Dr. Seán Ó Domhnaill:

I thank the committee for giving me the opportunity to address it. I am a consultant psychiatrist in general adult psychiatry employed by the Health Service Executive. I also work on a pro bono basis with Cuan Mhuire addiction treatment services. I have worked exclusively in psychiatry since 1997, having graduated form the Royal College of Surgeons in Ireland in 1994.

I will address my comments to head 4 in particular. I share some of the concerns expressed by Deputy Timmins and others in regard to whether this consultation can be truly meaningful if the Government is not prepared to take the expert evidence into account with regard to abortion and suicidality. There was almost complete agreement among the psychiatric experts who gave evidence in January that abortion - the direct and intentional killing of the unborn child - is not a treatment for suicidality. It is extraordinary that the Government has seen fit to disregard all the accrued evidence in proposing legalising abortion on the grounds of suicide. I draw the committee's attention to recent votes at the conferences of the Irish Medical Organisation and the Irish College of General Practitioners rejecting motions in support of abortion, even within the limitations envisaged in the X case ruling. It clearly emerged that the majority of doctors do not support legalising abortion on the grounds of suicidality.

Our profession is very much evidence-based in its approach to its work. There is no evidence base for the proposal to allow abortion for suicidality, regardless of any attempts to restrict the scope of the proposal. If there is no case for treatment of suicidal intent using abortion, then there is no point in proceeding with this legislation. We should nail the lie at this point that Ireland has any obligation, imposed by the European Court of Human Rights, to legislate for abortion. The European Court of Human Rights has requested that we clarify our law, not that we write new law.

I will now turn to the Bill, which, I believe, has been misnamed. While every person wishes to protect women in pregnancy - I would support absolute clarity for those medical practitioners, including me, caring for pregnant women - the primary purpose of this proposal is not the protection of life during pregnancy but to provide a legal basis upon which the deliberate ending of one life may be carried out. It would have been possible to provide further clarity for the protection of women in pregnancy without legalising abortion, as the Bill aims to do. The Government appears to have chosen instead to include the deliberate destruction of unborn human life. This is an enormous change for Irish medical practice and, in my view, it is a hugely retrograde step. Abortion has no place in modern medicine. It is a medieval solution to crisis pregnancy. This Bill is not about saving lives because it allows for the killing of a physically healthy baby being carried by a physically healthy mother. All of this is despite the evidence which shows that abortion does not reduce mental health risks and may be associated with an increased risk of mental health problems.

There are five key points I wish to make about the Bill. First, how would this proposal operate in practice? Again, it is time for a reality check. I have enormous respect for Irish medical practitioners, particularly during these difficult recessionary times, who are invariably working under extremely difficult conditions and in under-resourced hospitals. However, I would like to introduce some clarity in respect of head 4 of the Bill. It is a fact that there are some psychiatrists who are ideologically supportive of abortion and who believe it should be available on request or on demand to Irish women. It stretches the boundaries of credibility to suggest that those psychiatrists would not be more likely to approve abortions if the Bill becomes law. As matters stand and from the submissions that have already been made, they are demanding that only psychiatrists who are in agreement with them ideologically should be allowed to participate in the assessment panels outlined in the heads of the Bill.

We have seen this play out in practice in many other jurisdictions. I remind the committee of the experience in California, where abortion was legalised in 1967 on several grounds. One of those grounds was to preserve the mental health of the pregnant woman under supposedly very restrictive conditions. There was a genuine effort to make these conditions as restrictive as possible so as not to open the floodgates. It was required that a hospital committee would be obliged to unanimously agree that the pregnancy was causing such an extreme mental health risk to the pregnant woman that she would be required to be committed to a psychiatric institution. Despite this, in 1970 more than 65,000 abortions were approved and almost 63,000 of these were performed. Some 98% of these were for reasons of mental health. Did all 63,000 abortions take place according to the spirit of the law? The notion is ridiculous. The California Supreme Court questioned the integrity of the process and stated that "Serious doubt must exist that such a considerable number of pregnant women could have been committed to a mental institution." That was the criterion that needed to be met in order to meet the conditions of the law. Evidently, some doctors who believed that women had a right to access abortion used the subjectivity of making a judgment on mental health grounds for abortion in order to make abortion freely available.

