection to the restriction of abortion. Doctors such as me would face criminal sanction if we were to exercise our right to assist a woman in following up and having an abortion on the basis of her decision of informed consent. This in contrast to those who wish to have a conscientious objection not to take part in the process. While I believe people should have every right not to take part, this right should not be an institutional one.

I was asked whether time was critical. That is absolutely the case. Around eight or nine weeks is the most critical period, as a delay at that point will make the difference between a medical and a surgical abortion. The latter increases complications for the person involved.

As to whether the jurisdiction is relevant, it is absolutely relevant. People have forgotten that the 1861 Act was not passed in an Irish Parliament but in the British Parliament and it is a British law. While we can blame the Catholic Church for many things, we cannot blame it for the 1861 Act. Jurisdiction is also relevant because the services that between 4,000 and 5,000 women from Ireland engage every year are in the United Kingdom. It is medically, if not legally, relevant.

I fully agree that no psychiatric evidence was presented in the X case. The key question for psychiatrists is whether they agree with the decision by the Supreme Court justices in that case to certify eligibility for access to an abortion. While opinions on that issue may differ among psychiatrists, in my view the Supreme Court made the right decision. For many of us, the alternative of restricting travel and access to an abortion and forcing a 14-year-old rape victim through a pregnancy was intolerable. Given our tendency to become too abstract, we should always consider what alternative options are available. Most people who examined the case at the time, including psychiatrists, concluded that the Supreme Court justices were correct and the alternative was appalling.

As to whether abortion is the only treatment available, I am fascinated by the current interest in the certification. I cannot even remember if it was the High Court or some other court because the issue was not brought before the court. The certification was straightforward and obvious at the time. The children in question had decided that abortion was the best option for them. What I had to do was ensure they had the best chance to engage in non-directive counselling and that any mental health complications that were current or might follow would be adequately dealt with. In the midst of that, the nature of my certification was not really at the top of anyone's agenda. I am in some respects glad that was the case. All of those involved in that process, including the social workers, mental health workers - due credit must be given to the Irish Family Planning Association, which dealt with the request for certification - and the judge in question, behaved rather well and did the needful in a good, thoughtful and timely manner. If anyone wishes to ask me any particular or specific questions about that, I will be pleased to answer them outside the room.