We all know of the experience in Britain. It mirrors almost exactly that of California and occurred in the same year. We need to be honest - something which has been lacking to a large degree in this debate so far - and stop fooling ourselves that matters in Ireland will be different than has proven to be the case in every other country that has sought to take this particular route.

My own experience in psychiatry has been that abortion can be harmful to women and that this is largely ignored by those supporting abortion legislation. It is most unfortunate that women hurt by abortion, many of whom have been in contact with me in recent months, have been excluded from giving evidence at these hearings. This is a broad-based consultative process, not simply a professional forum. Abortion is not primarily about medical or psychiatric emergencies; it is usually about psychosocial stressors and the choices people make in response to them. We have all heard or read about the tragic story of Miss C, who was forcibly taken abroad for an abortion by this State - into the care of which she had been placed - and which she says quite categorically left her suicidal and caused her to attempt to take her own life many times. The distress is very real and the loss felt by these women is extremely acute. The harshness and lack of sympathy expressed by abortion supporters for women hurt by abortion and Miss C is, quite frankly, breathtaking.

I am in full agreement with Dr. Coulter-Smith, who spoke for many of this colleagues when he said:

our psychiatric colleagues tell us that there is currently no available evidence to show that termination of pregnancy is a treatment for suicidal ideation or intent and, as obstetricians, we are required to provide and practice evidence-based treatment ... It, therefore, creates an ethical dilemma for any obstetrician who has requested to perform a termination of pregnancy for the treatment of someone with either suicidal ideation or intent.

It is my opinion that psychiatry cannot support a provision which obliges obstetricians to deliberately end the life of a child being born to a physically healthy mother when the evidence that abortion is a treatment for suicidality simply does not exist. I noted, as did many others, that two obstetricians from the National Maternity Hospital gave evidence on Friday. I would have been most interested to hear the opinion of the master of the Coombe Women & Infants University Hospital, which is one of the largest and busiest maternity hospitals in western Europe, or that of a representative of the master.

The reality of abortion is being ignored at these hearings and in the wider debate in general. The idea that abortion is a political issue or is a matter for discussion in back rooms or in television stations is something really that we do not have the right to do. Abortion is a reality and anybody like me who has actually witnessed the corpses left behind by the victims of abortion would certainly not want that reality to be ignored. This Bill seeks to turn doctors into abortionists. We know from the website of the British National Health Service that unborn children before 12 weeks gestation will be sucked from the womb by a razor vacuum aspiration process, while after 15 weeks of pregnancy the doctor will have to cause a fatal heart attack and deliver the baby whole or piece by piece. We must not be fooled.

The suicide clause in this Bill is not about early delivery; it is about ending the life of children in the womb.

Finally, the evidence of medical experts has been remarkably consistent during these hearings. The committee has heard from a representative of St. Patrick's University Hospital, one of Ireland's leading psychiatric hospitals, who said that there is "no evidence either in literature or from the work of St. Patrick's University Hospital that indicates that termination of pregnancy is an effective treatment for any mental health disorder or difficulty." The committee has heard from Professor Kevin Malone, who stated that abortion is not a treatment for mental illness and in his written submission referred to a textbook of psychiatry and asked how it can suddenly become a recommended psychiatric treatment in this legislation. These are the words of one of the world's leading suicide researchers, who comes from Ireland. He must be listened to.

This committee and the Government have heard much of this evidence before. I sincerely hope that they display the integrity expected of them by the people of this nation and that they respond to what they have heard on this occasion. Mothers and babies deserve far more than an ideologically-driven Bill which seeks to end rather than protect human life in pregnancy.